What is Vertigo/Dizziness

Dizziness can be a more broad term referring to a range of conditions such as feeling lightheaded, weak, unsteady, or like you’re going to faint. Whereas vertigo is a more specific form of dizziness that involves the sensation of you or the world around you spinning/turning. These issues can be caused by a peripheral structure (e.g. issues with the canals in your ears) or by a central structure (e.g. vestibular nuclei in the brainstem).

Addressing Vertigo/Dizziness

Treatment of dizziness and vertigo tends to be more calculable and straightforward than that of other neurological conditions. Utilizing a good physical exam, orthostatic testing, videonystagmography (inner ear and central motor function testing), and posturography (balance/equalibrium test) we should be able to identify the exact cause of the dizziness. From there we have numerous treatment options to address these areas directly, most commonly utilizing physical or ocular movements for rehabilitation.

What are Executive Function Issues

Issues of focus and attention can be difficult for us to explain to our physician because it can be relative. Parents often ask me, “How focused should my kid be?” Or aging adults will ask me about how much mental decline is normal as we age. These issues can be easier to quantify when there is a notable before and after, for example someone who has trouble focusing after a concussion. However, if you find that your ability to focus/pay attention is affecting your everyday life than it’s worth looking into.

Addressing Executive Function Issues

Addressing issues of focus and attention can be very different in each individual. However, there are some systems that are commonly examined when looking into these issues. For example, frontal lobe function is a very important aspect that needs to be examined with any patient experiencing issues regarding executive function. The dopaminergic pathway is a very important biochemical pathway that has often been associated with focus and attention and should be assessed with each of these cases as well.

What is Dysautonomia?

When understanding dysautonomia it’s important to first understand the autonomic nervous system, which controls all the things you don’t think about (e.g. breathing, heart rate, digestion, etc.). It’s considered involuntary as you don’t consciously control it. It’s so important that it actually makes up 90% of your brain’s output, you only use 10% consciously. The autonomic nervous system is made up of two systems. The first is your parasympathetic system, which for simplicity is basically your rest and digest system. Secondly is the autonomic system which is essentially the fight or flight system. Dysautonomia is when this system becomes dysfunctional and results in physical symptoms. One of the most common examples of this that we see in our office is POTS or postural orthostatic tachycardia syndrome. This is where people have overactive sympathetic activity that causes their heart rates to elevate too high when they change positions resulting in them feeling lightheaded or fainting.

Addressing Dysautonomia

Dysautonomia is a broad term that can encompass a great deal of conditions. However, dysautonomia tends to have high correlations with physiological issues of the brainstem (e.g. the vagus nerve) or chemical imbalances involving the acetylcholine pathway. These systems, along with numerous others, need to be assessed and addressed to properly resolve dysautonomia. 

What You Need to Know About Your Appointment

It’s important to have all the documentation regarding your current condition to treat you properly. Below is a list of the necessary items to bring to your appointment or have sent over.