Vertigo

Vertigo (BPPV): a disorder of the inner ear (canals) where increased sensitivity causes feelings of dizziness and “room spinning” with changes in head/body position.

This is the most common cause of vertigo. 50% of people >70 years of age will experience but can happen to people in any age group. There is a 3:1 greater incidence in women compare to men.

Symptoms of BPPV:

• • Occurs 1-30 seconds after getting into provoking position
  • Short Duration: lasts typically from 10-20 seconds
  • Nausea
  • Specific movements may cause attack
  • Can trouble people for years with exacerbation and remission
  • Highly responsive to treatment maneuvers performed by trained professionals

Risk Factors for BPPV:

• Cardiovascular Disease
• Diabetes
• Head Trauma
• Migraines (44% of people with migraines suffer vertigo symptoms)
• Stroke/Transient Ischemic Attacks

Questions to ask yourself: Did the room spin? How long? Did something you did cause it to happen and could you cause it to happen again?

Migraine

Migraine: A chronic neurologic disorder that affects 13% or more of the adult population. 50% of people with migraines have not had a formal physician diagnosis. Of those who are diagnosed, most do not receive effective therapy. 28 million Americans suffer from migraines.

Vestibular dysfunction with Migraines

• • 44% of people with migraines have vestibular dysfunction
  • Meniere’s Disease is 2x more common with people who suffer from migraines
  • Pressure changes cause damage to inner ear, low frequency hearing loss as well as vestibular/balance dysfunction will remain after attack until treatment.
  • 25% have vertigo described as an “aura” or “foggy” feeling.
  • 66% are motion intolerant
  • 80% are triggered by light
  • 73% have nausea

Concussions

Concussions: “Any structural compromise or metabolic disturbance to the central nervous system or inner ear following a direct or indirect impact to the head.”

Structural Concussion: physical injury to the brain/central nervous system

Metabolic Concussion: injuries that involve the complex pathways involved in neuronal metabolism and can have widespread effects.

Labyrinthine Concussion: Damage to soft tissues of the labyrinth (inner ear) which can cause immediate vertigo and dysequlibrium as well as secondary vestibular issues.

The biggest and most effective treatment immediately for concussions is rest. If the brain is not given adequate time to heal. If someone sustains another concussion prior to the initial concussion being healed then the symptoms become much more severe and can include dilated pupils, loss of eye movement, unconsciousness, respiratory failure and possibly death.

Effective treatment of concussions and ability to return to sport/activity is based off of baseline cognitive and balance testing.

AIB Facts About Falls in the Elderly

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• 1 in 4 Americans aged 65+ fall each year
• Every 11 seconds, an older adult is treated in the ER for a fall
• Every 19 minutes, an older adult dies from a fall
• In 2014, the total cost of fall injuries was $31 Billion and is expected to reach $67+ Billion by 2020

• Falls are the most common nonfatal trauma-related hospital admissions among older adults
• Falls result in more than 2.8 million injuries treated in the ER annually, including over 800,000 hospitalizations and 27,000 deaths
• Falls are the leading cause of fatal injury

• 1 out of 5 falls results in serious injury such as broken bones or head injury
• At least 30,000 older people are hospitalized for hip fractures each year
• More than 95% of hip fractures are caused by a fall
• Falls are the most common cause of TBI (Traumatic Brain Injury)