Vestibular Disorders

Vestibular Disorders
It is estimated that over 90 million people have suffered from a balance disorder at one time in there life. It is hard to come up with the exact number because symptoms are very subjective, which makes diagnosis difficult. There is little known among the medical community on the diagnosis and treatment of vestibular disorders. Dr. John Epley, an international neuro-otologist, opened the first treatment center in 1975, in Portland Oregon. Since that time, treatment centers have slowly started to develop nation wide.
Several neurologists and otolaryngologists studied techniques and equipment used by NASA to study space sickness. These same techniques are used and studied in balance centers. Some of the signs and symptoms of balance disorders are dizziness, unsteadiness, frequent falls, double vision and lightheadedness which occur if the vestibular organs in the inner ear are not functioning properly. There are three areas that work together to control balance. They are inner ears, eyes and muscles. They send information to your brain that helps you walk, turn and bend easily.

Patients are diagnosed by using a “Balance Master machine” which is a virtual reality platform that the patient stands on. The patient is strapped into the machine, and they watch a video while the platform moves in different directions. Today, it is called Computerized dynamic posturography (CDP).

There are three ways to treat the disorder, surgery, medication and physical therapy. The least invasive form of treatment is physical therapy. The diagnostic testing can cost anywhere from $600 to $1,500 but is usually covered by Medicare and private insurances.

Very few physicians understand vestibular disorders or know how to treat the disorders. If they do, there are very few rehabilitation facilities available for patients to receive proper diagnostic and physical therapy treatments. The number of people who suffer from dizziness, vertigo and balance disorders is over 90 million and the majority of individuals over 70 years old complain of some form of dizziness. The numbers are staggering compared to the availability of treatment. Fall related injuries impact healthcare significantly, as well as the independence of many elderly.

Many times when patients complain to their physicians of vertigo or lightheadedness, a multitude of diagnostic tests will be done, if everything is negative, the patient is prescribed Meclizine or something similar, which leaves patients very drowsy and lethargic. This medication, prescribed by most physicians, causes the same side effects as the disorder. Ethical issues arise when physicians do not give there patients all the available information or make false assumptions.

At minimum, a consultation to see a neurologist or otolaryngologists should be set up. Vestibular disorders should be explained to the patient and the treatment options that are available. Most individuals have never heard of the term vestibular, so they do not know the right questions to ask when they visit their physician. Many physicians do not know the right questions to ask to get to the source of the dizziness or they just dismiss it completely.
Signs and symptoms of vestibular disorders vary in intensity and can be difficult to describe. Therefore many times assumptions such are made of laziness, inattentiveness; anxiety and attention seeking are made. These episodes can be very frightening for the patient. To make such assumptions is unethical, but unfortunately healthcare providers frequently make these judgments about their patients, not just physicians but all healthcare providers.

This nurse of 18 years had never heard the term vestibular, but has suffered from chronic lightheadedness and vertigo since the age of 17. No one was able to diagnose the problem correctly, and until now this time treatment was never an option. The organization I work for has just started a balance center and I have become one of their patients. I will keep you posted on my success.

If you have any questions about Vestibular disorders or where to find a Balance Center, please contact me through email or go to my Forum.

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Content copyright © 2019 by Colleen Moore, RN. All rights reserved.
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