My Top Interests In Vestibular Rehabilitation for 2011

Here are some of my greatest contemplated topics in vestibular rehab for 2011:
1.  HINTS to diagnose stroke
2.  Pseudospontaneous nystagmus
3.  Multicanal BPPV treatment
4.  Implications of GERD, Panic Attacks, History of Syncope when treating clients with BPPV
5.  Secondary BPPV
6.  Stages of BPPV: Dumping, Dumped and Recovery
7.  Motion Sickness and BPPV
8.  Vertebral Artery Dissection prediction
9.  Migraine and other central causes of dizziness
10.  Timing of vestibular rehabilitation and neck therapy working with clients with dizziness.
11.  Over 200 words used to describe dizziness
12.  Nystagmus suppression during normal activities of daily living
13.  Spatial disorientation training in younger and older adults
14  Tai Chi to help teach people to relax when off balance
15.  Many balance disorders seem to manifest themselves in hyperactive balance performance
16.  Imagination, memory and central preprogramming in clients with dizziness
17.  Post Concussion Syndrome in the elderly
18.  The Highly Sensitive Person with vestibular dysfunction
19.  Cardiovascular causes of central and/or peripheral vestibular dysfunction
20   Vestibular Rehab as an examination tool
21.  Evaluating the vestibular system using the video eye movement recording device over time to track changes in vestibular function
22.  Toxic, metabolic and hormonal causes of peripheral and central vestibular dysfunction
23.  Sensory processsing disorders in the adult

Is Benign Paroxysmal Positional Vertigo Really Benign?

I believe there are times when Benign Paroxysmal Positional Vertigo is truly benign and I believe there are times when it is not even close to benign.  Whether or not we agree that benign paroxysmal positional vertigo is benign depends upon our definition of benign.  If the term benign means not cancerous or malignant, then BPPV is truly benign.  However, if benign means not life-threatening, not recurrent, not progressive or of no danger to health, then there are times when benign paroxysmal positional vertigo is not benign at all. 

When is BPPV not benign?  I suggest the following examples:
1.  When BPPV is caused by circulatory problems.  In this case, BPPV may be a result of a lack of blood flow to the inner ear.  This could be a sign of more ischemia to come in more important life sustaining places like the brainstem or cerebellum.  In this case, BPPV is a sign of life-threatening problems that may soon occur. 
2. When an individual falls to the floor and injurs something (fractures, head injuries, sprains and strains).  In this case, BPPV is of danger to health and can be life-threatening.
3.  When an individual develops movement phobias because of the intense sensations they experience when they move.  This is of danger to health because individuals often become "scared stiff" and develop disuse dysequilibrium. 
4.  Many cases of BPPV recur frequently.  That is opposite of what some define as benign.

The vestibular system

is made up of two main parts: the central vestibular system and the peripheral vestibular system.  The central vestibular system is highly complex and includes structures within the brainstem and cerebellum.  The peripheral vestibular system is amazingly small, but has many important jobs.  It includes the vestibular nerve, the labyrinth and the vestibule. 

Dizziness coming from a problem with the central vestibular system is much more difficult to fix and can represent a serious life threatening problem.  Dizziness coming from a peripheral vestibular problem is often times more benign and is easier to correct.  Some individuals can experience dizziness from both peripheral and central vestibular disorders.

Both central and peripheral vestibular problems must be stable (controlled) in order for physical therapy to help most.