Vertigo from Vestibular Neuritis with Iyad Salloum

Mark: Hi, it's Mark from Remarkable Speaking. I'm here with the Iyad Salloum of Insync Physio in North Burnaby. He's the partner, he's the clinical director. And we're gonna talk about something that causes vertigo and dizziness for people that's a little bit different. How you doing Iyad? 

Iyad: Good Mark. How are you today?

Mark: Good. So big words, vestibular, neuritis, and labyrinthitis. What is this stuff? 

Iyad: Yeah, so the vestibular organ is kind of like an accelerometer in our inner ear. And what it does is it helps our brain figure out what our head's doing in space. So whenever we move our head, we get signals that go from the left ear and the right ear to our brain. And this is really important for us to maintain our balance. 

So the vestibular neuritis condition is when we get, usually we think it happens after a viral infection, as it's inflammation and swelling of the nerve. That swelling is pretty bad because it exerts just physical pressure too, on some of those cells. And you can actually get a bit of loss in function in those things. 

And then the labyrinthitis is, think of it as the bony house of the vestibular organ which is attached to our hearing organ. So you can get an inflammation of that whole thing. And it's the same idea, like you have an inflammation, swelling, and pressure, which can cause a disruption of those systems. 

And then from that, because usually it'll affect one side, it can affect both. But most commonly, we see it on one side. You'll see some people struggle with things like vertigo, dizziness, occasionally they get hearing symptoms or ringing in the ears. Those are pretty common too. Because of that, you'll have severe disruptions to balance and ability to function. 

Mark: So those are the symptoms. You mentioned viral things, is that the main cause? 

Iyad: That's what we suspect. Our best thought now is that you have a viral infection that affects those areas. And then the immune response that's associated can cause a bit of swelling in that area and inflammation of it. And that kind of can cause downstream losses of function. 

Mark: So if I'm feeling dizziness and vertigo and those sorts of things, is it my best course of action to just come and see you? Or is there a better plan? 

Iyad: That's a great question. Typically, what we see is people have been to their physician first because there's a lot of things that can cause dizziness and vertigo and another thing. And most people when they have it, because it happens so suddenly, might think they're having some kind of event in the brain. So think of potentially like a stroke. So we see the after effect of it. 

Obviously I encourage everybody who's having unexplained symptoms like this that are not just lasting in short periods of time, to consult their physician right away, just to make sure that it's just let's say, limited to the vestibular organ and not something bigger. But yes, we are able to kind of assess these. And if somebody requires more, let's say of a workup, we will send them to their physician when they come see. 

Mark: Well, it's it's can also be caused by the medication you're on too. If you're on certain heart medications, this is a side effect, is that right?

Iyad: Dizziness could be a side effect and maybe lightheadedness could be a side effect. However some things can cause vertigo. Yes. But typically we'll assess that in the history and we'll figure that out. Some medications are bad for your vestibular organ, but most of the time, the people we're talking about, it comes out of the blue.

Mark: So what's your typical treatment course that you're gonna put somebody on, once you've diagnosed this is what's going on. 

Iyad: So we would start by figuring out if their symptoms are mostly dizziness or vertigo related. We could help with things called the gay stability exercises to address that certain impairment. So we would figure out where is this deficit first? And then put 'em on a regimen of exercises. In some cases you can have somebody having BPPV on top of this. So we would also be able to figure that out, which is where you have one of the crystals being dislodged in the canals in the vestibular organ. That could be treated with a repositioning maneuver. 

It doesn't happen to everybody, but it's good to do a thorough assessment. And then we would also do a set of exercises to help them desensitize to things such as, usually get people saying whenever I tie my shoe and I come back up, I get burst of dizziness or I feel like I'm gonna fall. So those are things that we can address. And it's really functionally dependent on what they can and can't do. And that's where the program is very specific. So you'll almost never see two people with this condition get the same treatment because it affects us so, so, so differently. And it'll depend on lots of things. 

So for example, If you get this when you're younger, usually people don't have bad balance. Like generally when they're a bit younger. So if somebody let's say in their eighties, when they're already kind of struggling with balance and then like maybe vision and then a few other things, so you'll see a different treatment regimen for somebody like that.

Mark: If you're having some dizziness issues, vertigo, feeling like you're falling, the guys to see in North Burnaby are Insync Physio. You can book online at insyncphysio.com. They have two offices. You can reach the Burnaby office at (604) 298-4878. If you want to call somebody and book. Or in Vancouver at (604) 566-9716. Thanks Iyad. 

Iyad: Thanks Mark.