VRT – A Professional’s Guide

Etiology of Dizziness

The main problem in helping a dizzy patient is identifying the cause.

Dizziness comes from a large number of sources. Some of the things that give rise to a dizzy patient include:

  • Medication Issues: Interactions and side effects.
  • Cardiovascular Insufficiency, such as Arrhythmias, TIAs, Defective Valves, Orthostatic Hypotension, Vertebral Artery Atherosclerosis, Carotid Sinus Reflex Slowness, etc.
  • Neurological Dysfunction, such as Acquired Brain Injuries, Cerebral Vascular Accidents, Multiple Sclerosis, etc.
  • Visual Deficits such as Macular Degeneration, Glaucoma, etc.
  • Psychogenic Disorders, such as Anxiety conditions, Somatoform Disorders, etc.
  • Vestibular System Disorders, caused by: BPPV, Vestibular Neuritis (Neuronitis), Ototoxicity (Gentamicin, carbon monoxide), Ménière’s disease, Vestibular degeneration, Acoustic Neuroma, Barotrauma, Whiplash, etc.

Prevalence of conditions causing dizziness

Etiology of dizzy patients over 60 years of age (Tusa et al. 2000)

The good news is that, although there are many sources of dizziness, the largest contributors to dizziness and imbalance are effectively treated by Vestibular Rehabilitation Therapy.

For those ages over 60 (i.e. the majority of your dizzy patients), fully two thirds come from 3 conditions that are treated effectively by Vestibular Rehabilitation Therapy:

  • Benign Paroxysmal Positional Vertigo (BPPV) – 32%
  • Vestibular Loss (e.g. Labyrinthitis, Neuritis,  etc.) – 13%
  • Fear Of Falling & Disuse Disequilibrium – 22%

When is Vestibular Rehabilitation Therapy appropriate for a dizzy patient?

Differentiation of causes of dizziness is not easy. Screening dizzy patients takes a lot of time and effort. How does a medical practitioner decide whether a referral to a physiotherapist certified in VRT is most appropriate, or to a specialist? To assist you to know if VRT is suitable for a dizzy patient, please use the following GreenRed light decision tree.

A Decision Tree for where to refer Dizzy Patients

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This information is not provided to self-diagnose. Dizziness comes from many sources. It is therefore very IMPORTANT that you also consult your doctor.