Wednesday, June 9, 2010

Dizziness, Vertigo and Balance Problems

Dizziness, vertigo and balance problems account for up to 10% of all physician visits. Dizziness is the number one reason for physician visits in people over age 65 and will affect 50% of all adults at one time or another. In 2005, the estimated cost for medical treatment of dizziness and balance disorders exceeded 1 billion dollars. These conditions can range from a mild annoyance to a life altering experience.

Good balance and stability are dependent on input from these three systems:

1) Vestibular System- Canals and Otoliths

2) Visual System

3) Proprioceptive System (especially from the cervical spine) – a complex network of nerves in skin, muscles, joints, tendons and ligaments that send important sensory information to your brain regarding your body’s position in space.

Input from all three systems is processed and calibrated in your cerebellum. Located in the back part of your brain, the cerebellum is responsible for all balance and coordinated movement. Deficits in any one of these three areas, often times can be compensated for, if you have good cerebellar function.

Traditional management of dizziness and balance problems focuses almost entirely on the canals. A patient might be prescribed antivert or meclizine. Some patients are diagnosed with Benign Paroxysmal Positional Vertigo (BPPV) and may have a doctor or physical therapist perform something called Epley’s Maneuver (a canal repositioning technique). Unfortunately, if either of these two things doesn’t work, a person is often told they will have to live with it.

If you are still suffering from dizziness, vertigo or other balance problems and it is not a hard lesion (tumor etc), you either have a peripheral problem which hasn’t been addressed or a bad cerebellum. Any balance recovery program should involve cerebellar rehabilitation as a central component. The cerebellum is like a top and as it slows down we start to wobble a little bit more. There are specific activities or therapies we can use to help activate or stimulate the cerebellum to increase its firing rate.

The cerebellum is also one of the most metabolically sensitive tissues in the body. It is very susceptible to changes in fuel supply (oxygen and glucose) and toxins (ex ethanol). Unfortunately, as we age, our body’s ability to utilize oxygen decreases by about 1%/year after the age of 20. By combining supplemental oxygen with exercise and cerebellar rehabilitation we can help our patients get better faster.

A thorough functional evaluation can determine which area(s) of the brain and nervous system are involved in a person’s problem. Once these areas are identified, they can be addressed to through specific neurologically based therapies. By handling any metabolic factors (blood sugar, anemia’s. inflammation, allergies/food sensitivities etc) that are contributing to your problem or preventing you from getting better, we can greatly improve our outcomes

To determine whether you are a candidate fro Dr. Diehl’s Balance Recovery Program, please call our office at (814)238-0232.