Vestibular rehabilitation


Vertigo is defined as an illusion of rotational movement without loss of consciousness, associated with a feeling of pseudo-drunkenness. They reflect the acute, asymmetrical deficit of the vestibule in the ear.

It includes Benign Paroxysmal Positional Vertigo (the famous “crystals in the ear”), vestibular neuritis, Ménière’s disease for the best known.

Vestibular rehabilitation consists of using the brain's ability to develop new balancing strategies in the face of damage to the vestibular system. The physiotherapist will use a rotary chair, an optokinetic target generator, virtual reality or other posturology platforms.

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Physiotherapy for vertigo and BPPV

Do you have feelings of imbalance and dizziness? Frequent dizziness and lightheadedness? Difficulty standing or simply car sickness? Know that these ailments can be relieved and treated by our physiotherapists specializing in vestibular rehabilitation.

Among the most common types of vertigo: benign paroxysmal positional vertigo (BPPV). Its treatment must be done by a physiotherapist, at the KinéOParis office, in Paris 9, after examining your vestibular system and your nervous system.

  • What types of vertigo are treated?

    Have you ever felt the ground give way under your feet, had trouble staring, or the sensations that your bed is spinning at high speed? It is indeed a vertigo, but which one?

    Vertigo is defined as an illusion of rotational movement with neuro-vegetative signs, without loss of consciousness, associated for the most part with a feeling of pseudo-drunkenness. They translate the acute, unilateral or at least asymmetrical deficit of the vestibular sensory input by damage to the labyrinth or the vestibular nerve. They fall within the framework of so-called "vestibular" syndromes that can be individualized as follows: Benign Paroxysmal Positional Vertigo (the famous "crystals in the ear"), vestibular neuritis, Ménière's disease for the best known.

    Neurosensory disorganizations correspond to an inappropriate response of the brain, linked to a conflict between the different sensory inputs of balance: vision, vestibule and proprioceptive system; at the origin, for example, of kinetosis (motion sickness).

    Vestibular physiotherapy establishes a diagnosis on the causes of vertigo and headaches and offers you adequate treatments to put an end to these feelings of floating and dizziness. It also offers you a treatment for the dizziness you feel when you take a means of transport. It treats balance disorder, spontaneous nystagmus and signs of neuritis.

    Among the causes of vertigo treated by our specialist, BPPV (benign paroxysmal positional vertigo). It is a paroxysmal dysfunction of your inner ear that causes this kind of positional vertigo. This anomaly has become very well known, in particular thanks to the development of vestibular physiotherapy. BPPV sometimes comes with feelings of nausea and vomiting and usually lasts no more than 5 minutes.

    However, it can cause permanent instability, cause dizziness and headaches.

  • Motion sickness (kinetosis)

    The vestibular re-educator is also authorized to treat motion sickness.

    They correspond to a neurovegetative alteration, of variable intensity, induced by the movements produced by land, sea or air vehicles in their travels.

    These would be triggered by sensory conflicts. When, for example, vision gives information to the brain and it is not concordant with that collected by the inner ear: a sensory conflict is created at the central level and this can result in neurovegetative manifestations. This is what happens to people who feel bad reading in the car.

    Today, we can obtain good results in the treatment of motion sickness through specific treatment based on the phenomenon of desensitization.

    This mainly concerns:

    • transport sickness (car, bus, metro, etc.)
    • seasickness (naaupathy)
    • freeway syndrome
    • desensitization to vertigo from heights

    Virtual reality is an excellent rehabilitation tool, with specific software for the treatment of these different disorders.

  • What is a BPPV?

    It is probably the most frequent vestibular pathology. She presents with violent rotational vertigo of short duration, generally less than a minute, caused by certain changes in position: when lying down, getting up, turning over in bed, or bending over or raising her head. This dizziness is sometimes accompanied by nausea, vomiting, cold sweats and unsteadiness.

    In a large majority of cases, dizziness appeared during the night or upon waking.

    From a physiopathological point of view, this is explained by a detachment of otoconia from the utricular macula (we often speak of "crystals" in the ear) which will become lodged in one of the three canals of the vestibule modifying its activity and causing dizziness to head movements.

  • Our vestibular physiotherapist takes care of you

    If you feel that you are dizzy, you will probably need to consult your doctor or an ENT specialist or even a neurologist. Having vertigo is not normal. Some serious pathologies can cause dizziness. So if you feel faint or dizzy, don't ignore this symptom.

    Our physio will examine you to determine if your dizziness is due to a particular cause, such as an otolith problem (BPPV), old trauma, stroke or intense stress and will ensure that the dizziness comes from peripheral vestibular damage. Then, the therapist will identify the affected channel using positional maneuvers under videonystagmoscopy. Once the diagnosis has been made, a liberating maneuver is performed in order to evacuate the lithiasis (the "crystals") from the incriminated channel: it mobilizes the patient's head gently in a sitting position or in a lying position while looking down. This technique usually cures positional vertigo.

    If the dizziness persists, the physiotherapist can refer you to your doctor to readapt the treatment for the dizziness.

    There are also other maneuvers, depending on the condition and diagnosis of each patient. But, this option remains one of the best to treat patients who suffer from vertigo and mainly from BPPV.

    For any additional information, you can contact our vestibular physiotherapist by phone or make an appointment in our Paris office. We will be happy to answer all your questions.

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