Vestibular dysfunction is a process

that may occur over time.  There are some who experience vestibular dysfunction once or twice over the period of several years while there are others who battle the problem much more often.   When it comes to helping these individuals, I believe we need to be careful how we educate people regarding what they should expect for the future.  Sometimes I think looking at vestibular dysfunction one day in the clinic may be like looking at a digital picture of the following:

Snow: is it melting or freezing?
(Is the inner ear in the process of getting worse or better?)

Rain: just began or stopping?
(Is the inner ear problem at it's early stage or is it almost done running its course?)

Building being built: is it a home or office (Is the inner ear problem BPPV or is it signs of Menieres, Vascular Insufficiency or Autoimmune Dysfunction?)

The Unpredictability is a Killer!

Many individuals perceive their vestibular problems to be unpredictable.  One of my clients stated, "The unpredictability is a killer!"  My client was not referring to a life threatening problem.  However, dizziness can be a sign of a life threatening problem.  Individuals with undiagnosed dizziness should either call their Medical Doctor or go to the Emergency Department.   Clients who make these types of comments are referring to the terrible, controlling and inconvenient nature of dizziness.  I think what clients mean by "unpredictable" is the way vestibular dysfunction may come and go at any time for no reason. This part of vestibular dysfunction is definitely unpredictable.  That aspect of vestibular dysfunction can be terrifying for many.  Over the years, however, I have noticed that the unpredictability of the problem seems to be more predictable than one might recognize. 

With many of my clients (not all), the way their problem returns is fairly predictable.  For instance, the spells usually last about the same amount of time.  The intensity seems to either stay the same or even become less.  The nausea, over time, may actually become less.  The movements that cause the problem remain consistent.   It even seems that I notice patterns of when the problem may return and when it may go away on it's own.  If vestibular rehab worked once for an individual, it seems as though it is likely to work again should their problem return.

We have to be careful not to give more power to vestibular dysfunction than it deserves.  I know that in the moment, the problem is horrendous.  However, the greater our brains perceive vestibular dysfunction as a threat, the greater our sympathetic nervous systems will respond.  This will cause a stronger response in our bodies.  We must be honest about how "unpredictable" these spells actually are so that we do not have as intense of a response when the problem returns.

Christmas Lights and Dizziness

Some individuals have told me they become dizzy looking at christmas lights...especially in stores.  Why does this happen?  I think it depends on the individual.  Here are a few possible reasons.

1. For people who have a predisoposition toward visual dependence and/or motion sickness, they tend to rely more on their eyes for balance.  For these individuals, they may be light sensitive.  Seeing several different lights at different depths can confuse the brain because their is not a consistent pattern.  This can cause a sense of dizziness.
2. For people with vestibular problems, looking at lights at varying levels (depths, heights) can cause the brain not to be able to focus the eyes as well.  When this occurs, if an individual has a vestibular dysfunction, nystagmus can occur.  When nystagmus occurs we usually become dizzy. (spinning, off balance and/or a sense that things are moving, etc).