Medical Conditions Related to Brain Injury
Dizziness in Brain Injury
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Dizziness after a head injury (acquired or traumatic) is not uncommon. People with head injury may experience dizziness immediately upon waking up, during the rehabilitation process, or after they have returned home. Symptoms may cause them to feel “lightheaded”, “I’m losing my balance”, “the world is spinning”, or “I’m being pushed off balance.” In addition, they may have nausea and/or vomiting when the dizziness occurs.
If the person with a head injury can verbalize these symptoms while still in the hospital or rehabilitation unit, the doctor should be informed so the problem can be addressed. If the person is in an outpatient setting, the physical therapist or occupational therapist may be able to direct the person to someone who can find the cause of the dizziness and determine what, if anything, can be done for it.
If the person is at home and starts complaining of dizziness, he or she should see the treating physician. It may be helpful to write down when the dizziness occurs, how long it lasts, and what, if anything, helps minimize the problem. This will aid the doctor in determining the next course of action.
There are many reasons dizziness occurs. Sometimes, the actual impact of the head injury affects the part of the brain regulating inner ear activity, causing the brain to have difficulty interpreting the incoming information. If the information is processed incorrectly, dizziness can result. It is also possible that an actual problem in the vestibular system (what we know as the inner ear) exists because of direct damage caused by the impact during the accident. Dizziness can also be caused by medication side effects or changes in blood pressure that occur when changing positions from lying down to sitting up, or sitting to standing.
If the doctor feels the dizziness is related to an inner ear problem or that the actual impact of the head injury has affected a part of the brain that regulates inner ear activity, then he or she will likely refer the person with head injury to an ENT or Otoneurologist for further work-up. An ENT is a physician specializing in Ear, Nose, and Throat problems; an Otoneurologist is a physician specializing in ear problems only. ENT physicians may be more accessible to people in more rural areas. If needed, the ENT or Otoneurologist may perform tests in a clinic to determine what the problem is and what the best course of treatment may be.
For some patients, medication or medication changes will eliminate or reduce the dizziness. Others may need Vestibular Therapy. This is a type of exercise treatment generally performed by an Occupational or Physical Therapist. Vestibular therapy focuses on what movements trigger the dizziness, then finds ways to help the brain compensate for the problem through exercise and movement. Nausea, often caused by dizziness, may also be reduced with the therapy.
In many cases, changes in or additions to medications and/or Vestibular Therapy may decrease or completely resolve the symptoms. Unfortunately, in some cases, if the dizziness is a by-product of damage incurred by the brain injury, there is no successful treatment. In that event, the person may have to learn to live and deal with the dizziness. Still, before accepting that outcome, it is important to explore all avenues of treatment and to feel confident that everything possible has been done to address the problem.
To find out more information about dizziness related to the inner ear, as well as doctors and therapists in your area who provide these evaluations and treatments, contact the Vestibular Disorders Association at. www.vestibular.org
Another website offering information on therapists in your area who can provide vestibular therapy is www.onbalanceandmobility.com
Sary H. Korrick PT is the Physical Therapy Clinical Education Supervisor at Shepherd Pathways, a post-acute facility specializing in brain injury in Decatur, Georgia. Ms. Korrick is a 1981 graduate of the Ithaca College Physical Therapy program. She has worked at Shepherd Pathways since it began 5 years ago. She has completed a competency course in Vestibular Therapy.
www.shepherd.org
www.vestibular.org
www.onbalanceandmobility.com