Therapy for Dizziness and Imbalance
Due to the coronavirus pandemic, as of 9/6/2020 we are mainly treating dizziness patients with suitable conditions (such as BPPV) with home protocols, sometimes supplemented by televisits. We also offer BPPV treatments with one of our providers, Dr. Cherchi, best suited for complex cases or persons who are close to the clinic. If patients need to see a physical therapist, we attempt to find one close to them. We have a BPPV DVD that illustrates the home Epley and Logroll maneuvers, and many handouts, that can be supplemented by online video material.
CDH providers treat all variants of BPPV
including posterior canal, lateral canal
, anterior canal
, and multicanal. We understand the difference between canalithiasis and cupulolithisis. We are fully equipped with video frenzel goggles
that enable us to determine if treatment has succeeded, and detect complications.
During the coronavirus epidemic, we are relying to a much greater extent on home treatment protocols -- we evaluate the patient in the office with the video goggles, and then prescribe them the appropriate home exercises
- Patients with unilateral vestibular loss may take as long as a year to recover. Our exercises can speed up and improve compensation.
- Patients with bilateral vestibular loss may never return to normal. Our exercises can help them maintain the highest levels of function.
- Chicago Dizziness and hearing has balance testing equipment that can determine whether or not balance goals have been met. This includes a VHIT test capability that can measure the degree of compensation through comparison of "covert' and "overt" saccades.
- Motion sickness can sometimes be treated using habituation. We use traditional methods as well as adaptations of Dr. Puma's protocol for habituation. These are home exercises.
- Visual dependence is a variant of motion sickness where visual motion causes space/motion discomfort. Visual dependence can be treated with visual habituation. We are presently mainly using very "busy" videos, again in a home setting, sometimes using VR goggles to enhance the experience.This treatment is overseen by our visual vertigo specialist.
- PPPD -- persistant postural perceptual dizziness. We favor a combination of medication and visual habituation. Treatment for this heavily visual syndrome is provided by our visual vertigo specialist.
- Driver disorientation syndrome -- driving can be limited because of anxiety and discomfort provoked by going above certain speeds, getting on or off an expressway, bridges, tunnels, or high contrast driving situations. We treat this at Chicago Dizziness and Hearing by using immersive video games that habituate driving behaviors, and often combine this with medication. This treatment is overseen by our visual vertigo specialist. A "taste" of our approach can be found here.
Mal de Debarquement
- Mal de Debarquement. We presently favor medication combined with visual habituation (i.e. similar to our approach to PPPD). We no longer offer clinic based habituation treatment, similar to that offered at Mt. Sinai in New York. However, we provide patients with tools to habituate themselves using devices at home.
Other rehabilitation techniques
-- Dr. Hain was one of the earliest to show that Tai Chi can improve balance. Chicago Dizziness and Hearing provides training DVD's from the original study.
Sometimes patients need to find therapy closer to them.
We get it that people are dizzy, they find it hard to drive, and it is more convient to "go local".
For BPPV providers, we recommend using the VEDA (vestibular disorders association). We also have some that we know of in Chicago that we can recommend to our patients.
For neck physical therapy, we recommend using the AAOMPT web site. This is a group of expert manual therapists.
Additionally, over the years we have had had many physical therapists work with us. We are proud
to note that several have continued to provide sophisticated vestibular physical therapy services
elsewhere in the Chicago metropolitan area. We know that these people have had a good grounding
in vestibular physical therapy. See our PT Alumni page for more details.