Dizziness Case Study
Dizziness can affect participants in many sporting activities. Miss Jones (not her real name) came to the PhysioStudio as she was suffering from dizzyness.
Her symptoms began following a flight to America. She remembered she had a head cold on departure for her holiday and her ears popping during the flight. During her trip she suddenly developed attacks of severe spinning vertigo when she turned over in bed, on looking over to the right and on bending over. These symptoms also made her feel quite sick. To avoid the vertigo, Miss Jones stopped turning her head and moved very carefully, which really restricted her holiday.
Miss Jones consulted her GP on returning from her holiday and he prescribed some anti-dizziness medication. Her GP explained that her symptoms were related to an inner ear problem. He recommended she see a Physiotherapist for some exercises if the dizziness did not resolve with the medication. The medication did not help, and so Miss Jones came to see one of our Physiotherapists, although she was unsure of how physiotherapy could help her.
Katie, her physiotherapist, performed a thorough assessment of her eye and head movements and tested her balance, which she realised was more "wobbly" than she remembered. A movement test was then performed which exactly reproduced her dizziness. Katie diagnosed her as having Benign Paroxysmal Positional Vertigo (BPPV). She explained to Miss Jones that this is a condition affecting her inner ear within the Semicircular canals of the Vestibular system (balance centre of the ear). The semicircular canals normally detect certain head and body movements and give messages to the brain about what we are doing. On occasions crystal deposits (which are normally located in a different area of the inner ear) become dislodged and become stuck in one of the semicircular canals. This can then cause dizziness, nausea and balance problems.
Katie explained to Miss Jones that the treatment for BPPV was a "particle repositioning manoeuvre" (Epley Manoeuvre) to clear the semicircular canal of the crystal deposits. Katie performed the Epley manoeuvre, which involved a sequence of body and head movements. After the treatment Katie explained that her symptoms may temporarily increase that evening but she should notice the improvement within the next 2 days.
The next morning Miss Jones noticed a significant improvement, being able to turn over in bed and bend over with no dizziness. She was only aware of mild light headedness when she turned her head quickly. Over the week she was also aware she felt slightly uncomfortable when in busy situations, for example at the supermarket.
When reassessed by Katie, Miss Jones was advised to work on a series of desensitisation exercises, which she had to perform regularly through the day until her symptoms fully resolved. It took one week of regularly doing the exercises and Miss Jones was 100% recovered and her balance had returned to normal.