Imagine the feeling – the surroundings around you spinning in circles, making you feel dizzy and off-balance. This sensation is known as vertigo. It often occurs as a symptom of an underlying condition. It is a common symptom in conditions affecting the inner ear and the brain.
Broadly, there are two types of vertigo:
Peripheral Vertigo: This results from conditions affecting the inner ear and vestibular nerve.
Central Vertigo: This results from conditions affecting the brain, such as post-stroke, post-traumatic brain injury, and conditions of the cerebellum in particular.
Treatment
Medications for Vertigo
Betahistine: These drugs reduce dizziness, loss of balance, and ringing sensations in the ears. Vertin is a commonly used betahistine to treat vertigo.
Repositioning Maneuvers
These maneuvers ease symptoms by repositioning the body and head in a particular manner. One such maneuver is the Epley maneuver.
Epley Maneuver:
The patient is sitting on a couch and is asked to turn their head 45 degrees to one side.
Keeping the head turned, the patient is asked to lie down.
The patient is then asked to turn their head back and turn it 45 degrees to the other side.
The patient is told to lie on the side of the same side.
The patient is finally asked to sit up, keeping their head turned.
This technique can be performed by the patient at home, at least three times a day, for good results.
Physiotherapy
Balance Training:
Here, patients are trained to regulate their posture and movement by slowly processing the sensory inputs from different areas of the body. The program incorporates:
Static and dynamic stability postures
Single-leg stands, then progressing to reaching marked points in all directions with the other leg or carrying an object in one hand
Minimal base of support
Tandem (one foot placed just in front of the other foot) standing, progressing to standing with eyes closed
Tandem walking
Varying center of gravity
Staircase climbing: First, both feet on a step, then progress to one foot per step
Stepping up sideways: A stepper/raised platform is kept on either side of the patient, and the patient is asked to turn, stand on the platform, return back, and then move to the other platform.
Proprioception Training:
Rocking in a quadruped position
Low kneeling to high kneeling
Ankle rocking
Vestibular Rehabilitation
The Cawthorne Cooksey exercise is one method used by physiotherapists for vestibular rehabilitation. It involves eye movements, head movements, shoulder movements, combined movements, picking up and throwing a ball, and walking in a particular manner.
Strength Training
Strength training is also included during rehabilitation, along with balance and vestibular training. Core muscles, quadriceps, hamstrings, calves, and the muscles of the buttocks are major muscle groups that are assessed and managed accordingly.
With proper diet, medication, and physiotherapy management, patients can alleviate the symptoms of vertigo.
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