DrRajiniENT

VERTIGO (GIDDINESS MANAGEMENT)
THE ABILITY OF NORMAL PEOPLE TO ORIENT THEMSELVES IN SPACE DEPENDS ON INFORMATION FROM THREE SETS OF SENSORS.
FIRSTLY-EYES (OPTO KINETIC)
SECONDLY- FROM THE BODY MUSCLES (PROPRIOCEPTORS)
THIRDLY- SEMI CIRCULAR CANALS IN THE INNER EAR CALLED “VESTIBULAR SYSTEM”

VERTIGO IS ONLY A SYMPTOM AND NOT A DISEASE.THERE ARE MAINLY THREE TYPES OF VERTIGO(DIZZINESS0
1.OBJECTIVE: PERSON FEELS THAT THE OBJECT AROUND HIM KEEPS ON MOVING.
2.SUBJECTIVE: PERSON FEELS THAT HIS HEAD IS ROTATING.
3.POSITIONAL:WHEN HIS BODY OR HEAD POSITION CHANGES(TURNING-BENDING)

SOMETIMES THIS SENSATION APPEAR ASSOCIATED WITH NAUSEA,VOMITTING,RINGING SOUND IN THE EAR(TINNITUS) WITH FULLNESS IN HEAD OR LOSS OF HEARING(MENIERS DISEASE)
SOME OTHERS NARRATE AS IF THEY TEND TO FALL WHILE WALKING(IMBALANCE).
THIS SYMPTOM MAY APPEAR INCASE OF VARIATIONS IN BLOOD PRESSURE .DIABETES MELLITUS OR EVEN WITH CASES OF CERVICAL SPONDY-LOSIS AND EVEN WITH VARYING ATMOSPHERIC PRESSURE(FLYING).HAEMODYNAMIC CHANGES,FUNCTIONS OF CAROTID & VERTEBRAL BLOOD SUPPLY TO THE BRAIN.
THEREFORE A PERSON SUFFERING FROM GIDDINESS NEEDS TO BE EVALUATED BY A PHYSICIAN,NEUROLOGIST.AN ENT SURGEON TO FIND OUT THE UNDERLINED PATHOLOGY AND FACE TREATMENT.THERE ARE MANY PEOPLE WHO ARE ON CONTINUOUS MEDICATION WITH AFEWAVAILABLE DRUGS.BUT WITH NO SIGNIFICANT IMPROVEMENT IN THE SENSITIVITY OF GIDDINESS.
BEFORE STARTING THE TREATMENT FOR GIDDINESS THE FOLLOWING INVESTIGATIONS ARE ESSENTIAL,
1. DETAILED HISTORY OF CASES
2. ENT OPINION AND OPTHALMOLOGY REPORT.
3. PURETONE AND SPEECH AUDIOMETRY.
4. IMPEDENCE AUDIOMETRY.
5. BERA(EVOKED POTENTIALS) IF REQUIRED.
6. CALORIC TEST
7. ELECTRONSTAGMOGRAPHY
8. VESTIBULAR FUNCTION ASSESSMENT.
9. CAROTID AND VERTEBRAL DOPPLER STUDIES
10. BLOOD INVESTIGATION
MANY TIMES THESE INVESTIGATIONS MAY NOT REVEAL ANY ABNORMILITY AT ALL THEY ARE A MUST TO RULE OUT ANY UNDERLINED ORGANIC PATHOLOGY.
MOST OF THE PATIENTS NARRATED THAT
1 THEY USED COLLARS OR
2.THEY USED MEDICINES LIKE VERTIN,STUGERON OR STEMITIL
3.THEY DID SOME POSTURAL NECK EXCERCISES.
ULTIMATELY ,THEY MIGHT NOT HAVE BEEN BENEFITTED.THESE PATIENTS KEEP ON CONSULTING ONE DOCTOR OR THE OTHER SPEACIALIST ALL THE TIME.FINALLY THEY BECOME DESPERATE AND A FEW MAY EVEN RESORT TO AYURVEDIC AND HOMEOPATHIC TREATMENT.IN MANY OF THE HOSPITAL ,NURSING HOMES AND CLINICS FACILITIES TO CARRYOUT ALL TESTS MAY NOT BE AVAILABLE.,BUT THIS DEPENDS ON MANY OTHER PARAMETERS AND CONDITION OF THE PATIENT.NOW ONE SHOULD THINK OF AN ADEQUATE APPROACH TO THIS PROBLEM OF TREATING GIDDINESS.IT IS KNOWN THAT THE ORGAN PROBABLY EFFECTED IS “VESTIBULAR HABITUATION: IS KNOWN IN THE LITERATURE.SO WE HAVE TO “STIMULATE”THESE ORGANS,i.e (SEMICIRCULAR CANALS,OTOLITHS,UTRICLE AND SACCULE)FOR MORE EFFECTIVE MANAGEMENT OF GIDDINESS.SO BEFORE TREATING VERTIGO PATIENTS THE EXACT CAUSE IS ESSENTIAL.
PSYCHOLOGICAL ASPECTS
LIKE ALL SENSORY SYSTEMS VESTIBULAR SYSTEM EXHIBITS A DECREASED RESPONSE TO STIMULI THAT ARE PERSISTENT(ADAPTATION)OR REPETITIVE(HABITUATION)
INCREASE IN PERCEPTUAL AND MOTOR RESPONSIVENESS TO VESTIBULAR STIMULATION IS TERMED A VESTIBULAR ENHANCEMENT THIS OCCURS WHEN STIMULATION IS NOVEL,THREATENING OR WHENEVER SOATIAL ORIENTATION IS RECEIVED TO BE IMPORATANT.IT IS BELIEVED TO BE DUE TO EFFERENT VESTIBULAR NERVOUS CONTROLLING THE GAIN OF THE VESTIBULAR SYSTEM SO AS TO EFFECT SUPPRESSION OR ENHANCEMENT ,ALSO HABITUATION DEPENDS ON “AROUSAL’ACTIVITY IN DRAIN SYSTEM NUCLEI.
ANYTHING WHICH KEEPS THE SUBJECT IN AN ALERT STATE(SUCH AS MENTAL ARITHMATIC)DELAYS OR PREVENTS HABITUATION WHILE DAY DREAMING OR LACK OF ATTENTION HELP HABITUATION.
SOME PEOPLE FEEL HABITUATION TO ANGULAR ACCELERATION
TRANSFER OF HABITUATION CANNOT BE OBTAINED FOR DIFFERENT CONDITIONS.
EACH CONDITION MUST BE PRACTICED SEPARATELY DESPITE THEIR SIMILARITY IN SENSATION AND NYSTAGMIC RESPONSES.
THERFORE IT IS ESSENTIAL TO INSTALL PARALLEL SWING FOR STIMULATING OTOLITH ORGAN AND TORISON CHAIR AND ROTATING CHAIR TO STIMULATE ALL CANALS AT THE SOMETIME.
OTHER BALANCE TESTS CAN ALSO WILL BE ADDED FOR THE BENEFIT OF THE PATIENTS.MORE THAN ANYTHING ELSE IT REQUIRES EXTREME CO-OPERATION FROM PATIENTS AND THEY HAVE TO ATTEND REGULARLY THERAPY SESSIONS ATLEAST FOR A PERIOD OF 10 TO 15 DAYS.AND THEY POSITIVELY DERIVE BENEFIT BY THESE NON MEDICAL ASPECTS OF TRAETMENT.THESE EQUIPMENTS WERE DESIGNED AND EXTENSIVELY USED ON SCIENTIFIC BASIS AND FOUND VERY MUCH BENEFICIAL .

VESTIBULAR REHABILITATION EXERCISES.(EPLEY’S AND SEMENTS)
EXERCISES TO BE CARRIED OUT FOR 15 MINUTES TWICE A DAY INCREASING TO 30 MINUTES.
EYE EXERCISES TO BE CARRIED OUT SITTING IN BED.
LOOK UP FORST AND THEN DOWN.SLOWLY AT FIRST ,QUICKLY LATER 20 TIMES.
HEAD AND NECK EXERCISES TO BE CARRIED SITTING ON BED.
BEND HEAD FORWARDS ,THEN BACKWARD WITH EYES OPEN.SLOWLY FIRST,THEN QUICKLY 20 TIMES .TURN HEAD LEFT TO RIGHT THEN VICE VERSA.SLOWLY FIRST,THEN VICE VERSA.SLOWLY FIRST ,THEN QUICKLY 20 TIMES.AS DIZZINESS IMPROVES ,THESE EXERCISES SHOULD BE CARRIED OUT WITH EYES CLOSED.
SHOULDER AND TRUNK EXERCISES TO BE CARRIED OUT SITTING IN BED.
SHRUG YOUR SHOULDERS UP AND THEN DOWN SLOWLY 20 TIMES
TUM SHOULDERS TO THE RIGHT AND THEN TO THE LEFT,SLOWLY FIRST THEN QUICKLY 20 TIMES.
BEND FORWARDS AND PICK UP OBJECTS FROM THE GROUND AND SIT UP 20 TIMES.
STANDING UP EXERCISES
CHANGE FROM SITTING TO STANDING UP AND BACK AGAIN WITH EYES OPEN 20 TIMES REPEAT WITH EYES CLOSED.
THROW SMALL RUBBER BALL FROM HAND TO HAND ABOVE EYE LEVEL.
THROW BALL FROM HAND TO HAND UNDER ONE KNEE.BALL BOUNCING AND CATCHING.
MOVING ABOUT EXERCISE
WALKS ACROSS ROOM WITH EYES OPEN AND THEN CLOSED-10 TIMES
WALK UP AND DOWN A SLOPE WITH EYES OPEN AND THEN CLOSED-10 TIMES.
WALK UP AND DOWN STEPS WITH EYES OPEN AND THEN CLOSED-10 TIMES.
ANY GAME INVOLVING STOPPING OR TURNING IS GOOD .
THE ABOVE MENTIONED EXERCISES HAVE BEEN NARRATED BY EPLEY AND SEMONT

Labels: GIDDINESS