My tip is: If there’s any opportunity for vestibular rehab therapy, take it, even if you feel it won’t help! I say this mainly because the two PTs I have encountered over the years have been mines of information and insight and practical assistance - more so than neurologist, ENT, primary care doc.
1 Like
VT can make some with MAV worse, all the head shaking can be too much for some. Probably best to get on a medication/ lifestyle regime that controls symptoms first and once stable look at VT to help in the longterm. I tried VT for months to no avail, but I havent found a med that works either. If/ when I do I intend to revisit it again.
2 Likes
The last time I took Vestibular Therapy, the therapist stressed that I was to go slow, and that if any exercise was starting to trigger an episode, I should stop immediately and not go back to it again until I’ve had at least a couple of normal days. She stressed slowly working my way up to more speed over a long period of time.
3 Likes
I agree. VT can potentially make vestibular migraine worse unless you’ve already got a decent benefit from medication. You need to stabilise your brain first before possibly considering VT. It might be more helpful for those who have secondary vestibular conditions though, like PPPD.
1 Like
Yes, too much VT can worsen your symptoms. But hearing a different professionals opinion can definitely help too. So I get the OPs point.
1 Like
My VT’s opinion is that my very-long-term VM has morphed into VM + PPPD. Reading up about PPD, it makes sense to me. Which matters insofar as I have a new way of looking at it - which helps me. She was adamant that any testing (such as head shaking) would stop as soon as I alerted her. So, I am going to proceed with a few weeks of VT, stay more committed to daily “exercises” and improving some habits (e.g., NOT lying down every time I get in from a walk; NOT always standing with my feet wide apart), keep seeing the psychotherapist to help manage stress.
I know this has got off the Pro Tips a bit.
3 Likes
Yes I’ve seen the theory that long term, chronic, untreated or unresponsive to meds VM morphs more into 3PD territory ( although to my mind they arent seperate entities, what seperates the symptoms is paper thin). My vestibular physio has suggested the same to me, probably because I’ve tried and failed so many meds. But I’m holding off on VT until I see my private Neuro next month to explore what other treatments are available.
1 Like
My neuro told me that pppd dizziness disappears, or vastly lessens, when lying down. If it’s just as bad lay down as standing then it’s more likely to be VM. Not sure how accurate that simplified view is but it ruled out my symptoms as my dizziness was always just as bad lying down, if not worse.
1 Like
I think its difficult, because BPPV can be bad if you are laying down for instance, many sufferers report turning over in bed triggers their dizziness, and MdDS is worse when still than when in motion. Do we really have all these different syndromes and entities with the long sounding names or are they all manifestations of the vestibular disorder/ migraine spectrum.
I just hope there is more research being done into migraine and other vestibular conditions because they are so poorly understand. They’ve been overlooked for decades.
Thought I’d share some info about vestibular therapy I found on a pdf from https://balanceanddizziness.org
Once you have started reducing triggers, making lifestyle changes, and trying medical treatments for VM, vestibular rehabilitation therapy can help by Increasing your balance confidence and reducing persistent symptoms.
It is very important to have VM under control before starting vestibular rehabilitation. Your dizziness and imbalance will not improve, despite
diligence, unless the underlying problem of VM has been addressed adequately. It should be considered
for all VM patients. The vestibular therapist can record and effectively communicate your progress
to your doctor.
Vestibular rehabilitation is a type of exercise Therapy. People with stable VM may be helped by exercises including:
• gaze stabilization
• habituation
• eye tracking
• balance
• hand-eye coordination
It is important to be patient and persevere with the
exercises. Do not, however, “push through” your symptoms. Continuing with vestibular rehabilitation when VM symptoms are exacerbated may worsen your VM, increasing the frequency and severity of
your symptoms. If vestibular rehabilitation therapy Is worsening your migraine attacks, speak to your
therapist.
2 Likes