WHAT WE DO

Here at The Dizziness Directive we offer a range of evidenced based and individualised assessments and treatments to not only diagnose the cause of your dizziness but treat it efficiently and effectively.

ASSESSMENTS

Neuro-otological & Oculomotor Assessment

Given our extensive experience with acute dizziness in the emergency department, we will comprehensively assess the quality of eye movements and reflexes in the clinic.
There are many causes for dizziness that can range from central causes; involving the brain and brain stem this could be from a stroke or tumour. To peripheral causes involving the ear and nerves supplying the ear.
Subtle changes in your eye movements can give insight into where the issue is within the vestibular system and whether onward referral to a medical specialist in Neurology or ENT is required. It may show the need for further testing from an audiologist, vestibular function testing or if additional neuroimaging such as an MRI is required.
We will help guide you if you need additional medical referrals.

Video Infrared Nystagmus Assessment

Using the latest technology The Dizziness Directive will use infrared video nystagmus assessment to more complexly analyse your dizziness.
By performing tests with the use of goggles we can record and more accurately diagnose the source of your dizziness.

Positional Vertigo Assessment

The most common cause of peripheral vertigo is Benign Paroxysmal Positional Vertigo (BPPV). To learn more about the types of BPPV please click here.
BPPV is easily diagnosed at the bedside. During your assessment you will be moved into various positions most commonly lying down with your head tilted and/or rotated to one side.
If you are found to test positive for BPPV you will receive an initial repositioning manoeuvre to treat this form of vertigo.
You may require a long consultation if multiple manoeuvres are required during this initial consultation.

Balance Assessment

Your postural stability will be assessed in both static (standing still balance) and dynamic (moving around balance) through a variety of tests.
This may include force platform digital assessment as well as testing your balance on different surfaces and conditions of locomotion.

TREATMENTS

Canalithic Repositioning Techniques

Benign Paroxysmal Positional Vertigo (BPPV) is a mechanical disorder of the inner ear involving the semi circular canals - for more information please click here.
Dislodged otoconia (crystals of the inner ear) need to be repositioned back to the utricle for your positional vertigo to be treated successfully.
This involved specific manoeuvres your physiotherapist will complete with you in our clinic.
We are credentialed to perform;
- Posterior canal BPPV manoeuvres
- Horizontal Canal BPPV manoeuvres
- Anterior Canal BPPV manoeuvres

Gaze Stability

Aimed at improving vision while the head is moving.
This involves moving your head at a certain speed while maintaining focus on a target.
Gaze stability exercises are useful for people who have vestibular neuronitis which has resulted in unilateral hypofunction, acoustic neuroma or bilateral loss from otoxicity.
There has also been evidence that gaze stability can assist people with Meniere's Disease during an attack, motion sickness from Mal de Debarquement, post traumatic vertigo such as concussion and psychogenic vertigo in PPPD.

Cervical Proprioception Retraining

Following concussion and whiplash injuries you may experience dizziness, head pain, neck pain and vertigo.
One source of this complex diagnosis could be from your neck.
Proprioception retraining involves using a laser to use tactile and visual feedback of head and eye movements. This restores sensory ability and reduces mechanical sensitivity.
We may also include some manual techniques such as stretching, massage and manual mobilisation of the upper cervical spine where indicated.

Habituation & Individualised Exercise program

Where specific movements or environments cause your dizziness your physiotherapist will be able to construct a graded exposure program to desensitise your response.
This maybe certain functional movements such as bending over to do your shoes, hanging washing, climbing stairs or even visiting the grocery store.
This may include the use of Virtual Reality (VR) goggles and videos.