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Diagnosis & Treatment

Diagnostic Tests for Vestibular Problems

Descriptions and explanations of the purpose of various tests, including ENG (electro- videonystagmography), rotation tests, computerized dynamic posturography (CDP), audiometry, and scans (MRI, CT).

Trouble Getting a Diagnosis?

A list of reasons why many people with dizziness, imbalance, or vertigo have trouble obtaining a diagnosis, along with suggestions for speeding up the diagnostic process.

Vestibular Rehabilitation Therapy—An Effective, Evidence-Based Treatment

Describes the specialized form of exercise-based therapy designed to alleviate both primary and secondary symptoms of vestibular disorders. Includes descriptions of assessments of vertigo and dizziness, eye movements, balance and gait, and the musculoskeletal system, as well as treatment using vestibular habituation, gaze stabilization, and balance training exercises.  (Click here for a condensed version of the VRT article that may be more appropriate for printing.)

Surgery for Peripheral Vestibular Disorders

Descriptions of surgical procedures used to repair or stabilize vestibular organs damaged by disease or injury. Procedures discussed include vestibular neurectomy, labyrinthectomy, transtympanic or intratympanic gentamicin treatment, endolymphatic sac decompression, oval or round window plugging, canal partitioning, PE tubes, and stapedectomy.

Pharmacologic Treatments for Vestibular Disorders

There are five basic treatment options for vestibular disorders: repositioning manuevers, vestibular rehabilitation exercises, surgery, medication, and psychotherapeutic measures. This paper looks in detail at pharmacological treatments for different types of vestibular disorders used to treat the cause of the disease, control symptoms, accelerate central compensation, and diminish psychological comorbidity.

Chiropractic for the Treatment of Vestibular Disorders

There are a lot of people who may think a chiropractor will automatically “snap the neck” of every patient they see, including patients suffering from dizziness. Spinal manipulation, whether performed by a chiropractor, medical doctor, osteopath or physiotherapist may or may not be an appropriate intervention for a patient. There are particular cases where spinal manipulation should be avoided and these “absolute contraindications” and “red flag symptoms” are well known. Chiropractors, like other health professionals, are trained to select the most appropriate treatment for a patient, and may use alternative types of manual therapy when spinal manipulation is not indicated.

Common Misconceptions About ENG

Electronystagmography (ENG) has been the cornerstone of vestibular testing for more than fifty years. Yet there is some confusion about the extent and limitations of the information that can be obtained from an ENG examination. ENG refers to a battery of tests that examine specific aspects of the vestibular system. This battery consists of oculomotor tests, positioning and positional tests, and the caloric test. This document discusses these tests and their role in planning a vestibular rehabilitation program.


 

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