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Vestibular Rehabilitation



Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of

positional dizziness or vertigo in the community. The major symptom of BPPV is sudden

vertigo caused by changes in head position including: turning in bed, lying down with

head extended, looking up, looking down, or any sudden changes in head position.

Other symptoms of BPPV include spinning sensations, dizziness, loss of balance or

unsteadiness, nausea, and vomiting. Most often there is no specific cause for BPPV,

but at times it could be due to a blow to the head such as a fall. Inside your inner ear,

there is a labyrinth system that monitors positional sense, this labyrinth system consists

of 3 semicircular canals that contain fluid and hair-like sensors, and otoconia which are

crystal-like objects that detect movements in the linear plane. These otoconia are

dislodged into the semicircular canals which cause BPPV and the vertigo symptoms.


At Premier, we have staff with experience treating these conditions. BPPV falls

under a niche considered vestibular rehabilitation. Treatment for BPPV includes canalith

repositioning maneuvers such as an Epley maneuver. Patients with BPPV, usually also

present with a vestibular hypo-function due to the unaffected ear having to compensate

for the dysfunction on the affected side. A vestibular hypo-function is a dysfunction in

either the visual, vestibular, or somatosensory system and at times could be a

combination. Treatment for vestibular hypo-function includes adaptation, habituation,

and substitution activities. We believe in implementing these treatments in combination

with the latest research in this unique field to address your conditions to improve your

quality of life!


Miguel Silva, PT, DPT

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