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Dizziness and vertigo are some of the most common symptoms in post concussion syndrome, or after someone has had a brain injury. The injury to the brain causes a disruption of how the brain is processing information about the environment, and how the brain understands the body’s position within the environment.
First let’s break down the difference between dizziness and vertigo.
Dizziness is defined as including things like feeling woozy, lightheaded or disoriented.
Vertigo is when you feel as though you or the room is spinning.
First it’s important to understand that the brain uses information from three areas to maintain balance.
Vestibular System (inner ear)
Proprioception (awareness of body position)
Problems can arise in each of these areas.
Benign paroxysmal positional vertigo or BPPV. This is a disorder arising from a problem with the inner ear where the crystals (small calcified otolith) have come loose and is disrupting the normal inner ear function. Testing for this includes the Dix-Hallpike test, and it is treated with the Epley maneuver, and with treatment it should resolve within several days to a week. Self Screen: The vertigo is triggered by movement and different positions of the head, which cause the crystals in the ear to change position. Seek treatment with an evidence based chiropractor or physiotherapist with special training.
Central Vestibular Disorder. This is diagnosed when the peripheral vestibular system (inner ear and crystals) is determined to be ok. This means the problem with integrating sensory information is higher up the chain. Very often a Central Vestibular Disorder has large visual and proprioceptive or cervicogenic (neck) components.
The neck is one of the main areas that can be damaged during a concussion or head injury. If the brain is getting mis-information about the body through the neck, it can cause a lot of dizziness and other symptoms such as headaches and fogginess. Self Screen: Sit in a swivel chair and look at a target across the room. Preferably the Pattern Glare test (linked). Keeping the head still (reduces vestibular input), swivel all the way to one side and the other in the chair. If symptoms are worse in either direction than straight ahead, or if there is any change with position the neck is likely involved. An evidence based chiropractor or physiotherapist with special training can help to diagnose and treat neck and muscle problems post-concussion.
Post Trauma Vision Syndrome is one of the most common diagnoses in concussions or head injury that is not healing on it’s own. Over 90% of brain injury patients were found to have problems with eye movement. This can include problems with visual-vestibular integration (how vision and the inner ear integrate), problems with how the eyes track or work together and more. Symptoms are often provoked with visual stimulus such as:
Busy visual environments like the grocery store
Reading and concentrating
Any other activity involving visual demand..
These post-concussion vision problems can cause:
Self Screen:Use the pattern glare test found in our self screener (link) to see if the visual stimulus provokes any symptoms. Or have someone you know do the VOMS test with you. If your symptoms are provoked, book an appointment with a developmental or neurological optometrist (neuro-optometrist) who can test and diagnose any vision problems that were caused by the concussion or head injury.
Vision is often the least understood cause of dizziness after head injury and most vision examinations only check clarity and eye health. For this reason, it’s often common for these problems to be missed or mis-diagnosed as a post-concussion vestibular disorder.
Most cases of post concussion dizziness that have not gotten better in the usual 2-3 weeks have vision problems that can be addressed, allowing for a person to properly recover and regain their quality of life.
Since 2012 we have been treating post concussion dizziness that is caused by vision problems for people from Nanaimo and all over Vancouver Island. We have state of the art and have develop proprietary testing and treatment procedures that allow us to provide a satisfaction guarantee on our discussed treatment outcomes.
After years of people having to travel to Victoria, we are excited to be able to serve the people of Nanaimo and Vancouver Island out of our Nanaimo location.