Central processing of information in the brain is essential for balance

Central processing of information in the brain is essential for balance

It is obvious you need brain power to keep your balance. The two-legged human is not inherently stable. If your brain stops working, you will collapse into a heap on the ground. To be able to sit, stand, keep your balance, walk, run and jump, are learned skills.
Even sitting up straight requires an immensely complex series of calculations, carried out microsecond by microsecond.
Instructions are sent from the brain down the nerve fibres to the muscles which control your head position, neck and spine, allowing you to stay stay upright.
The instructions are constantly updated by feedback from the joints and muscles themselves (proprioception) from the skin which feels the pressure of the seat, from the eyes which can see where you are, and from the inner ear which knows whether you are tilted backward, forward, sideways or moving.

Standing Exercise and Moving about exercises for Vertigo

Standing exercises
Move from sitting to standing up, and back again, with your eyes open, 20 times.
Repeat with eyes closed.
Throw a small ball from one hand to the other, above eye level, 20 times.
Throw the ball from hand to hand at knee level, 20 times.
Turn around 360 degrees on the spot, eyes open.
Repeat with eyes closed.
As vertigo lessens, speed up.
Moving about exercises (special caution advised)
Walk across the floor with your eyes open 20 times.
Repeat with eyes closed.
Walk up and down a slope with your eyes open 20 times.
Repeat with eyes closed.
Walk up and down steps 20 times with your eyes open.
Repeat with eyes closed.
Any game or exercise that involves stooping, turning, bending, stretching and hand-eye coordination - for example bowling, tennis - is good for improving your balance.

Head and sitting exercises

Head exercises
With your eyes open, bend your head forwards, then backwards, 20 times. Start slowly at first, then speed up.
With your eyes open, turn your head from side to side 20 times. Start slowly at first, then speed up.
As the dizziness improves, repeat the head exercises with your eyes closed.
Sitting exercises
Shrug your shoulders 20 times.
Turn your shoulders to the right and left 20 times.
From the sitting position, bend down and pick up objects from the floor, and sit back up again. Repeat 20 times.

Eye movements and Vertigo

One of the reflexes connected with balance is not learned, it is present at birth. That is the automatic control of eye movements during head turns, known as the the vestibulo-ocular reflex. In health, if you turn your head, your vision does not normally turn into a blur. You will focus very briefly on one view, then another, then another, until you have completed the head turn. To do this requires rapid, accurately controlled eye movements. Eye movements are controlled by muscle activity, under the control of an image stabilization system which receives information from the inner ear. There are good survival reasons why we have evolved this system. If you are a monkey swinging through the trees, you need to keep the ability to focus on the next branch while moving. Otherwise, pretty soon you'll be a dead monkey.
The control of eye movements is assisted by predictive reflexes from the inner ear balance organ.
If the brain receives a signal that you are turning rapidly to the right, it will automatically trigger a series of reflex actions designed to keep your vision in focus.
Your eyes will sweep across from right to left, at the same rotational speed as the surroundings, helping them to fixate on one point in the rotating view.
Just before the eyes reach their limit of movement within the eye socket, they are then sent flicking very fast to the right - much faster than the speed of rotation. For this split second only (instead of the whole length of time of the head turn) vision would be blurred.
The eyes then start another sweep to the left.
This repetitive horizontal jerking movement of the eyes, with a slow phase to one side and a fast phase to the opposite, is called nystagmus.
Nystagmus can be seen in normal life if you are sitting on a roundabout.
Nystagmus is usually seen in patients suffering acutely from vertigo.
If you have nystagmus, it will look to you as though your surroundings really are moving.
As well as the inner ear telling you that you are spinning, if you look at your surroundings with nystagmus, your eyes confirm that either you or the world around you is spinning.
Because the reflex control of eye movements is built in to the brainstem at such a low level, it can be difficult to stop nystagmus and vertigo from happening during very rapid head turns in someone with a damaged inner ear.
http://www.entkent.com

Cawthorne-Cooksey exercises

Eye exercises
Look up and down 20 times. Start slowly at first, then speed up.
Look from one side to the other 20 times. Start slowly at first, then speed up.
Hold up one finger at arm's length. Focus on it. Move it slowly in towards you and out again 20 times.
Head exercises
With your eyes open, bend your head forwards, then backwards, 20 times. Start slowly at first, then speed up.
With your eyes open, turn your head from side to side 20 times. Start slowly at first, then speed up.
As the dizziness improves, repeat the head exercises with your eyes closed.
Sitting exercises
Shrug your shoulders 20 times.
Turn your shoulders to the right and left 20 times.
From the sitting position, bend down and pick up objects from the floor, and sit back up again. Repeat 20 times.
Standing exercises
Move from sitting to standing up, and back again, with your eyes open, 20 times.
Repeat with eyes closed.
Throw a small ball from one hand to the other, above eye level, 20 times.
Throw the ball from hand to hand at knee level, 20 times.
Turn around 360 degrees on the spot, eyes open.
Repeat with eyes closed.
As vertigo lessens, speed up.
Moving about exercises (special caution advised)
Walk across the floor with your eyes open 20 times.
Repeat with eyes closed.
Walk up and down a slope with your eyes open 20 times.
Repeat with eyes closed.
Walk up and down steps 20 times with your eyes open.
Repeat with eyes closed.
Any game or exercise that involves stooping, turning, bending, stretching and hand-eye coordination - for example bowling, tennis - is good for improving your balance.

The balance control area of your brain acts like the pilot of an aeroplane, making adjustments to the controls to keep your body in balance. The pilot of an aeroplane does not need instruments to fly straight and level if the weather outside is good, and he can see the horizon. Even if the aeroplane instruments are faulty and give a false reading, it doesn't have to cause a problem with the flight, provided that
The pilot knows to ignore the faulty instrument,or the faulty instrument gives a predictable and stable mis-read, and the pilot knows by how much, and in what direction, so that he can compensate for the error.
He will always find it much easier if he has other independent sources of the necessary information
If, however, the aeroplane has faulty instruments and the pilot tries to fly through cloud, he is then forced to rely on those faulty instruments.
If he then takes those false readings at face value, believes them to be true, and makes adjustments to the controls accordingly, he will almost certainly end up crashing.
This is what happens to a person with false signals from a damaged inner ear who tries to walk in the dark across uneven ground. source-http://www.entkent.com

important factors for balance

The inner ear is not the only source of information to help you balance. You also receive information from:
The eyes - you can see which way up you are, whether you are moving and in which direction.
The soles of your feet (if you are standing) or the seat of your pants (if you are sitting down). You can feel where you are.
All of your joints and muscles - including the joints in your neck, back, legs, feet, arms and hands - have sense-organs in them which send signals up the nerves and spine, telling the brain what position they are in. You don't need to look to see whether your arms are outstretched or by your side - they tell you where they are. This position-sense is known as proprioception. Proprioception is reduced in various medical conditions including arthritis and diabetes. The information comimg from the eyes, skin, muscle and joints is integrated with the information coming from the inner ears and processed in the brain.
If there is plenty of information coming from the eyes, skin and joints, you do not really need to rely on information from the inner ear to help you balance.
If the information coming from the other sources is reduced, lost or confused - for example in the dark, on soft or uneven ground - your brain has to rely more on the information coming from the inner ears.
This is why your balance will be worse in the dark, on soft or uneven ground, if you have a problem with your inner

How damage to the inner ear causes vertigo

Vertigo can result from many causes, but is most often caused by damage to the balance organ of the inner ear. As well as the cochlea for hearing, the inner ear contains a very sensitive organ, the vestibular labyrinth, designed to help maintain balance.
The vestibular labyrinth is made up of three semicircular canals - lateral, posterior and superior. They join together at the vestibule.
The semicircular canals are arranged at right angles to one another. They can detect and measure movements and acceleration in all three planes of space.
The inner ear balance organ can also detect the direction of gravity.
The right and left balance organs work together, constantly sending signals via the audiovestibular nerves to the brain, telling you which way up you are, whether you are moving, turning, etc. and in which direction.
When your inner ear balance organ is damaged, it sends a false signal to the brain.
Vertigo results when the brain believes the false signal and acts accordingly.
The commonest condition to affect the inner ear is labyrinthitis, which means inflammation of the labyrinth and causes severe rotatory vertigo.
Labyrinthitis often causes permanent and irreversible damage to the inner ear. The recovery that follows is not because the inner ear gets better, but because the brain learns to ignore, adjust to or compensate for the false signal.
The brain learning to make allowances for the faulty information coming from the inner ear is known as central compensation.

Vertigo is a particular form of dizziness or giddiness. Rather than just feeling faint or light headed, it is an illusion of motion.
The sufferer feels as though they, or their surroundings, are turning, spinning, falling, or some other form of movement when in fact they are not.
Like sea-sickness, vertigo is often accompanied by nausea and vomiting.
Vertigo does not mean fear of heights, that mistake was spread by Alfred Hitchcock's 1958 film "Vertigo".
After acute vertigo settles, it is often followed by dysequilibrium, an uneasy feeling of imbalance, as though one might be about to fall over.
Vertigo and dysequilibrium can be very frightening, but do not usually signify any serious or life-threatening disease.

Sterling jumped to a 26-year high versus the dollar for a third day on Wednesday, vaulting $2.02 and showing no signs of vertigo so far against a broadly weak dollar that stayed near record lows versus the euro.

The greenback, dogged by troubles in the U.S. high-risk mortgage market that could hurt the wider economy, also weakened against the high-yielding Australian and New Zealand dollars.
Trade was expected to be relatively quiet, however, due to the U.S. Independence Day holiday.
Key central bank decisions on interest rates are due on Thursday from Britain and the euro zone. Fifty-six of 70 economists polled by Reuters expect a 25 basis point UK rate hike to 5.75 percent, widening the gap over the Federal Reserve's 5.25 percent policy rate.

"Sterling is maintaining its leader status amongst the majors with regards to outperformance against the generally weaker dollar...We are likely to see sterling continuing to move higher ahead of the BoE meeting," said Ian Stannard, senior foreign exchange strategist at BNP Paribas.

"As far as the U.S. is concerned the dollar remains under pressure across the board. Financial markets' uncertainty is starting to increase and the spillover effects from subprime are starting to have some knock on effects on other markets."

Self care tips for vertigo

If you experience dizziness associated with BPPV, consider these tips:
Be aware of the possibility of losing your balance, which can lead to falling and serious injury.
Sit or lie down immediately when you feel dizzy.
Avoid sleeping on the side of your affected ear.
When getting out of bed, do so slowly. Sit on the edge of the bed for a minute.
Avoid bending down to pick something up. Don't extend your head back, such as when getting something from an upper cabinet.
Be careful when getting up from lying back at the dentist's office, beauty parlor or barbershop, or during activities, such as yoga or massage.
Use two or more pillows at night to avoid lying completely flat.
Use good lighting if you get up in the night.
Walk with a cane for stability.
Work closely with your doctor to manage your symptoms effectively.

The MediFocus Guidebook

A variety of conditions can cause vertigo and can affect your sense of balance. Seeing a doctor is particularly important if your vertigo is accompanied by other symptoms, including hearing loss, neurological symptoms, severe headache, inability to stand or walk, and any of the risk factors for stroke, such as diabetes, heart disease, and hypertension.The MediFocus Guidebook on Vertigo contains information that is vital to anyone who has been diagnosed with this condition.You will learn about the causes, risk factors, common signs and symptoms, medical tests that are used to establish the diagnosis, and standard treatments. You will also learn about the latest clinical advances in the management of Vertigo as well as about the newest treatment options that are available.The MediFocus Guidebook on Vertigo will also inform you about important new, exciting research in the area of Vertigo. You will also learn about the doctors, hospitals, and medical centers that are at the leading edge in conducting clinical research about Vertigo.

Emory Researchers Report Ways To Diagnose And Treat Patients With Vertigo

Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of dizziness spells and vertigo. But if diagnosed correctly, it can often be treated with immediate results, according to two Emory University researchers.

Ronald J. Tusa, M.D., Ph.D., professor of Neurology, Emory University School of Medicine, and director of Emory's Dizziness and Balance Center and Susan J. Herdman, P.T., Ph.D., Emory University School of Medicine, will report at the American Academy of Neurology meeting, in Philadelphia, successful diagnostic procedures and treatment options for BPPV.
BPPV is caused by misplaced calcium carbonate crystals (otoconia) in the semicircular canals (SCC) in the inner ear that have broken free and are found in the fluid of the inner ear. When the head is moved in certain positions, it causes brief periods of vertigo.
"Patients with BPPV usually complain of vertigo in the morning when they get up or turn over in bed," according to Dr. Tusa.

"It can also occur when the patient lies down in bed or tilts the head backwards, maybe while taking a shower or sitting in a dentist chair." Patients also complain of poor balance and trouble walking that may last for several hours following an episode of positional vertigo.
BPPV can affect three areas of the SCC, the posterior, the anterior and the horizontal SCCs. The most common is the posterior SCC.
Drs. Tusa and Herdman have studied several ways to diagnose and treat patients with BPPV. "A common test used to confirm the diagnosis of BPPV is the Dix-Hallpike test," says Dr. Herdman. "It involves turning the head to a certain degree while the patient is sitting, then quickly lying the patient back so the head is hanging off the examination table. If the patient has BPPV, the patient should feel a sense of dizziness." Patients can also be tested for BPPV using a sidelying test and a test of balance.

According to Drs. Tusa and Herdman, there are three basic bedside treatments for BPPV, all of which take less than five minutes to administer. They are canalith repositioning treatment (CRT), Liberatory treatment and Brandt-Daroff (BD) treatment.
CRT is used on patients with severe canalithiasis (free-floating otoconia). It is effective in 85-95% of patients with one treatment. Liberatory treatment is effective in dislodging otoconia attached to the cupula (the cover of the semicircular canals). This procedure has a success rate of 53% after one treatment and 76-90% after two treatments. However, this treatment is difficult to perform on elderly patients because of the quickness of the procedure.

The BD treatment is a series of repetitive exercises that works by dispersing free-floating otoconia and possibly by dislodging any otoconia attached to the cupula. This is the best treatment for mild canalithiasis, when the patient still has symptoms but no signs of BPPV after a single treatment. BD treatment can also be used in patients with severe BPPV, but it is not the first choice since it causes vertigo and takes up to two weeks for success.

In all of the treatments, patients come to the Dizziness and Balance Center and undergo evaluation, testing and treatment by Drs. Tusa and Herdman. Then, in many cases, the patients learn how to administer the treatment themselves and can perform them at home. There are still more ways to treat other forms of BPPV in the anterior and horizontal SCCs. "Treatment varies according to the SCC involved, whether the otoconia is free-floating or attached to the cupula and the severity of the vertigo," says Dr. Tusa. "We hope our research will be of assistance to a number of people who haven't been able to find relief from their vertigo elsewhere."

Emory's Dizziness and Balance Center uses a multidisciplinary approach for diagnosis and treatment. It features physicians and therapists trained in neurology, ophthalmology, otolaryngology, psychiatry and physical therapy. Specialized equipment, including a rotary chair to measure eye movements during head rotation and a dynamic platform posturography to test balance, help provide key information to aid in proper diagnosis.
Dr. Tusa, who holds joint appointments in the Emory Departments of Neurology, Ophthalmology and Otolaryngology, is the founder and former director of the University's of Miami's Dizziness and Eye Movement Center.

Before that, he spent 13 years at Johns Hopkins University, where he began his research in vision and eye movement. He is the author of two books and numerous chapters and articles for professional journals concerning disorders of the eyes and ears.
Dr. Herdman supervises the Center's Vestibular Rehabilitation Program, which includes balance and vestibular or inner ear retraining through a series of special exercises. She is the author of the nation's most utilized textbook on vestibular rehabilitation.

It isn't just dizziness

Vertigo, as its sufferers know, isn't just dizziness - a word that can describe any number of feelings from lightheadedness to feeling weak or unsteady. The medical condition called vertigo is dizziness that creates the sense that you or your surroundings are spinning or moving. It is defined as a false illusion of motion with a distinct sensation of rotation ("The room was spinning around me"). Vertigo can be acute or chronic. Acute attacks are well-defined isolated spells of vertigo with a distinct beginning and end. Chronic vertigo is a continuous sensation. When acute attacks recur, they are treated as chronic vertigo. Doctors can diagnose 75% of vertigo cases based on individual medical history, but you must tell your physician the facts of your case, or the case of the loved one you are helping. When did your dizziness start, what you are feeling and does the spinning sensations come and go or does it persist? Describe what medications you are taking, any stress you are experiencing and any related symptoms that affect you, including nausea, vomiting, tinnitus, deafness or a feeling that your ear is "full." Particularly in the elderly, dizziness can be associated with other diseases and conditions.

Causes of vertigo

Vertigo is usually associated with a problem in the inner ear balance mechanisms (vestibular system), in the brain, or with the nerve connections between these two organs.
The most common cause of vertigo is benign paroxysmal positional vertigo, or BPPV. Vertigo can be a symptom of an underlying harmless cause, such as in BPPV or it can suggest more serious problems. These include drug toxicities (specifically gentamicin), strokes or tumors (though these are much less common than BPPV).
Vertigo can also be brought on suddenly through various actions or incidents, such as skull fractures or brain trauma, sudden changes of blood pressure, or as a symptom of motion sickness while sailing, riding amusement rides, airplanes or in a vehicle.
Vertigo is typically classified into one of two categories depending on the location of the damaged vestibular pathway. These are peripheral or central vertigo. Each category has a distinct set of characteristics and associated findings.

Vitamin E and Hearing Loss

In a preliminary study, researchers find that vitamin E may be effective in restoring sudden onset hearing loss of unknown origin (idiopathic sudden hearing loss). These findings suggest that further research may reveal the role of antioxidants in the prevention and restoration of hearing loss. Each year some 4,000 Americans report the onset of sudden hearing loss (SHL), sensorineural hearing loss of 30 dB or more for at least three contiguous audiometric frequencies occurring within three days or less. Numerous attempts have been made to identify the cause of this disease and many factors have been documented such as infectious diseases, both bacterial and viral. Other causes can include circulatory disorders, traumatic injuries, as well as immunologic, toxic, neoplastic, metabolic, and neurologic sources. However, the cause of SHL can only be identified in 10 to 15 percent of patients, the remainder of cases, which have no obvious cause are termed idiopathic sudden hearing loss (ISHL). About two thirds of patients with ISHL recover without treatment within days, most in the first two weeks after onset. The prognosis is worse if the patient has severe hearing loss with downward-sloping audiograms and vertigo, and does not begin recovery within two weeks. Many treatment regimens have been proposed for ISHL, but none has been consistently supported. Previous research has shown that superoxide anion radicals (O2-) appear in the inner ear of experimental animals after damage caused by noise-induced trauma, administration of ototoxic drugs, and inflammatory disease. Other studies have shown that antioxidants could prevent the ototoxicity of cisplatin, a common chemotherapy drug. These findings leading this research team from Israel to believe that antioxidants such as vitamin E may have a restorative or protective role in the inner ear. With this evidence, they assumed a similar mechanism may be involved in idiopathic sudden hearing loss and, in that event, antioxidants could reduce the damage and enhance recovery. The authors of "Antioxidants in Treatment of Idiopathic Hearing Loss," are Arie Gordin MD, Avishay Golz MD, Aviram Netzer MD, David Goldenberg MD, Henry Z. Joachims MD, all from the Department of Otolaryngology and Head & Neck Surgery, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Their findings are being presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting & OTO EXPO, being held September 19-22, 2004, at the Jacob K. Javits Convention Center, New York City, NY. Methodology: From 1998 to 2001, 92 patients were hospitalized with sudden hearing loss. After exclusions (known cause of the disorder, recovery), 66 patients were enrolled in the study and divided randomly into two groups (study group, S; control group, C) of 33 patients each, ranging in age from 17 to 68 (mean age, 41 years). The mean age in Group S was 42.2; in Group C, it was 38. Fourteen patients had vertigo (eight in Group S, six in Group C), and 34 had tinnitus (19 in Group S, 15 in Group C). Only patients admitted within eight days from onset of hearing loss were included in the study. Hearing evaluation (pure tone audiometry, speech reception threshold, and speech discrimination) was performed after complete histories had been taken and physical examinations had been done. Severity of the disease was based on the mean hearing loss in frequencies of 250 to 4,000 Hz. Up to 40 dB loss was defined as mild, 41 to 70 dB loss was defined as moderate, and 71 dB loss or more was defined as severe. Hearing gain and recovery rate were used as parameters for hearing recovery. The recovery rate was defined as a result of the hearing gain after treatment divided by the difference in initial hearing level between the affected and unaffected ear, multiplied by 100. Treatment of idiopathic sudden hearing loss consisted of bed rest, steroids (prednisone at a dosage of 1 mg/kg/day), intravenous magnesium sulfate 4 g/day, and carbogen (95 percent O2 + 5 percent CO2) by mask, 30 minutes four times a day. This treatment was given to both groups. In addition, Group S received oral vitamin E (d-[alpha]-tocopherol acetate), 400 mg twice daily. Results: This study divided 66 patients with diagnoses of ISHL into two groups. The basic treatment of both groups was identical except for the addition of vitamin E 800 mg/day administered to the study (S) group. The severity of hearing loss was only marginally significant in the rate of recovery, whereas age and sex difference, incidence of tinnitus, and vertigo were nonsignificant in the rate of recovery. Although the difference in complete recovery in both groups was statistically insignificant, the success of treatment, defined as improvement of 75 percent or more at the time of discharge, was significantly better in the study group (78.78 vs. 45.45 percent), as was the case on follow-up (76.42 vs. 55.79 percent). Conclusions: With the suggestion that antioxidants might prevent cisplatin-induced ototoxicity, reduce the incidence of deafness after bacterial meningitis, and protect against noise-induced hearing loss, this research team sought to determine whether the use of antioxidants in ISHL could improve the outcome of the disease. Vitamin E was selected for this effort. The antioxidant properties of vitamin E have been known for many years. Since its discovery, vitamin E has been recognized as an essential factor in neurologic function, preventing destruction of red blood cells, and some genetic disorders. Its role in the prevention of cardiovascular diseases, reduction of risk of cancer, and functioning of the immune system has also been cited. The recovery rate was better for the patients in the group treated with vitamin E. The researchers believe that the exact pathologic changes inflicted by superoxide anion radicals should be further studied, as should the possible role of antioxidants in the prevention of cochlear damage. Note: The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) represents the nation's 11,000 otolaryngologist-head and neck surgeons. These specialists diagnose and treat disorders of the ear, nose, and throat and related structures of the head and neck. Learn more about the specialty and otolaryngic disorders at the AAO-HNS Internet web site, http://www.entnet.org.
source- medicalnewstoday.com

Vertigo Causes

Vertigo can be caused by problems in the brain or the inner ear.

Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements.
Vertigo may also be caused by inflammation within the inner ear. This is known as labyrinthitis. This condition is characterized by the sudden onset of vertigo and may be associated with hearing loss.

Meniere disease is composed of a triad of symptoms: episodes of vertigo, ringing in the ears, and hearing loss. People have the abrupt onset of severe vertigo, fluctuating hearing loss, as well as periods in which they are symptom-free.
Acoustic neuroma is a type of tumor causing vertigo. Symptoms include vertigo with one-sided ringing in the ear and hearing loss.

Vertigo can be caused by decreased blood flow to the brain and base of the brain. Bleeding into the back of the brain is known as cerebellar hemorrhage and is characterized by vertigo, headache, difficulty walking, and inability to look toward the side of the bleed. The result is that the person's eyes gaze away from the side with the problem. Walking is also extremely impaired.

Vertigo is often the presenting symptom in multiple sclerosis. The onset is usually abrupt, and examination of the eyes may reveal the inability of the eyes to move past the midline toward the nose.

Head trauma and neck injury may also result in vertigo, which usually goes away on its own.
Migraine, a severe form of headache, may also cause vertigo. The vertigo is usually followed by a headache. There is often a prior history of similar episodes but no lasting problems.

What Causes Headaches?

In general, kids get the same types of headaches as adults. And headaches often are hereditary, so if you or your partner get them, your child may get them too.

Some of the many potential headache triggers include:
certain medications (headaches are a potential side effect of some)
too little sleep or sudden changes in sleep patterns
skipping meals
becoming dehydrated
being under a lot of stress
having a minor head injury
using the computer or watching TV for a long time
menstruation
experiencing changes in hormone levels
taking a long trip in a car or bus
listening to really loud music
smoking
smelling strong odors such as perfume, smoke, fumes, or a new car or carpet
drinking or eating too much caffeine (in soda, coffee, tea, and chocolate)
consuming certain foods (such as alcohol, cheese, pizza, chocolate, ice cream, fatty or fried food, lunchmeats, hot dogs, yogurt, aspartame, or anything with the seasoning MSG)

Disorders of Balance - Pathophysiology
Vertigo - Subjective sensation of movement
- will occur where there is a mismatch of sensory input, i.e. between vestibular + visual data. e.g after acute labyrinthitis with loss of function of 1 perpheral vestibular system. The vestibular data is suggestive of rotation and the eyes are therefore moved via the vestibulo-ocular reflex causing a sensation of the visual environment moving.Nystagmus - Involuntary eye movements due to a variety of causes:-
ocular
vestibular
neurological
congenital
hysterical Vestibular nystagmus - is usually horizontal or rotational and results from an ‘imbalance’ between the paired peripheral vestibular systems causing inappropriate eye movements.
There are 2 phases:-
slow phase – as the eyes deviate to one side.
fast phase – is the corrective movement, this results in beating movements of the eyes.
Disorders of balance occur when there is either a mismatch of sensory input (due to malfunction of 1 system relative to the others) or inadequate sensory or central function

Treating Vertigo

One of the most important aspects of vertigo treatment lies in the complete history and the events that proceeded before the vertigo occurred.
The doctor would require details such as the sensation you felt, whether nausea was present and other sensation defects such as weakness of limbs or poor vision.
Details will help the doctor get the correct diagnosis. Most simple vertigo go off on their own but if there were specific diseases causing it, a complete investigation and treatment is warranted.
There are few medications that help in relieving vertigo. Most anti-vertiginous medication have a sedative effect on the brain, which should not be taken for too long as the brain is required to align back.
Vertigo symptoms would then slowly decrease. Betahistine Dihydrocloride is a proven medication, which increases blood supply to the inner ear and stabilises the firing effect of the vestibular nuclei in the brain stem. It also has no sedative effect.
However, it has to be taken for a long period under doctor’s supervision and also does not help in acute attacks.
Vertigo is common in all populations but its management is tricky at times.
It is essential that patients with vertigo seek early treatment to rule out other more dangerous causes. In most cases, the condition is self-limiting, but they show encouraging results.

Motion Sickness

Motion Sickness: Physiological Vertigo
Vertigo while in moving vehicles particularly is known as motion sickness. This is due to a "sensory conflict" between one’s vision and the actual movement sensation. In motion sickness, it is caused by multi-sensory motions that do not correlate to the expected pattern of movement.
Many feel better sitting in the front seat of the car or bus as it gives them more visual input than at the back seat.
These individuals are encouraged to keep their eyes open as this will let the brain gain more information of the movement of the vehicle and decrease the vertigo.

• Hereditary vertigo, geriatric vertigo, drug induced vertigo, psychogenic vertigo

• Hereditary vertigo, geriatric vertigo, drug induced vertigo, psychogenic vertigo
These are rare but are diagnosed when common causes cannot be identified.
More than 30 per cent of individuals aged 65 and above have shown to experience dizziness in a study done by Sloane in 1989. It is important to understand that aged folk have multi-factorial causes of vertigo. Management of vertigo in elderly is important as falls due to vertigo could lead to other severe multi-morbidity conditions, such as head injury, hip and spine trauma.
Geriatric causes would be due to poor vision, deteriorating sensation of the nervous system and general disability to maintain a balance.
Medications for various ailments, such as anti-hypertensive, anti-depressants, muscle relaxants, non-steroids anti-inflammatory drugs, hormonal products, certain antibiotics, etc have some effect on the inner ear and can thus cause vertigo.
The effect of these medicaments is individual specific, as vertigo will not be present in all the patients who take them.
Psychological and psychiatric ailments can contribute to persistent vertigo sensation. It is seen in those who are anxious, depressed or suffer from panic disorders or fear of heights (acrophobia).

2 more vertigos

Vascular vertigo
Vascular vertigo is mostly associated with the lack of blood supply to certain areas in the brain, which causes various vestibular syndromes.
These syndromes are usually associated with vertigo and may sometimes be misdiagnosed as pre-stroke symptoms and sometimes as migraine.
Decompression sickness in deep-sea divers sometimes has symptoms of vascular vertigo syndrome. Confusion and vertigo during diving trips could be a result of this.
• Traumatic vertigo
Head injuries from motor vehicle accidents or any other kind of trauma would result in traumatic vertigo. The site of injury is in the inner ear, including damage to the balance nerve. Divers and mountain climbers suffer this kind of vertigo due to barotraumas, which is a result of pressure change.
In both high and low-pressure environment, the inner ear can be damaged due to sudden rupture of the inner membranes.

2 more types of vertigo

• Central vestibular vertigo
Central vertigo means there is a lesion within the brainstem or brain and very often, the patient has specific eye symptoms and also tendencies of balance loss. The doctor will be able to differentiate these finer points with the aid of a Magnetic Resonance Imaging (MRI) or CT scans.
• Positional or positioning vertigo
This is a condition where vertigo is only experienced in specific head positioning. It can occurs suddenly while the sleeping person gets into a particular position. It is episodic but disappears soon after. However, the after effects is even more disturbing than the real thing. There is often a feeling of uneasiness and unsteadiness after one specific episode.
Diagnosis of this condition is simple. Usually, after an in-depth consultation, the treating physician will perform a simple manoeuvre called the Dix Hallpike, to ascertain the condition.
Once vertigo is proven, the follow-through procedure would be an Epley, Semonts or Brandt Daroff manoeuvres. The reasons for these are to displace abnormal calcium deposits within the inner ear to an area which prevents it from stimulating the nerve cells, which caused vertigo.

Vestibular Vertigo

• Vestibular vertigo
Vestibules are two paired organs within the ear. They are sensitive to the movement of our head. Any type of irritation or damage to the vestibules may cause confusion in the brain, resulting in vertigo. Common cause may be vestibular nerve (balance nerve) inflammation, which is predominantly viral in nature. It is self-limiting and almost always resolves by itself.
Less common in Asia is Meniere’s disease where patients experience vertigo with hearing loss and ringing sounds within the affected ear. The cause of this condition is unknown.
Leaking inner ear fluid (perilymph fistulas), vestibular failure, infection of the vestibule and tumours are known causes of vestibular vertigo.

Vertigo is a symptom

YOU have lead a healthy life all this while, with no indication of any disease or ailment. But then, within seconds, you experience an awful sensation, as if the entire environment has begun to spin or that you are spinning against a stationary environment.
This scenario likely makes you one among five to 10 per cent of individuals who is suffering from vertigo.
Vertigo is a symptom and not necessarily a disease, but it is an outcome of a physiological or pathological processes.
Vertigo occurs when sensation from the inner ear, eyes and sensation throughout the body (somatosensory) are mismatched. Humans need all three to get their balance through co-ordination of the brain. Any abnormality in one or more of these will trigger vertigo. A simple sign of vertigo is nystagmus, which is involuntary movement of the eyeballs. Of course, you will not see it in the mirror because when we fix our vision in the mirror, nystagmus disappears.
Sometimes, we feel dizzy or light-headed but it may not be vertigo. This is common when you suddenly stand up from a lying or seated position, when experiencing panic disorders, have low blood sugar count or when intoxicated with either drugs or alcohol.

Vertigo Etymology

ver·ti·go (vûrt-g) KEY NOUN: pl. ver·ti·goes or ver·ti·gos
The sensation of dizziness.
An instance of such a sensation.
A confused, disoriented state of mind.

ETYMOLOGY: Middle English, from Latin vertg, from vertere, to turn; see wer- 2 in Indo-European roots

Vertigo Exercises

The inner-ear form of vertigo affects about 64 people in every 100,000. It is most common in people over age 50 and occurs twice as often in women. Simple exercises performed at home may help patients with vertigo find relief, say researchers according to a new study.

Researchers studied 70 patients who had a form of vertigo caused by loose particles floating in the inner ear canal. Participants reported experiencing episodes of nausea or a feeling of spinning when they moved their heads a certain way. Their vertigo symptoms lasted an average of eight weeks.Patients were instructed to perform exercises at home three times a day. Half of the participants performed an exercise called the modified Epley’s procedure, while the other half performed the modified Semont maneuver. Both exercises require patients to perform head and body movements to clear particles from the ear canal. The latter requires more extreme whole body movement.Results reviewed, after one week showed, 95 percent of patients who performed the modified Epley’s procedure reported no symptoms of vertigo. Nearly 60 percent of those who performed the modified Semont maneuver said they were symptom-free. Specialists conclude saying that, BPPV (benign paroxysmal positional vertigo) is caused by loose particles derived from the utricular macula that are free-floating ... Until recurrences can be prevented, self-treatment for BPPV using particle repositioning is likely to become part of the routine management for this condition.

Vertigo, or dizziness, is a symptom, not a disease. The term vertigo refers to the sensation of spinning or whirling that occurs as a result of a disturbance in balance (equilibrium). It also may be used to describe feelings of dizziness, lightheadedness, faintness, and unsteadiness. The sensation of movement is called subjective vertigo and the perception of movement in surrounding objects is called objective vertigo.

Vertigo usually occurs as a result of a disorder in the vestibular system (i.e., structures of the inner ear, the vestibular nerve, brainstem, and cerebellum). The vestibular system is responsible for integrating sensory stimuli and movement and for keeping objects in visual focus as the body moves.

When the head moves, signals are transmitted to the labyrinth, which is an apparatus in the inner ear that is made up of three semicircular canals surrounded by fluid. The labyrinth then transmits movement information to the vestibular nerve and the vestibular nerve carries the information to the brainstem and cerebellum (areas of the brain that control balance, posture, and motor coordination). There are a number of different causes for dizzy spells.

Incidence and Prevalence Vertigo is one of the most common health problems in adults. According to the National Institutes of Health (NIH), about 40% of people in the United States experience feeling dizzy at least once during their lifetime. Prevalence is slightly higher in women and increases with age.

Home Remedies for Vertigo

Tips 1:Soak 2 tbsp wheat grain, 1 tsp poppy seeds (khus-khus), 8 almonds,8 water melon seeds and make a paste. Heat 1 tsp ghee fry 2 cloves in this add to the paste mix with milk and drink everyday for a week.

Tips 2:Soak 1 tsp of alma (gooseberry) powder along with 1 tsp coriander seeds. Leave over night. Strain and add 1/2 tsp sugar and drink.

Common Causes of Vertigo
Due to the free-floating calcium carbonate crystals in the posterior semicircular
Canal An infection in the ear fore example syphilis
Vision problems
Acute head injury
Cardiac conditions
Brain tumors
Thyroid disease
Anemia
Calcium disorders
Motion sickness
Insufficient blood supply to brain
High blood pressure
High cholesterol
Diabetes

Head and Neck Medical Findings

Some 37 original articles are featured in the October, 2004, edition of Otolaryngology - Head and Neck Surgery, the peer-reviewed scientific journal of the American Academy of Otolaryngology - Head and Neck Surgery Foundation. This issue can be accessed at http://www.mosby.com/oto; abstracts of the articles can be viewed online. Among the new research studies are: 1. Proton pump inhibitor therapy for chronic laryngo-pharyngitis: A randomized placebo-control trial. Inflammation of the larynx and pharynx can lead to hoarseness or even loss of voice. Researchers from Cincinnati explore the effectiveness of proton pump inhibitors, medicine often used in treating severe gastro esophageal reflux, but also suggested as a treatment for chronic laryngo-pharyngitis. 2. Vocal fold augmentation with calcium hydroxylapatite: Calcium hydroxylapatite has been used for dental applications where bone build-up is needed for reconstruction and also in block form for cosmetic applications such as cheek, jaw, cranial, and chin implants. New research examines whether injection of this material for augmentation of the vocal folds is effective in treating vocal fold atrophy, part of the normal aging process, with up to 60 percent of 60-year-old individuals displaying evidence of such glottal insufficiency. 3. Laser cryptolysis for the treatment of halitosis: Good dental hygiene alone cannot help those who suffer from chronic fetid (foul smelling) tonsillitis. Israeli researchers have found confirmed that laser application to accumulated bacterial and other material in the tonsil crypts provide relief to those conscious of their bad breath. 4. Severe hypertrophy of the base of the tongue in adults: An unnatural increase in the size of tongue base follicles is rare in adults. Researchers in otolaryngology in Brazil have concluded from their research that the frequency of hypertrophied follicles is found with gastro-esophageal reflex (GER). Consequently, hypertrophy of the tongue base symptoms are confused with those of GER, except for nasal voice and noisy respiration. 5. Safety of outpatient tonsillectomy in children: A review of six years in a tertiary hospital experience: A major retrospective study of children undergoing outpatient tonsillectomy in a major hospital has found that approximately one in 11 children had post-operative complications with three percent experiencing major bleeding. 6. Pediatric temporal bone fractures in a rural population: Temporal bone fractures can have serious consequences for the facial nerve, middle ear, inner ear, and intracranial contents. These fractures are commonly associated with head trauma, occurring in 30 to 75 percent of adult blunt head traumas and six to 14 percent of pediatric blunt head traumas. Pennsylvania otolaryngologists have found that in a rural environment animal-related injuries were the second most common cause of fractures in children five and younger. Such injuries were caused by dog attacks, horse falls and tramplings, and cow kicks. 7. Hearing loss in steel band musicians: Steel band musicians delight lovers of music. But fans of this West Indian music should realize new research findings reveal that the performers suffer permanent auditory damage from their instrument's high-intensity sound levels and that preventative measures are required to prevent this hearing loss, particularly in younger players. 8. Diagnostic, pathophysiologic, and therapeutic aspects of benign paroxysmal positional vertigo: Greek researchers describes the advances in understanding how benign paroxysmal positional vertigo, the most common peripheral vestibular disorder is generated, and discuss the current therapeutic modalities. 9. Harmonic Scalpel versus cold knife dissection in superficial parotidectomy: The parotid gland is the largest of the glands that produce saliva important in the digestion of food. The gland lies under the angle of the jaw just beneath the ear. Surgery of the parotid gland may become necessary in the presence of infection or tumor. The Harmonic Scalpel has been found to provide improved operative time, less blood loss, and decreased facial nerve injury compared with conventional techniques in thyroid surgery. Now the procedures are compared for parotid gland removal. 10. Revision cochlear implant surgery: Causes and outcome: Cochlear implantation is not necessary a one-time surgical procedure. Recipients of this technology to assist the deaf have found it necessary to have the device re-inserted into the inner ear for reasons related to device failure or upgrade. A new research effort explores the success of repeating this surgery. These, and 27 other research findings are available in the October, 2004, edition of Otolaryngology-Head and Neck Surgery.

A microscopic reason!

Scientists may have pinpointed a microscopic reason why people suffering from the most common type of vertigo experience a distinct time lag between a rapid head motion and the onset of dizziness. The explanation, the researchers say, could be that it takes five to six seconds for minuscule crystals in the inner ear to sediment after the head moves suddenly, an event that can set a dizzy spell in motion. The team of engineers and physicians from Harvard University, the California Institute of Technology, and Northwestern University reports in the August issue of the Journal of Biomechanics on a mathematical model they've developed to support this theory on the cause of benign paroxysmal positional vertigo (BPPV). "While BPPV is not life-threatening, it induces disorientation that is severely discomforting and can cause nausea and accidents," says Howard A. Stone, Harvard College Professor and Gordon McKay Professor of Chemical Engineering and Applied Mechanics in Harvard's Division of Engineering and Applied Sciences. "We used hydrodynamic models to show that if tiny particles in the inner ear become dislodged, which researchers have previously posited as the trigger for BPPV attacks, the period of time for these particles to fall far enough to adversely impact pressure within the inner ear roughly matches the typical lapse between a head tilt and onset of vertigo." BPPV is a mechanical disorder originating in the vestibular system within the inner ear, where three fluid-filled semicircular canals detect head rotation about each of three axes. Many researchers believe BPPV attacks are triggered when calcite particles called otoconia, which normally reside in the inner ear, dislodge and interfere with proper functioning of these semicircular canals. The disorder is characterized by a lag of several seconds between a rapid head movement and the onset of a debilitating spinning sensation. Along with Harvard undergraduate Michael S. Weidman, Todd M. Squires at Caltech, and Timothy C. Hain of Northwestern, Stone examined whether this delay might coincide with movement of otoconia. Their fluid-modeling work showed that the latency characteristic of BPPV nearly matches the amount of time it would take for loose otoconia to detrimentally affect pressure within the semicircular canals of the vestibular system. "Otoconia are tiny, generally just a minute fraction of a millimeter, but still large enough to cause disruptions in the inner ear," Stone says. "The otoconia settle over a period of five to six seconds to a point where the semicircular canals undergo a significant reduction in radius, increasing the pressure within the semicircular canals and possibly leading to dizziness." BPPV is also known as "top-shelf vertigo," since attacks are often prompted by a sudden tilting back of the head, as if to look at objects on a high shelf. It is the most commonly diagnosed type of vertigo, with some studies suggesting that it affects 9 percent of older individuals. Treatment for BPPV is purely mechanical, involving a set of head motions (a common version is called the Epley maneuver) that are believed to flush otoconia from the sensitive semicircular canals. Hain, a medical scientist who studies motor control of the head and neck, originally sought Stone's assistance in studying the possible role of fluid dynamics in BPPV. Stone says that he, Squires, and Weidman, none of whom are physicians, bring a different perspective to a medical ailment that's largely mechanical in nature. In addition, Stone and his collaborators are able to provide other quantitative insights useful for characterizing BPPV. "This is a new way of thinking for the medical community, which tends to look at problems differently than engineers or physicists might," he says. "Because of its mechanical nature, BPPV may be an illness that requires a degree of cooperation between physicians and engineers."Contact: Steve Bradtsteve_bradt@harvard.edu617-496-8070Harvard University

Dr. Dave and Dr. Dee

Dear Dr. Dave and Dr. Dee,I've been dizzy off and on for the past several days, with a spinning sensation. Sometimes it feels like the ground tilts while I'm walking. This morning when I woke up and looked at the alarm clock it was spinning. When I went to get up, I rolled out of bed and fell on the floor. Then I felt OK and went to work. I felt some little twinges during the day. It's scaring me. I would see a doctor, but I don't have any money.Signed,DizzyDear Dizzy,Vertigo is a type of dizziness that's characterized by the sensation of spinning. It's sometimes referred to as a hallucination of motion. Imagine what it would feel like to be placed suddenly on a roller coaster that won't stop, and you begin to understand the alarming symptom of vertigo.A fairly common cause of vertigo is labyrinthitis (explanation below). This type of vertigo may occur after a flu-like illness, severe ear infection, or may have no clear cause. It's usually self-limited, meaning it goes away all by itself. But it may intermittently reappear over weeks to months. Bouts of vertigo are commonly treated with meclizine (Antivert).Vertigo can also result from other vestibular (balance center) disorders. Benign Paroxysmal Positional Vertigo (BPPV) is thought to be caused by tiny loose particles floating freely in the fluid (endolymph) of the vestibular system. Meniere's disease is a chronic condition that causes vertigo associated with ringing or roaring and progressive hearing loss in the affected ear(s). Other causes of vertigo include vestibular neuronitis (inflammation of the vestibular nerves), and post traumatic vertigo, which may occur after an injury to the head involving the inner ear structures. Sometimes vertigo may be a symptom of a more serious underlying illness such as a stroke or tumor.So, anyone with the symptom of vertigo should be seen immediately by a doctor in order to determine the cause. If you can't get in by appointment, then obtain a ride to your local emergency room. They're well equipped to do the required initial evaluation, and provide relief from the unpleasant symptoms, regardless of one's ability to pay. Don't drive or operate machinery until cleared by your physician.

WHAT IS LABYRINTHITIS? People sometimes refer to labyrinthitis as an inner ear infection, but it usually isn't due to an actual ear infection. In the most general terms, it is a condition that causes irritation of tiny structures such as microscopic hair cells which project into fluid-filled canals (labyrinths) within the vestibular system located deep in the inner ear. Normal balance is, to a degree, controlled by movement of fluid and particles in the labyrinths, in response to changes of body position. This causes the hair cells to send electrical impulses to the brain helping to define the body's orientation. In labyrinthitis the hair cells and other structures in the labyrinths have become irritated or inflamed. They discharge randomly, sending chaotic messages to the brain, tricking the brain into thinking you or your surroundings are moving or spinning.

soucre-http://www.drdaveanddee.com/dizziness.html

Synonyms and Keywords Related to Vertigo

Synonyms and Keywords
vertigo, dizzy, dizziness, disequilibrium, lightheaded, benign positional vertigo, Meniere disease, labyrinthitis, migraine, acoustic neuroma, cerebellar hemorrhage, hearing loss, tinnitus

Vertigo Outlook

The prognosis depends on the source of the vertigo.
Vertigo caused by problems in the inner ear, while usually self-limited, in some cases can become completely incapacitating. The use of drugs and rehabilitation exercises are the mainstay of treatment. Most commonly this will make the symptoms completely go away or make the condition tolerable.
The prognosis of vertigo from a brain lesion depends on the amount of damage done to the central nervous system. All vertigo caused by a brain lesion needs emergency evaluation by a neurologist and neurosurgeon.

It was March 21 when Luis Castillo stepped into the on-deck circle at Hammond Stadium in Fort Myers, Fla., for some practice swings, took one cut and watched the weighted donut fly off the end of his bat and smack Twins hitting coach Joe Vavra in the side of the head.
Vavra downplayed the severity of his injury, but the puddle of blood coming from a cut on his right ear kept getting bigger. He went to a hospital, underwent tests, received stitches on his ear and was back throwing batting practice in the cage at the ballpark by the end of the game.
In subsequent days - weeks, even - Vavra began to feel the effects of his head injury more and more. Vertigo set in and lasted for more than a month, and Vavra said it has been just more than 10 days since the dizziness subsided.

While the vertigo lingered, Vavra's thoughts were clouded and his patterns skewed. Nothing seemed right, not simple everyday tasks and not his job as hitting coach. Certainly the Twins' offensive tailspin in recent weeks can't be traced to one particular thing, but that sunny afternoon in Florida knocked Vavra out of his routine, and when his went, Vavra believes some of his hitters' routines suffered as well.

"We had a lot of routines going last year," Vavra said while sitting in the Twins' dugout at the Metrodome last week, "and everybody was locked into a pretty good one, whether it was five, 10 minutes a day. Maybe at the start of the year when I wasn't physically functioning as well as should have, maybe a couple of them backed off."
A few days after the incident, which actually fractured Vavra's skull and caused a deep cut on his right ear, he started feeling nauseous and dizzy. He took a spring road trip or two off and tried to rest, but that's not his nature.

He was back in the clubhouse quickly, with a bandage on his ear to cover the cut and a façade that made people think he felt fine.
For the first two weeks, Vavra said he didn't want to drive at all. When he did, his vertigo would put his world in an uncomfortable spin. At a stop sign, Vavra would put both feet on the break as the cars around him, though stationary, seemed to keep moving.
"I was very unsure of my surroundings," he said.

"Everything seemed to be moving around me. I felt like I could control my balance, but it was like everything else was just a little off-center."
It wasn't just driving. Vavra would reach into the bucket of balls during batting practice, stand up, and things around him would start moving. Or he would turn around too quickly and, again, nothing would stand still, forcing Vavra to sit until the room stopped spinning around him.
Throwing batting practice, he said, provided the biggest challenge.
"I wasn't necessarily out of the strike zone," Vavra said, "but I couldn't control exactly where I wanted to go, which is half of the battle of early batting practice, locating the pitch so that you can work on a certain area with some consistency.

"From analyzing to physically doing the work, it was like I didn't feel like I had the confidence to do any of it. It was pretty strange."
Twins manager Ron Gardenhire said the team's problems at the plate surely stem more from players' injuries than Vavra's vertigo. It was hard to know, he said, when to spell the hitting coach because Vavra never let anyone know he wasn't feeling well until a bout of dizziness had passed.

Gardenhire and his staff easily recognized Vavra's most obvious symptom, though - occasionally he would start talking to himself. He had such a difficult time trying to reach a conclusion that he sometimes talked things through aloud.

Nice to know

People whose balance is affected by vertigo should take precautions to prevent injuries from falls. Those with risk factors for stroke should control their high blood pressure and high cholesterol and stop smoking. Someone with Meniere disease should limit added salt to their diet.

Anyone with a new diagnosis of vertigo should follow up with their doctor or be referred directly to a neurologist or ENT specialist.

Medications that are commonly prescribed for Vertigo

Commonly prescribed medications include the following:
Meclizine hydrochloride (Antivert)
Diphenhydramine (Benadryl)
Scopolamine transdermal patch
Promethazine hydrochloride (Phenergan)
Diazepam (Valium)
Take these medications only as directed by and under the supervision of your doctor.

Treatment- home and medical

Home therapy should only be undertaken if you have already been diagnosed with vertigo and are under the close supervision of a doctor.

Medical Treatment

The choice of treatment will depend on the diagnosis.
Vertigo can be treated with medicine you take by mouth, through medicine placed on the skin (as a patch), or drugs given through an IV.
Specific types of vertigo may require additional treatment and referral:
Bacterial infection of the middle ear requires antibiotics.
For Meniere disease, in addition to symptomatic treatment, people might be placed on a low salt diet and may require medication used to increase urine output.
A hole in the inner ear causing recurrent infection may require referral to an ear, nose, and throat (ENT) specialist for surgery.
In addition to the drugs used for benign paroxysmal positional vertigo, several physical maneuvers can be used to treat the condition.
Vestibular rehabilitation exercises consist of having you sit on the edge of a table and lie down to one side until the vertigo resolves followed by sitting up and lying down on the other side, again until the vertigo ceases. This is repeated until the vertigo is no longer inducible.
Particle repositioning maneuver is a treatment based on the idea that the condition is caused by small stones in the inner ear. Your head is repositioned to move the stones to their normal position. This maneuver should be repeated until the abnormal eye movements are no longer visible.

Exams and tests associated with Vertigo

The evaluation of vertigo consists primarily of a medical history and physical exam.
The history is comprised of 4 basic areas. The doctor will ask you about the following areas:
During the exam, the doctor will want to find out if true vertigo exists. The doctor will want to know if you feel any sensation of motion. Report any nausea, vomiting, sweating, and any abnormal eye movements.
The doctor will ask about how long you have had symptoms and whether they are constant or come and go. Do the symptoms occur when you move or change position? Are you currently taking any new medications? Has there been any recent head trauma or whiplash injury?
Are there any other hearing symptoms? Specifically, report any ringing in the ears or hearing loss.
Do you have weakness, visual disturbances, altered level of consciousness, difficulty walking, abnormal eye movements, or difficulty speaking?
The doctor may perform special tests such as a CT scan if a brain injury is suspected to be the cause of vertigo. The use of blood tests, specifically to check blood sugar levels, and the use of an ECG to look at the heart rhythm may also be helpful.

When to seek medical care

Any signs and symptoms of vertigo warrant an evaluation by your doctor. The majority of cases of vertigo are harmless. And although vertigo can be extremely debilitating, it is easily treated with prescription medication. Have your doctor check out any new signs and symptoms of vertigo to rule out any potentially serious or life-threatening causes.
Certain signs and symptoms of vertigo may require evaluation in a hospital's emergency department:
Double vision
Headache
Weakness
Difficulty speaking
Abnormal eye movements
Altered level of consciousness, not acting appropriately, or difficulty arousing
Difficulty walking or controlling your arms and legs

This is very important to do...

It is very important to determine if vertigo truly exists. Vertigo implies that there is a sensation of motion either of the person or the environment. This should not be confused with symptoms of lightheadedness or fainting.
To determine if true vertigo exists, you must describe a sensation of disorientation or motion. In addition, you may also have any or all of these symptoms:
Nausea or vomiting
Sweating
Abnormal eye movements
The duration can be from minutes to hours and can be constant or episodic. The onset may be due to movement or change in position. It is important to tell your doctor about any recent head trauma or whiplash injury as well as any new medications you may be taking.
You may have hearing loss and a ringing sensation in your ears.
You might have visual disturbances, weakness, difficulty speaking, decreased level of consciousness, and difficulty walking.

Overview and causes

Vertigo is the feeling that you or your environment is moving when no movement occurs. Imprecisely called dizziness, the term vertigo is the specific term used to describe an illusion of movement. Unlike nonspecific lightheadedness or dizziness, vertigo has relatively few causes.

Vertigo can be caused by problems in the brain or the inner ear.
Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements.
Vertigo may also be caused by inflammation within the inner ear. This is known as labyrinthitis. This condition is characterized by the sudden onset of vertigo and may be associated with hearing loss.
Meniere disease is composed of a triad of symptoms: episodes of vertigo, ringing in the ears, and hearing loss. People have the abrupt onset of severe vertigo, fluctuating hearing loss, as well as periods in which they are symptom-free.
Acoustic neuroma is a type of tumor causing vertigo. Symptoms include vertigo with one-sided ringing in the ear and hearing loss.
Vertigo can be caused by decreased blood flow to the brain and base of the brain. Bleeding into the back of the brain is known as cerebellar hemorrhage and is characterized by vertigo, headache, difficulty walking, and inability to look toward the side of the bleed. The result is that the person's eyes gaze away from the side with the problem. Walking is also extremely impaired.
Vertigo is often the presenting symptom in multiple sclerosis. The onset is usually abrupt, and examination of the eyes may reveal the inability of the eyes to move past the midline toward the nose.
Head trauma and neck injury may also result in vertigo, which usually goes away on its own.
Migraine, a severe form of headache, may also cause vertigo. The vertigo is usually followed by a headache. There is often a prior history of similar episodes but no lasting problems.

The Causes

Inner ear
benign paroxysmal positional vertigo
labyrinthitis and vestibular neuronitis
Ménière's disease
perilymphatic fistula
neurinoma of the acoustic nerve

Central Nervous System

posterior fossa neoplasm
concussion
migraine
multiple sclerosis posterior circulation stroke

Vertigo Overview

Vertigo is the feeling that you or your environment is moving when no movement occurs. Imprecisely called dizziness, the term vertigo is the specific term used to describe an illusion of movement. Unlike nonspecific lightheadedness or dizziness, vertigo has relatively few causes.

from- emedicinehealth.com

Vertigo and instabilities

In some cases ligamental injuries of the upper cervical spine result in head-neck-joint instabilities which can cause vertigo. Instabilities of the head neck joint are affected by rupture or overstretching of the alar ligaments and/or capsule structures mostly caused by whiplash or similar biomechanical movements. If patients describe prolonged vertigo after a whiplash trauma, professionals should think about ligamental damage of head-neck-joint structures.
Symptoms during damaged alar ligaments besides vertigo often are
dizziness
reduced vigilance, such as somnolence
seeing problems, such as seeing "stars", tunnel views or double contures.
Some patients tell about unreal feelings that stands in correlation with:
depersonalisation and attentual alterations
Most medical professionals don't know about the disease complex of head-neck-joint instabilities. Often the patients are having an odyssey of medical consultations without any clear diagnosis and are then sent to psychatrist because doctors think about depression or hypochondry. Standard imaging technologies such as CAT or MRI are not capable of finding instabilities without taking functional poses.

Vertigo...

Associated symptoms of vertigo include motor or sensory deficits, dysarthria (slurred speech) or ataxia. Causes include things such as migraines, multiple sclerosis or tumors. Less commonly, strokes, seizures, trauma or infections can cause also central vertigo.

Vertigo should not be confused with dizziness. Dizziness is an unpleasant feeling of light-headedness, giddiness or fuzziness often accompanied by nausea.

Vertigo is often incorrectly used to describe a fear of heights. This is due to a false etymology that associates "vertigo" with "vertical."
Vertigo is often experienced when breathing helium, as a result of decreased oxygen flow to the brain. Klinefelter's Syndrome people with this condition - have enhanced spatial thinking capabilities, so might be more susceptible to vertigo - research is ongoing.

Did you know this?

Vertigo is typically classified into one of two categories depending on the location of the damaged vestibular pathway. These are peripheral or central vertigo. Each category has a distinct set of characteristics and associated findings.
Peripheral vertigo: The lesions, or the damaged areas, affect the inner ear or the vestibular division of the acoustic (CN VIII) nerve. Vertigo that is peripheral in origin tends to be felt as more severe than central vertigo, intermittent in timing, always associated with nystagmus in the horizontal plane and occasionally hearing loss or tinnitus (ringing of the ears).

Peripheral vertigo can be caused by BPPV, Ménière's disease or acute vestibular neuronitis. Peripheral vertigo, compared to the central type, though subjectively felt as more severe, is usually from a less serious cause.

Central vertigo: The lesions in central vertigo involve the brainstem vestibular nerve nuclei. Central vertigo is typically described as constant in timing, less severe in nature and occasionally with nystagmus that can be multi-directional.

Vertigo according to Wikipedia

Vertigo, a specific type of dizziness, is a major symptom of a balance disorder. It is the sensation of spinning while the body is stationary with respect to the earth or surroundings. With the eyes shut, there will be a sensation that the body is in movement, called subjective vertigo; if the eyes are open, the surroundings will appear to move past the field of vision, called objective vertigo.
Most people experience at least some degree of vertigo sensation while looking at images like this.
The effects may be slight. It can cause nausea and vomiting or, if severe, may give rise to difficulty with standing and walking. Vertigo is usually associated with a problem in the inner ear balance mechanisms (vestibular system), in the brain, or with the nerve connections between these two organs. The most common cause is benign paroxysmal positional vertigo, or BPPV. Vertigo can be a symptom of an underlying harmless cause, such as in BPPV or it can suggest more serious problems. These include drug toxicities, strokes or tumors (though these are much less common than BPPV). Vertigo can also be brought on suddenly through various actions or incidents, such as skull fractures, sudden changes of blood pressure, or as a symptom of motion sickness while sailing, riding amusement rides or in a vehicle.

dizzytimes.com

There are many great features availale at Dizzytimes.com including:
Access to a growing number of dizzy sufferers from around the globe.
Ask and answer questions about your condition.
Access our live chat facility.
Use of our gallery system to post your pictures.
and much much more...

Dizzytimes.com is an online community for vertigo sufferers. check it out.

...in older persons?

How common are falls and balance problems in older persons?

Each year, falls occur in over a third of persons over age 65, and in over half of persons over age 75. About a third of the older population reports some difficulty with balance or ambulation, and this percentage also increases in frequency and severity after age 75.

I sometimes get dizzy when I stand up. What causes this?I sometimes get dizzy when I stand up. What causes this?

This problem is called orthostatic dizziness and is often caused by a drop in blood pressure upon standing (orthostatic hypotension). Orthostatic hypotension can be caused by a number of conditions, including diabetes, Parkinson's disease, heart failure, drop in blood volume, dehydration, infection, and a number of medications (such as diuretics and blood pressure medicines). A less common cause of orthostatic dizziness not associated with falling blood pressure is caused by abnormalities in the inner-ear vestibular (balance) system, or its connection to the brain.

More Information, please

Where can I go for more information?

A variety of services can provide you with guidance on balance and dizziness.

Among them are: Vestibular Disorders Association: (503) 229-7705; website: www.vestibular.org National Institute on Deafness and Other Communication Disorders: (301) 496-7243;E-mail: nidcd@aerie.com American Academy of Otolaryngology/Head and Neck Surgery, Inc.: (703) 836-4444; TTY (703) 519-1585. To locate local support resources including home health providers, call Eldercare Locator at (800) 677-1116

Walking Aids

What kinds of walking aids are available and whom should I talk to about getting the right one?
A whole spectrum of walking aids are widely available, ranging from simple canes to fancy types of walkers and wheelchairs. Any walking aid should be carefully matched to your particular needs. It must be measured to the right size and provide the optimal level of stability without creating too much dependency. This is best done by an experienced provider, such as a physical therapist, physician, or prosthesis specialist. When used properly, these aids can dramatically improve mobility and safety.

This is so useful!

What can I do to decrease my chances of falling?
Ask your physician to evaluate your strength, balance, gait, entire medication list, and overall risk for falls. The chances are good that there will be a number of things that can be done to reduce fall risk, such as adjusting medications, obtaining physical therapy, starting an exercise regimen, or receiving an assistive device such as a cane or walker, to make walking safer.

What can be done to improve balance?
Similarly, there are a number of exercises and assistive devices that can improve stability. Ask your physician what would be best for you.

How can I make my home environment safer?
There are many pamphlets available to assist in hazard-proofing your home environment. Alternatively, a home health provider, such as a visiting nurse or occupational therapist, can come to the home and provide a hands-on inspection and set of recommendations. Common recommendations include installing bathroom grab bars, improving lighting in key areas, removing hazardous conditions on the floor, and making stairways and entrance areas safer.

How can I find out if any of the medications I take may increase my risk of falling?
Your physician is the best person to systematically assess the risks and benefits associated with medications and should be asked to do so. Be sure to tell your physician about all medications you are taking, even products such as over-the-counter sleeping medications and cold tablets and those medicines prescribed by other providers.

Everyone, especially seniors, should read this

What are the major causes of falls?
The most common causes of falls include environmental hazards (such as slippery floors and loose rugs), weak muscles, unstable balance, dizziness, vision problems, and side effects from medications (such as dizziness and confusion).

How can I tell if I am at risk for falling?
The most important predictors of fall risk include: muscle weakness (difficulty rising from a sitting position without use of hands to push off); unsteady balance (needing to walk slowly or with a wide base of support to maintain balance); having fallen in the past year; and taking certain medications (some blood pressure medications as well as psychoactive medications, such as sedatives or anti-depressants).

Many people experience increasing difficulty with balance and safe mobility as they age, which leads to the common and serious problem of falls. These problems are associated with loss of confidence and decreasing ability to function independently and can lead to the consideration of institutional care. Falls are also a major cause of death in the older population. Fortunately, most causes of falls and instability can be treated successfully, with improved mobility, and fall risk reduced.

Drug Treatment

Drugs

Any heart and blood pressure problems should be managed appropriately for the specific condition. Acute attacks of vertigo from a viral inner ear infection can be treated with drugs used for motion sickness, eg, meclizine. If symptoms last more than several days, meclizine should be discontinued, and the older adult should revisit their healthcare provider. Any of the medications used for this purpose may cause sleepiness or confusion and are not recommended for long-term use. Mild sedatives can also be used in older adults hospitalized for acute episodes of vertigo. Drug treatment with antidepressants or pain relievers may be needed to treat underlying problems.

Remember this!

It is important to remember that dizziness may have two or more possible causes, each contributing to symptoms. These can include depression or anxiety, vision or hearing loss, the use of multiple medications, balance or walking problems, orthostatic hypotension, diabetes, and heart disease. In these cases, all possible causes need to be evaluated and addressed (either together or one after another) to reduce the frequency or severity of dizziness.

Dizziness

Treatment and Management

The prognosis for most cases of dizziness is good, often with no treatment. In up to 50% of cases, dizziness goes away on its own or improves substantially within about 2 weeks. For example, many common causes of vertigo (eg, inner ear inflammation or BPV) typically resolve within days or weeks.

If BPV is disabling, comes back frequently, or just hangs on too long, it is important to know that there is safe and effective treatment. Because BPV is caused by crystals floating freely in the inner ear, those crystals can be coaxed to land and stay put using head positioning. Generally, this is done by an audiologist, although some primary healthcare providers may do this as well. One treatment is usually sufficient.

Orthostatic hypotension may occur because the older adult is taking medications that affect blood pressure, and these will need to be adjusted or discontinued. Other people have disorders of blood pressure control that cause orthostasis, and they may need medicine to increase blood pressure, to increase blood return to the heart (eg, specially-fit support stockings).

If symptoms occur with position change and there is little or no drop in blood pressure, people can be reassured that it isn’t something more serious, and they can usually learn to make position changes more slowly.

Unsteadiness while walking (eg, related to vision problems, arthritis, etc) usually improves immediately when the person holds onto the arm of and walks with a companion. These people can be greatly helped by using a properly fit cane (see Canes in Chapter on Rehabilition). Also, physical therapy for strengthening and balance will reduce symptoms of unsteadiness. Treatments for this type of unsteadiness may include proper glasses or hearing aids. Keeping the lights on at night can also help unsteadiness and help prevent falls. If unsteadiness is caused by arthritis or other problems that make moving difficult, treatment for pain is needed (see Pain Management).

In some older adults with severe episodes of vertigo with vomiting, a short hospital stay may be needed to replace lost fluids. This is most likely to occur in Ménière’s disease. Once the vomiting has stopped, recurrence of Ménière’s can usually be prevented with a very low-sodium diet. Usually, counseling from a dietician is necessary to learn how to maintain such a diet. Surgery is reserved for only the most severe cases of Ménière’s disease, because it involves destruction of the nerve of hearing on the affected side.

Dizziness Diagnosis

Diagnosis and Evaluation

A detailed history is the most useful part of the evaluation. The information you provide is critical in helping your healthcare provider determine the cause of the dizziness. You should make sure to give your healthcare provider the following information:

Is the dizziness characterized by sensations of spinning, fainting, unsteadiness, or lightheadedness?
Is the dizziness related to different body positions?
Do you have other symptoms (eg, nausea, vomiting, fainting, fatigue, depression, or ringing in the ears, etc) along with the dizziness?
Is the problem most likely to occur after a meal, with coughing, urinating, while turning over in bed, or with other specific activities? How often does it happen?
What medications are you taking? A "brown-bag" inventory (see Health Assessment) can help make sure that all drugs are accounted for, including over-the-counter preparations.
The physical examination will include multiple blood pressure measurements in both arms, while you are lying down, standing, and sitting. An electrocardiogram and other testing (eg, stress test) may be recommended to evaluate your heart. Your healthcare provider may also want to perform some tests that involve putting your head and body in various positions. This can help identify signs of inner ear problems (eg, if characteristic eye movements are brought on) or BPV (if symptoms are reproduced).

More than 75% of cases of dizziness can be diagnosed by history and physical examination. However, depending on the results of the history and physical, your healthcare provider may recommend other tests, such as an MRI, CAT scan, inner ear tests, etc.

Lightheadedness

Lightheadedness

Some people who complain of dizziness actually feel lightheaded. Although lightheadedness may occasionally be used to describe other types of dizziness, it is most often used as a vague description for symptoms that do not fit vertigo or near fainting. Many people use lightheadedness or unsteadiness to mean the same thing. Feelings of lightheadedness may be associated with psychological or mood disorders, such as depression or anxiety. Often, no cause can be found.

Near fainting

Some people who complain of dizziness feel like they are going to faint. This problem is usually due to a lack of blood flow to the brain. The most common cause is "orthostatic hypotension," in which blood pressure drops when someone stands up from a bed or chair (see also Fainting). Near-fainting spells can also be caused by the straining associated with coughing or going to the bathroom. An older person who gets up to urinate in the middle of the night, who strains to have a bowel movement, or who has a respiratory problem may experience near fainting, or even fainting. Probably the most serious causes of near-fainting spells are heart problems, including narrowed heart valves and problems with heart rhythm.

Unsteadiness

Some people who complain of dizziness actually feel unsteady when standing and especially when walking. The medical term for this is "disequilibrium." It can be caused by anything that leads to unsteadiness or lack of balance, including poor vision, middle ear problems, arthritis, and foot problems. An older person with more than one of these problems is much more likely to experience disequilibrium. It can also be caused by problems with the nervous system, such as those often seen after a stroke. Unsteadiness is associated with difficulty walking and with falls.

Veritgo

Vertigo is dizziness accompanied by a sensation of spinning. The most common causes of vertigo are middle or inner ear problems. Benign positional vertigo (BPV) involves the middle ear. Spells of BPV are brought on by changes in head position, such as from turning, rolling over, lying down, sitting up, or bending over. These spells often last only 5—15 seconds, and they are milder than attacks of vertigo seen with conditions of the inner ear. Generally, BPV gets better on its own, but it can come back. In some people, it is long lasting and disabling and warrants prompt attention and treatment.

Most vertigo associated with the inner ear happens suddenly, lasts for several days, and then goes away on its own. These episodes may be caused by viral infections or inflammation of the nerves in the inner ear. In this condition, the eyes may "swing" rhythmically and quickly back and forth (left to right or right to left), which is called nystagmus. People may also have difficulty walking, nausea, or vomiting. Usually, hearing is not affected, and there are no other problems with the nervous system.

One particularly severe type of inner ear problem is called Ménière’s disease. In this disease, there are repeated episodes of severe vertigo, nausea, and vomiting. Between episodes, there is often mild dizziness and ringing in the ears. Ménière’s disease can worsen over time, leading to deafness and, sometimes, problems with balance and walking.

Diseases of the brain, such as stroke, brain tumors, multiple sclerosis, or blood vessel problems, can occasionally cause vertigo. These disorders are more commonly accompanied by other neurologic problems, such as weakness or inability to move an arm or a leg, difficulty walking, or vision problems such as double vision.

Types of Dizziness

People often use "dizziness" to describe faintness, lightheadedness, or poor balance. Blurred vision, double vision, and changes in blood pressure may also be interpreted as dizziness. Dizziness is classified into several distinct types based on symptoms:

Vertigo
Unsteadiness
Near fainting
Lightheadedness
These different types have different causes and different treatments.

Quality of Life

Dizziness describes a variety of unpleasant sensations that often interfere with balance and walking. It is a common complaint of people over age 65, affecting 13%—38% of older Americans. Dizziness can have many different causes that can be difficult to diagnose.

Dizziness doesn’t usually last long, but in about one-quarter of older adults with this problem, it can last a year or more. It is not usually associated with increased risk of death, unless it is a sign of heart disease. However, dizziness can increase the risk of falling and decrease quality of life, especially if it is persistent or severe.

VEDA- what it does...

Vestibular (inner ear) disorders can cause dizziness, vertigo, imbalance, hearing changes, nausea, fatigue, anxiety, difficulty concentrating, and other symptoms, with potentially devastating effects on a person's day-to-day functioning, ability to work, relationships with family and friends, and quality of life.
Diagnosing and treating vestibular disorders is not always straightforward. In addition, such disorders are often "invisible," making it difficult for others to understand how disabling they can be.
The Vestibular Disorders Association (VEDA) is a non-profit organization that serves people with vestibular disorders and the health professionals who treat them.
VEDA provides information, resources, support, and advocacy. We strive to elevate public awareness about vestibular disorders in order to promote understanding, access to diagnosis and treatment, research, and help for those facing the challenges of living with a vestibular disorder.

Pediatric Vestibular Disorders

Vestibular disorders in children are generally considered uncommon. They are not as easily recognized as vestibular disorders in adults, in part because children cannot describe their symptoms as well. Symptoms and signs that may indicate vestibular dysfunction in children include developmental and reflex delays, visual-spatial problems, hearing loss, tinnitus, motion sensitivity, abnormal movement patterns, clumsiness, decreased eye-hand and eye-foot coordination, ataxia, falls, nystagmus, seizures, dizziness, nausea, ear pressure, difficulty moving in the dark, behavioral changes, and/or delays in performance of developmental activities such as riding a bicycle, hopping, and stair climbing involving alternating left-right leg movements. Possible causes include head-neck trauma, chronic ear infections, maternal drug or alcohol abuse during pregnancy, cytomegalovirus, immune-deficiency disorders, migraine with or without headache, meningitis, metabolic disorders (e.g., diabetes), ototoxic medications, neurological disorders (e.g., cerebral palsy, hydrocephalus), genetic syndromes (e.g., branchio-otorenal syndrome, Mondini dysplasia, Wallenberg syndrome), posterior brain tumors (e.g., malignant medullo-blastomas or the less frequently seen benign acoustic neuromas), and a family history of vertigo, motion sensitivity, hearing loss, or vestibular disorders. Dizziness can be the first symptom of depression in a teenager. Alcohol intoxication can produce dizziness, imbalance, staggering, and abnormal eye movements. Children may also develop a vestibular disorder for no known reason. The underlying reasons often cannot be determined even with the most aggressive testing. This does not preclude successful treatment or recovery. Children can experience the same vestibular disorders as adults. Benign paroxysmal positional vertigo (BPPV) in children is typically associated with physical trauma and can result from accidents, falls, or sports injuries. Infrequently, BPPV has also been observed following cochlear implantation. Vestibular neuritis or labyrinthitis occurs in children, as well as ototoxicity. Children that experience ototoxicity can have severe imbalance, falls, and visual-motor problems, including oscillopsia (bouncing vision). Less common in children is Meniere's disease, enlarged vestibular aqueduct, perilymph fistula, autoimmune disease, and vascular insufficiencies. In addition to all the vestibular disorders that adults are subject to, children have two of their own. Childhood paroxysmal vertigo, often referred to as migraine equivalent, is typically seen in children 2–12 years old and is characterized by true spinning vertigo, nystagmus, nausea, and vomiting. Children tend to “grow out of” this condition, but it may progress into benign positional vertigo or migraine-associated vertigo in adulthood. Paroxysmal torticollis of infancy consists of head-tilt spells that may be associated with nausea, vomiting, pallor, agitation, and ataxia. Evaluation and treatment: Age-specific techniques are used for assessment and treatment of vestibular dysfunction in children. A diagnostic work-up might include a history and physical exam, a hearing test, and possibly brain scans to rule out other pathologies. In addition, a vestibular therapist can help evaluate the child's ability to use the vestibular system for balance and visual-motor control, as well as test the child's developmental reflexes that have control mechanisms in the vestibular system. Using these results, the therapist develops vestibular-therapy exercises, which are tailored to the individual child. Children with vestibular disorders can respond well to such intervention. In fact, children typically respond more quickly than adults, because of their greater plasticity—the ability of their neurological systems to more quickly compensate for and adapt to vestibular deficits. In addition, children tend to be less fearful of movement than adults, so they participate well in the balance and movement aspects of therapy. Vestibular therapy can be effective for reducing or eliminating vertigo, improving visual-motor control, improving balance and coordination, and promoting normal development in children with vestibular disorders.