DIZZINESS & NEUROLOGICAL
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Vertigo is the sensation that you or your surroundings are spinning or moving when no actual movement is occurring. It is commonly associated with inner ear conditions such as benign paroxysmal positional vertigo (BPPV) and may be accompanied by nausea, balance difficulties, and motion sensitivity. Accurate assessment is important to identify the underlying cause and determine the most appropriate management approach (Bhattacharyya et al., 2017).
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BPPV is one of the most common causes of vertigo and occurs when small crystals within the inner ear become displaced. Symptoms are often triggered by changes in head position such as rolling in bed, looking up, or bending over. Research supports repositioning manoeuvres as an effective treatment for many cases of BPPV (Bhattacharyya et al., 2017).
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The vestibular system helps regulate balance, spatial awareness, and eye movements. Dysfunction within this system can result in dizziness, imbalance, motion sensitivity, and difficulty performing daily activities. Vestibular rehabilitation has been shown to improve symptoms and functional outcomes for many vestibular conditions (Hall et al., 2016).
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Persistent dizziness can occur following illness, injury, vestibular dysfunction, concussion, or periods of prolonged inactivity. Symptoms may include unsteadiness, light-headedness, motion sensitivity, and difficulty tolerating busy environments. A comprehensive assessment can help identify contributing factors and guide rehabilitation.
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Cervicogenic dizziness is a form of dizziness associated with neck dysfunction. Symptoms may include feelings of imbalance, unsteadiness, neck pain, and difficulty with head movements. Assessment is important to differentiate cervicogenic dizziness from vestibular or neurological conditions and guide appropriate treatment (Reid & Rivett, 2011).
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Vestibular migraine is a common cause of recurrent dizziness and vertigo and may occur with or without headache symptoms. Individuals may experience episodes of dizziness, motion sensitivity, balance problems, visual disturbances, and migraine-related symptoms. Management often involves a combination of medical management, education, lifestyle modifications, and rehabilitation strategies (Lempert et al., 2022).
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Exercise-induced headaches can occur during or following physical activity and may be associated with exertion, dehydration, fatigue, neck dysfunction, or underlying headache disorders. A comprehensive assessment can help determine contributing factors and guide appropriate management.
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Balance problems may develop due to vestibular dysfunction, neurological conditions, concussion, ageing, or reduced physical activity. Symptoms often include unsteadiness, fear of falling, and reduced confidence with movement. Rehabilitation commonly focuses on improving balance, coordination, strength, and movement confidence (Hall et al., 2016).
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Some individuals continue to experience symptoms weeks or months following a concussion. Common symptoms include headaches, dizziness, fatigue, balance difficulties, reduced exercise tolerance, and difficulty concentrating. Research supports active rehabilitation approaches that address vestibular, cervical, and exercise-related impairments following concussion (Leddy et al., 2018).
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Functional neurological disorders (FND) involve genuine neurological symptoms that occur due to changes in how the nervous system functions rather than structural damage. Symptoms may include dizziness, balance problems, altered movement patterns, weakness, and sensory disturbances. Modern rehabilitation approaches focus on improving movement, confidence, and nervous system function through individualised care (Nielsen et al., 2020).
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POTS is a condition affecting the autonomic nervous system, often resulting in dizziness, light-headedness, fatigue, exercise intolerance, rapid heart rate, and difficulty standing for prolonged periods. Research supports graded exercise therapy, autonomic rehabilitation, education, and lifestyle strategies as important components of management for many individuals with POTS (Raj et al., 2022).
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With Aura
Migraines with aura involve temporary neurological symptoms that typically occur before or during a migraine attack. These symptoms may include visual disturbances such as flashing lights, blind spots, or zigzag patterns, as well as sensory changes, speech difficulties, or other neurological symptoms. Aura symptoms usually develop gradually and resolve within an hour. Research suggests that migraines with aura affect a subset of people with migraine and may have different clinical characteristics compared to migraines without aura (Steiner et al., 2020).
Migraines are complex neurological conditions that can involve severe headaches, nausea, dizziness, light sensitivity, sound sensitivity, and visual disturbances. Research suggests that migraines affect approximately 15% of the population and can significantly impact quality of life (Steiner et al., 2020). While migraines do not originate from the neck, addressing musculoskeletal contributors may form part of a comprehensive management approach.
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Without Aura
Migraines without aura are the most common form of migraine and occur without preceding neurological warning signs. Symptoms may include moderate to severe headache, nausea, dizziness, and sensitivity to light, sound, or movement. Migraine attacks can significantly impact daily activities and quality of life. While migraines do not originate from the neck, addressing musculoskeletal contributors may form part of a comprehensive management approach.
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Headaches can develop following concussion, whiplash, or other traumatic injuries. These headaches may be associated with neck dysfunction, vestibular disturbances, reduced exercise tolerance, and neurological factors. Assessment is important to identify contributing factors and guide rehabilitation (Silverberg & Iverson, 2011).