Brain injury - Dizziness

  • The vestibular system is the part of the body that is responsible for balance. It is located in the inner ear. Vestibular dysfunction can cause symptoms such as dizziness and vertigo. These can be treated by vestibular rehabilitation.

    What is it?

    There are three main types of vestibular problems that children may develop following trauma to the head:

    Unilateral vestibular dysfunction

    Symptoms may include balance problems, dizziness or a spinning sensation.

    Bilateral vestibular dysfunction

    This occurs when both sides of the vestibular system are affected. Symptoms are similar to unilateral dysfunction but may also include the illusion that objects are moving or bouncing when the person moves their head.

    Benign paroxysmal positional vertigo (BPPV)

    This condition occurs when tiny crystals within the inner ear become dislodged, usually due to trauma to the head. These crystals float within the balance canals and cause a spinning sensation whenever the person moves their head in certain ways.

    What are the symptoms?

    You may suspect that there is a vestibular problem if there are symptoms of:

    • dizziness
    • vertigo
    • a spinning sensation
    • the sensation that objects are bouncing or sliding around in your field of vision with certain head movements

    How is it diagnosed?

    There are a number of specialised tests required to diagnose a vestibular dysfunction. Your child's GP or physiotherapist may detect that a vestibular problem is present and will refer you to one of the specialist vestibular rehabilitation centres for further investigation.

    What is the treatment?

    Unilateral and bilateral vestibular dysfunction are treated by vestibular rehabilitation. This is usually undertaken by a physiotherapist. It consists of an exercise program, developed for the patient, that helps them to compensate for the dysfunction in the vestibular system. The program may include balance exercises, exercises to help coordinate the reflexes that control eye movement and practice of functional activities such as walking and bending.

    Benign Paroxysmal Positional Vertigo (BPPV) can often be treated in a single session by a head-positioning manoeuvre. This can be performed by a physician or physiotherapist who is trained in the procedure. It takes approximately half an hour and is not painful for the patient, although it does provoke some dizziness. One treatment is usually all that is required.

    Key points to remember

    • Vestibular problems can develop after a brain injury.
    • If your child experiences dizziness, vertigo, a spinning sensation or the sensation that objects are bouncing or sliding around in their field of vision with certain head movements, this may indicate there is a vestibular problem and you should consult your doctor.
    • Vestibular dysfunction can be treated by vestibular rehabilitation.

    More information

    Developed by The Royal Children's Hospital Paediatric Rehabilitation Service. We acknowledge the input of RCH consumers and carers.

    Reviewed August 2020.

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