Hearing Care is Health Care

 

Vertigo: the perception of movement or whirling – either of the self or surrounding objects.

Dizziness: a sensation of lightheadedness, faintness, or unsteadiness. Dizziness does not involve a rotational component.

 

Vertigo

Our Doctor of Audiology is the only Audiologist in Windsor-Essex performing balance assessments and offering rehabilitation services for vertigo, imbalance and falls-risk.  Bernice McKenzie has years of experience helping patients with dizziness.  She has teamed up with an in-house occupational therapist to collaborate to provide you or your loved one with a full vestibular diagnostic test battery and rehabilitation.

Do You Have Symptoms Of A Vestibular Disorder?

Our vestibular system is located in our inner ear and connected to the brain to help keep us oriented in space. Vestibular dysfunction can be brought upon by injury, age or disease. Symptoms that you may have a vestibular disorder include:

 Vertigo and/or dizziness, Imbalance, Vision or Hearing changes

Each person affected by a vestibular disorder is affected differently. Not all people with an inner ear disorder will experience the same symptoms. Symptoms may be severe to mild and be difficult to describe. They may come and go or may be constant. And these symptoms are not always caused by an inner ear vestibular disorder.

 Vertigo and/or Dizziness

  • A feeling that you are moving or that things around you are moving, when we know they are stationary (vertigo)
  • A feeling that you are floating or rocking or a light-headed feeling (dizziness)
  • Lateropulsion or a feeling of your body pulling to a particular side
  • Nausea, motion sickness or headaches

 Imbalance

  • Poor coordination, including stumbling or trouble walking a straight line, stumbling
  • Poor posture
  • Needing additional support for movement i.e. holding the wall or using a cane or walker for mobility
  • Difficulty in crowds or open spaces

Vision or Hearing Changed

  • Poor depth perception, light sensitivity, double vision, trouble focussing or following objects with your eyes
  • Poor, distorted or fluctuating hearing which may be associated with tinnitus (ringing or buzzing in the ears)
  • Sensitivity to loud noises
  • Difficulty hearing in background noise
  • Difficulty following speakers in conversations, meetings, etc., especially when there is background noise or movement

How Can We Help?

Ruling out a vestibular disorder requires a series of complex and specialized tests.  The vestibular test battery takes 2-3 hours with our Doctor of Audiology to complete.  Below is a summary of the tests we perform, however, if you all any questions, please feel free to contact us at any time.

The first piece of the puzzle of a vestibular disorder is a very thorough vestibular case history and questionnaires which allow our Doctors of Audiology to gain valuable information about your symptoms. These documents help us to gain insight to your concerns and the ways that they affect you and your quality of life.

Secondly, we perform a hearing test. This test not only reveals the status of your hearing and may  provide insight to your vestibular concerns.

Next we perform the Dix-Hallpike and Sensory Organizational Testing to check for involuntary eye movements due to specific changes in positioning. This test helps us determine if your vertigo is central or peripheral (i.e. in the brain or inner ear) and if peripheral, which ear is involved.

The next piece of the puzzle is a VNG, a Videonystagmography test. This test is used to determine whether your vestibular symptoms are caused by your inner ear. A VNG records, analyzes and reports your involuntary eye movements through the use of video goggles worn while you look or lie in different positions. There are four parts to this test: Saccade test – evaluates eye movements, Tracking test – evaluates your eye movements as you follow a moving target, Positional test – measures dizziness as associated with moving your head, Caloric test – measures the responses to warm and cold air in your ear canal.

The tests are then interpreted by our Doctor of Audiology and explained to you. She will  provide you with her recommendations, if any.  She is more than happy to collaborate with your Physician and a detailed report can be sent to your Family Physician for your records.

 

Vestibular Rehabilitation Therapy (VRT)

68 year old Kyle Harrison was once so afraid of falling that he stopped driving and golfing with his friends. Kyle’s falls were the result of balance issues which began after a trip to Florida. His audiologist recommended vestibular rehabilitation therapy which uses specialized exercises under the guidance of a physiotherapist to improve gaze and stabilization during walking.

What is Vestibular Rehabilitation Therapy?

Vestibular Rehabilitation Therapy (VRT) is a program designed to promote central nervous system compensation for inner ear deficits.    Vestibular lesions can be extremely debilitating by producing symptoms such as dizziness, vertigo, postural instability and gait disturbances which may result in a fall. VRT can help with a variety of vestibular problems.  VRT takes a look at all the aspects of balance – it looks at the vision aspect, the vestibular aspect (inner ear) and the sensory aspect. It is important to note, VRT does not actually involve a regeneration or treatment of the damaged vestibular organ itself. Instead, VRT works by allowing the brain and the central nervous system to adapt to opposing feedback coming from the vestibular mechanisms.

Why is VRT Needed?

Disease or injury can damage the vestibular organs resulting in the brain not being able to obtain accurate information about balance and motion, which can relate to symptoms of dizziness, imbalance, vertigo, double vision, and other symptoms.  For many people their brain can adapt (a process called vestibular compensation) and they are able to recover from these symptoms on their own.  Sometimes the vestibular compensation process is not successful.  The big red flag for somebody that needs some vestibular therapy is someone that is falling, or experiencing spinning or dizziness or feels like there are objects that are moving that aren’t really moving around them.

The goal of VRT is to retrain the brain to recognize and process signals from the vestibular system in coordination with vision (eyes) and proprioception (muscles and joints). 

What Happens During VRT

Our qualified Occupational Therapist (OT) will perform a thorough evaluation by observing and measuring posture, balance and gait, and compensatory strategies. The assessment also includes head/eye coordination tests (with or without head movement).  The  OT will also use other assessment tools such as lifestyle and symptom questionnaires.

Using the evaluation results, the therapist will develop an individualized treatment plan that includes specific head, body, and eye exercises to be performed both in the therapy setting and at home. These exercises are designed to retrain the brain to recognize and process signals from the vestibular system and coordinate them with information from vision and proprioception.