Vestibular deficits may be caused by lesions in the central nervous system including brainstem/cerebellar lesions, stroke, or vertebrobasilar disease. Peripheral lesions of the inner ear including neuritis or labyrinthitis, acoustic neuromas, Meniere’s disease or Benign Paroxysmal Positional Vertigo (BPPV) are also known causes of dizziness and balance issues. The most common peripheral disorder, BPPV, is a mechanical disorder of the inner ear involving debris which has collected in the semicircular canals, resulting in brief periods of vertigo and nystagmus related to head position change.
Vestibular Rehabilitation incorporates two successful methods of treatment for BPPV: Canalinth repositioning techniques (the Epley or Semont head maneuvers), and Brandt-Daroff exercises, to mechanically move debris out of the semicircular canals. Studies show up to 80% cure rate following the head maneuvers – often after one or two treatments, and a 95% success rate for the exercises when performed 3 times daily for two weeks. Vestibular Rehabilitation is also directed at treating impairments in gaze and postural stability, disequilibrium, motion intolerance and physical deconditioning due to vestibular disorders. Treatment is customized for each patient based on his or her specific impairments and functional limitations. Treatments may be used for patients with peripheral and central dysfunction.
A physician’s referral is required for Vestibular Rehabilitation.