Gaze stabilization exercises

Just saw on this article that you dont gain anything fro these excercises if you have MAV because “its episodic”. Like wtf?

https://www.dizziness-and-balance.com/treatment/rehab/gaze%20stab.html

Yep, Kon. Not too sure which you refer to here. If you mean why does Dr Hain refer to MAV as episodic. Not so much that it’s ‘episodic’. MAV can be both episodic and chronic (24/7) and it changes over time. All in my diary. But I’ve had both types, episodic for many years then it went chronic in 2014.

If you are querying why he thinks exercises aren’t helpful to people with migraine. That’s because it isn’t a stable condition. Think he’s saying you cannot reset something back to a baseline that isn’t stable in the first place. Every time another attack occurs baseline changes.

Dr Hain and many others don’t support VRT etc, gaze stabilisation exercises, etc for MAV because migraine is considered a central (coming from the brain) and not a peripheral (coming from ears etc) condition. He writes of this in much greater detail in another article which I think I’ve bookmarked. Try Section E (right at the bottom) before the references section, Helen

http://dizziness-and-balance.com/treatment/drug/vestibular%20compensation.html

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Yep, the problem here with MAV it is much harder to compensate when you have an instability.

In fact, I’d say instability in your vestibular system defines MAV. This in itself suggests it’s less about ‘damage’ and more like something is going on that the brain finds hard (or impossible) to control to bring things back to homeostasis.

The brain is seeing unpredictable changes it cannot learn to influence.

A good possibility here is physiological issues, like inflammation in the ET which fluctuates, changing the characteristics of the labyrinth response.

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Yes I thats what I was talking @Onandon03 So there is a possibilty to confirm a diagnosis from these excercises? I mean, you can do the excercises and see if you have a reduction of symptoms. If you dont you may have MAV/VM or the other disorders mentioned there. Also @turnitaround inflamation of ET can be seen? I mean I think there is a way to have a view of whats going on.

Just read the article. If understamd correctly it says its central not peripheral problem. So this means that there is no structual problem on the ears(labyrinth, cohlea etc), so every test done on the ears like caloroc test should be normal. Am I right?

No. The only way to establish if you have some type of convergence issue with your eyes is to see a suitably qualified ophthalmologist usually found in a hospital. Failing to respond to eye exercises is not going to confirm it. There could be many reasons a person could fail to achieve progress with trying eye exercises. Far more if you are doing them without professional instruction first. I wouldn’t suggest anybody with MAV did eye exercises or VRT without professional advice first because it could me them very much worse.

I don’t understand the technicalities but the Rotary Chair Test is used to trace source of dizziness I believe ie to tell whether it comes from eyes/ears (peripheral) or brain (central) The direction of nystagmus is also indicative to the doctor. Helen

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They do some superficial pressure test as a mile high check. I’m not convinced it’s taking into account all possibilities.

I’ve never demanded mine was physically checked but I know it’s a problem because it occasionally cracks open and it can make ‘squishy’ noises. None of that occurred prior to MAV.

In terms of VRT I wonder if the effect of twisting the neck repeatedly actually clears and opens the ET thus releaving symptoms and it’s nothing to do with compensation!!

That’s certainly been my experience.

My VRT was head still - eyes only. And it was tremendously helpful for me - but only really gained traction when I was stabilized on Effexor.

Blimey. Mine was shaking my head all over the shop!

But zero use in any case.

The proper rotary chair test is difficult to find sadly because it uses projectors and its mechanical. I wish Icould do this test somewhere in my country. I dont think it can tell if you have a central problem or not.
I had crack noises when I swallow many years but never thought its a problem.

The rotary chair test is traumatically nauseating. No amount of curiosity would inspire me to volunteer for that experience twice. Also, with MAV the test results are pretty useless. Treatment is the same no matter the results. Central, peripheral - same meds.

Fixing my ETD with ear tubes did not improve my MAV. Reducing overall inflammation improved my ETD and reduced the cracking, fullness, muffled hearing and my MAV. VRT and meds improved the visual vertigo, motion intolerable and nystagmus. The only use for the testing was to rule out more dire possibilities and to convince insurers to pay for care.

Oh much frowned upon so I read. Presumably you weren’t a prescription lens glasses wearer at the time. Prescription lens aren’t designed to be used that way. And as for glasses containing prisms. Wouldn’t bear thinking about, the distortion.

https://journals.lww.com/jnpt/pages/articleviewer.aspx?year=2016&issue=04000&article=00008&type=Fulltext

Similar to mine then and I deliberately sought out an American trained VRT therapist cos I thought they would be more knowledgeable than ‘ours’. Mine wasn’t so much the ‘shaking it all over’ but the constant head turns left and right, right and left. Prescribed exercises to do five times daily And as it included walking turning head one way or the other with every step I once counted I was turning my head some 450 times per day for months on end. Helen

We did a bit of head turning, but in a really limited capacity. When I first walked in the door, I could watch her move the card with the X on it side to side in a foot wide path twice, with my head still, before puking. By the end, I could watch a train go by and read the logos.

I’m pleased it proved a positive experience for you.

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Little late on this but then how are you supposed to go back to a stabilized baseline without moving around?

My doctor told me too much or wrong VRT can put you even worse where I was so I’m not doing it right now

Go for walks, preferably amongst nature.

Without moving around is not an option.

That’s true. And moving about your house? I’m trying to live as normal as possible and take breaks in between because my brain and body are so tired.

Yeah VM is not stable but compensation is possible again?

The more you push yourself, the easier it will eventually get. Going outside is easier than dealing with indoor lighting, arguably.

The other advantage of going outside and especially amongst nature is that that can lessen anxiety at the same time.

You have to fight it.

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I think you might have misread the start of this thread. We were discussing VRT eye exercises. Some are carried out with your head stationery, some with it on the move. Nobody was suggesting we all stopped walking around. Your doctors right. VRT can make MAV far worse. It did me. I agree with @turnitaround. Wallking outside in nature is good exercise and boosts feel good hormones etc, produces a calming effect. All natural and for free and depending on where you live can hopefully be safely carried out Socially Distanced.