Treatment of Balance Disturbance
There is an urgent need for highly specialised vestibular rehabilitation therapy (VRT) soonest after acute vertigo with nausea or vomiting has passed. There will be a natural compensation by the balance mechanism. Equally there will be ongoing natural recovery from any insult or injury.
Where there has been damage or injury, there is a natural “velocity of recovery”. That does vary from person to person but there is always a tendency to recover. Psychological mechanisms and failure to mobilise for whatever reason will lead to significant ongoing functional handicap and that needs to be treated soonest. If there is a significant emotional component, then the quicker that physical rehabilitation together with psychological support and possible pharmacotherapy introduced, then the better the final outcome.
On the whole, there is no reason to use vestibular sedatives which if anything are contra-indicated in terms of sub-acute or chronic rehabilitation. Medications such as Cinnarazine or Prochlorperazine or Betahistine may have a role in the acute management of vertigo. Once that acute phase has dissipated, then these medications should be stopped and the appropriate rehabilitative physiotherapy continued.
The more that individuals do the balance exercise programme, then the better they get. Those who do little or stop doing the exercise programme can expect to do less well and they will be a self-fulfilling prophecy as far as poor recovery is concerned.
Frequently people with a balance disorder go on to develop a whole range of secondary problems. These may include benign headache. This may represent migraine or tension type headache. Neck muscle spasm is very common leading to neck pain and stiffness. Anxiety and panic attacks because of the constant feeling of disequilibrium frequently manifest at presentation when in fact the diagnosis is a primary balance mechanism disturbance.
We work closely with highly-specialised and experienced Neurologists, ENT consultants and psychologists and, should the need arise, can arrange a referral for further medical investigations and treatment.