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Vertigo and Dizziness: Getting to the Root Cause

The feeling of dizziness and/or vertigo can come on suddenly and in many cases be debilitating. For many patients, the onset of symptoms can be memorable and scary. Dizziness is an umbrella term that can be hard to describe. Patients will explain it is unsteady, off balance, lightheaded, or “I just don’t feel right.”

Vertigo is a descriptive term used when the patient or the world around them is spinning in circles. The vestibular system is a complex and intricate system that can create symptoms far beyond just dizziness and vertigo. When symptoms go unresolved, patients are left feeling anxious, worried, and lost. Below we discuss the complexity of vestibular dysfunctions and how functional neurological treatment is an essential part of recovery.

Vertigo and dizziness: Getting to the Root Cause

Dizziness and/or vertigo can occur for various reasons that range from mild to severe. When life threatening conditions are ruled out, it is time to dig deeper into the underlying causes of these discomforts. Getting to the root cause is essential for a full and speedy recovery. At Carolina Functional Neurology Center we often see patients with dizziness/vertigo that fall under the following categories:

  1. Peripheral Vestibular Disorders

The most common cause of vertigo is known as benign paroxysmal positional vertigo (BPPV). This causes sudden vertigo when moving the head in specific positions, often seen when lying back in bed or tipping the head back in the shower. Patients may experience nausea and vomiting due to the perceived increase in motion. Other types of peripheral vestibular disorders include: vestibular neuritis, Meniere’s disease, and acoustic neuroma.

  1. Central Vestibular Disorders

Central Vestibular disorders are often seen after a traumatic brain injury (TBI), concussion (mTBI), chronic/unresolved peripheral vertigo, and with other central nervous system disorders (ie. multiple sclerosis, cerebellar atrophy). Central vestibular disorders can present similarly to peripheral vestibular disorders or can look very different. Patients may complain of lightheadedness, feeling like they are on a boat or swinging on a bridge, feeling off balance, uncoordinated, bobbing up and down, nausea, vomiting, car sickness, slurred speech, headaches and more. Central vestibular disorders usually present with dysfunction in the brainstem or cerebellum.

  1. Autonomic Dysfunction

The autonomic nervous system (ANS) plays a vital role for the proper function of every aspect of the brain and body. The ANS controls all of the “autonomic” things our brain does for us everyday; such as heart rate, blood pressure, sleep/wake cycle, digestion, breathing, proper blood flow, and reproductive health. Patients with dysfunctions in this system can experience feelings of dizziness, lightheadedness, and vertigo. This is why it is an important area to examine when a patient presents with these symptoms.

  1. Metabolic Conditions

Dizziness and vertigo can be symptoms of other underlying chronic conditions. We have seen patients experience feelings of dizziness and vertigo associated with anemias, dysglycemia (poor blood sugar regulation), thyroid disorders, celiacs disease, gluten sensitivities, medication induced and more.

  1. Higher Vestibular Disorders

The vestibular system is a complex and intricate system that has integration all the way up into higher cognitive aspects of the human brain. What this means is the vestibular system plays a role in the interpretation of where we are in space and where space is in relation to us. It helps to create a sense of “self” and align us properly with the world around us. Patients suffering from vestibular dysfunction may experience dizziness and vertigo but they can also present with anxiety, depression, loss of sense of self, memory loss, difficulty finding words, visual disturbances (ie. changes in visual field), and sensory disturbances (ie. numbness/tingling).

Our Treatment Approach

Proper diagnosis is crucial in uncovering where within the vestibular system the dysfunction is located. As seen above, the vestibular system is very complex and patients can present in varying ways. A comprehensive examination of all possible areas is key for proper diagnosis.

At CFNC we use a multitude of diagnostic and examination tools to peer into the functionality of the peripheral, central, autonomic, metabolic, and higher cognitive components of the vestibular system. When we can pinpoint the areas of dysfunction for an individual patient we can then begin formulating a customized treatment plan that suits each individual patient’s needs.

Treatment is not about the specific therapy that treats the specific condition, it is about exercises and activating the areas of the brain that need to be improved upon. Therapy may include neurological rehab such as eye movement therapies, somatosensory exercises, light/sound therapy, peripheral nerve stimulation, tilt table therapy, limbic retraining exercises, memory and high cognitive tasks, and hyperbaric oxygen therapy. It may also include functional medicine treatment in the form of supplementation and dietary changes.

When I came to CFNC, I was barely able to look down at the floor or turn my head all the way to either side without feeling like I was going to pass out. When I changed positions or stood up from a reclined position or laying flat everything would start spinning and begin to go black and I would pass out cold. Dr. Brindisi discovered that my heart rate was spiking 40 points when I was getting up, At the same time, my blood pressure was crashing. She also uncovered several problems with how my eyes were reacting to visual stimulation and worked to resolve those problems as well. Within one week, I felt significantly better. My headaches are entirely gone and I rarely feel dizzy or nauseous anymore. We have re-trained my eyes to function properly. I can not praise Dr. Brindisi highly enough. This was the most miserable time I had ever experienced physically. No other doctor was even looking at my symptoms from this perspective or testing to identify the underlying problems. I was given medications and told to rest. I would still be suffering with no hope of relief if not for CFNC. – Kevin, Carolina Functional Neurology Center Patient

If you have specific questions regarding yourself or a loved one, we strongly encourage a consultation with either our Raleigh or Charlotte locations to discuss your specific symptoms and needs.


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