Benign Paroxysmal Positional Vertigo is the most common cause of severe dizziness, especially in older people. Head trauma, falls, and car accidents are common causes. In people over age 60, it occurs suddenly with no apparent injury or illness. It is an inner ear condition, where small calcium particles become displaced out of the gravity sensor of the inner ear balance structure. The particles then move into the rotation sensor. This results in a sense of spinning with position change, usually with turning over in bed, lying down, bending down, or tilting the head back. The symptoms can range from severely disabling to a mild annoyance. Other common symptoms associated with BPPV are unsteadiness, nausea, a sense of blurred vision, and neck tightness.
To alleviate this problem, very specific tests are done to determine which of the three rotation sensors contain the displaced particles. Treatment involves particular positional maneuvers to move the displaced particles back to the gravity sensors, allowing them to settle or dissolve back into the place they are intended to be. Maneuvers can be either the Epley (CRP) maneuver, the Roll maneuver, the Semont maneuver, the Appiani, and others. The result is usually immediate relief of the condition. Treatment success rates for BPPV are 80% in one session, and 18 percent in 2-5 sessions. There is a very small percentage of people with BPPV who require medication management before the treatment can succeed.
The diagnosis and treatment of this condition does cause dizziness during the treatment session. While it is tolerable, I recommend you bring a driver to ensure your safe return home after the session. The procedures are done slowly, carefully, and at your pace. However, there can some lasting sensations of dizziness after the session.
The symptoms of this condition range from mild fatigue and dizziness, to weakness and imbalance, and at times more severe disability. For people with MS, exercise is medicine! Research has confirmed that exercising at the proper intensity has neuroprotective effects for the brain. Julie has over 20 years experience working with individuals at all levels severity, and with all symptom types. Treatment is tailored to the specific problems you are experiencing, your energy level, and your lifestyle. Julie works closely with many of the top MS Neurologists in the state to communicate effectively for changes to medications, coordination with other specialties, and make referals as needed.
Inner ear infection/Vestibular Neuritis
Vertigo, imbalance, dizziness, and blurred vision can persist for weeks following inner ear infection. Vestibular rehabilitation is highly effective in resolving all remaining symptoms, and is far more effective than medication. The brain has tremendous flexibility to relearn all functions of orientation, gaze stability, and balance. For many people, the brain needs vestibular rehabilitation to trigger this process for recovery.
Individuals with PD have a wide variety of challenges to overcome. Symptoms can include stiffness, shuffling gait, unsteadiness, falls, dizziness, slouched posture, and more. Medication effects on movement can add to the challenges in getting around. For people with Parkinsons, exercise is medicine! Your brain needs to learn cues for movement to bypass the short circuits that are created from a lack of dopamine. Julie has over 20 years of experience in assisting patients and their families with this learning process. Rehabilitation can include stretches, posture exercises, tips and tricks for moving easier from sit to stand, turning over in bed, and walking. Better balance is achieved with specific balance exercises. Treatment courses can be short and home-based, or may continue over a longer period of time to help you as your condition changes. Julie works with many of the top movement disorder Neurologists in the state, communicating effectively to help with adjustments or changes to medication as needed, coordination with other specialties, and referrals.
In the days following concussion, complete brain rest is critical to ensuring a recovery that occurs most completely, in the shortest amount of time. That rest includes avoiding/reducing reading, computer work, texting, and watching TV. As the days pass, activity can be gradually re-introduced. Communication with your doctor, teachers, coaches, and therapist is critical to success. The team of providers coordinate return to school, adjustment to homework levels, and accommodations during the school day. For many children and their parents, this process is scary and overwhelming. Julie has many years experience assisting with the coordination of the this process.
Ongoing symptoms can include headache, dizziness, blurred vision, neck ache, mood irritability, brain fog, and fatigue. These symptoms need to be prioritized, with treatment fitting well into an already busy schedule for students and parents.
In the days following concussion, complete brain rest is critical to ensuring that your recovery occurs most completely, in the shortest amount of time. That rest includes avoiding/reducing reading, computer work, texting, driving, and watching TV. As the days pass, activity can be gradually re-introduced. Light exercise begun at the right time aides recovery. Communication with your doctors and therapist is critical to success.
Ongoing symptoms can include headache, dizziness, blurred vision, neck ache, mood irritability, brain fog, and fatigue. Each of these symptoms are carefully evaluated, with treatment prescribed according to your tolerance and energy levels.
Facial Paralysis/Bell’s Palsey
Charcot Marie Tooth (CMT)
Dizziness and Vertigo/Vestibular Disorders
Post Concussive Syndrome
Neck and Back Pain/Sports Injuries