The 49-year-old female patient presented with a long history of vertigo with nausea and ‘head fog’. The symptoms were intermittent over five years with an increase in severity over a recent twelve months. She was treated with antinausea medication during this time. Her previous blood pathology and brain imaging studies were unequivocal. She was employed in a managerial position with travelling. Her worsening symptoms were impacting her concentration and performance both socially and mentally.
Vertigo is a very complex disorder. The complexity surrounds the various potential etiologies and thus create a challenge for clinicians. As such an inexperienced clinician can determine a generic diagnosis and therefore create ‘cookie cut’ therapy plans, which inevitably leads to the detriment of the patients health.
This lady had a unique form of vestibular hypo-function (ICD H81.9). She had Benign Paroxysmal Positional Vertigo (BPPV) with aberrant saccule activation. Some key findings include;
1. Dizziness Handicap Inventory (DHI) score-50% (mild dizziness) Giving this presentation, the practitioners therapeutic goals were:
After 12 weeks of therapy, the patient had improved with no further nausea or vertigo. The effective treatment involved Vestibular Rehabilitation Therapy (VRT). The vertigo was treated with specifically moderated routines with a combination of head and eye activities to support the balance function. VRT is a safe therapy enabling habituation of vestibular control. For more information follow the link, http://brainstormrehab.com.au/blog/vestibular-rehabilitation/ .
She had significant functional improvements with standard outcome measures (DHI score, MFES, and DVAS scores) and VOR function was full in all vertical planes. The ladies BPPV with saccule failure was corrected, and she returned to a full ADL.
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