Understanding Third Window Syndrome (TWS)

Jul 06, 2024

As healthcare providers, we occasionally encounter patients with dizziness that does not fit the usual patterns of vestibular disorders. One such condition is Third Window Syndrome (TWS), which most commonly presents as Superior Semicircular Canal Dehiscence (SSCD). There are other presentations of TWS aside from SSCD and TWS itself was first described by Minor in 1998. 

In this blog, we will cover what TWS is, its causes, symptoms, triggers, diagnosis, and treatment options.

What is Third Window Syndrome?

Third Window Syndrome (TWS) encompasses a group of inner ear disorders characterized by an abnormal opening or thinning in the bony structures of the inner ear. The most...

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Exploring the Skull Vibration Induced Nystagmus Test (SVINT)

May 25, 2024

We’re excited to share an assessment technique that has significantly enhanced our ability to evaluate patients with vestibular hypofunction: the Skull Vibration Induced Nystagmus Test (SVINT). After hearing about it a few times over the past few years, we decided to investigate further and are glad we did. Given our access to infrared goggles, implementing SVINT was quite affordable since portable handheld massage devices can be picked up at places like Walmart.

Clinically, the test has helped us pick up vestibular hypofunctions when our other battery of tests such as looking for gaze evoked nystagmus, head impulse test, head shaking nystagmus test, and dynamic visual acuity tests...

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Infrared Goggles: A Comparative Guide for Vestibular Therapists

May 09, 2024

At North 49, the three common questions we get asked about infrared goggles are:

  1. Can we get a discount rate on goggles through North 49?
  2. Do I really need goggles?
  3. Which goggles do you recommend?

Can we get a discount rate on goggles through North 49?

The answer to the first question is, unfortunately no. That being said, we would really appreciate that if you end up buying a pair of goggles from Vestibular First that you use: as it allows us to collect points that we redeem to purchase anatomical models that we give out as draws at our weekend courses. From time to time we also have give-away draws for our monthly newsletter subscribers....

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Acoustic Neuroma Review

Mar 28, 2024

As a healthcare provider, seeing patients with various medical conditions is part and parcel of our daily routine. However, there are certain conditions that are relatively rare, but require keen attention and understanding for effective management should they occur. One such condition is an acoustic neuroma, also known as vestibular schwannoma. In this blog, I will provide insights into what an acoustic neuroma is, its prevalence, clinical presentation, conservative treatment principles, and indications for surgery. Then, if you want to take a deeper dive, I'll provide some of my favourite resources at the end of the this blog. 

Understanding Acoustic Neuroma:

Acoustic neuroma is...

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Why Blogs Are Important

Mar 02, 2024

How Blogs Help SEO

In today's digital age, a strong online presence is crucial for the success of any medical practice, including physiotherapy clinics. A few years ago, we recognized the importance of being easily found on the web to attract new clients and when we did a search our clinic ranked high, being easily found if someone searched "physical therapy". However, with the search word "physiotherapy" we showed up on the fourth page.

Given that, we had to make some changes and one tool that has boosted our search engine optimization (SEO) or ability to be found on the web is by posting blogs using keywords such as "physiotherapy". The general experience from us and...

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End Point Nystagmus Differentiation

Feb 04, 2024

Do you ever struggle distinguishing between different types of nystagmus, such as end point nystagmus (EPN) and gaze evoked nystagmus (GEN)? If so, you're not alone. Working closely with therapists in vestibular therapy over the years we've found this to be a common issue. Given such, let's review three practical tips when assessing patients that we have found helpful.

Actually, before we get too far, we need to remember that end point nystagmus is a normal physiological response, while a true positive gaze evoked nystagmus finding is indicative of a central or peripheral vestibular disorder.

As we will see in this blog, end point nystagmus is a bit of a misnomer as it can be...

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Dizziness Handicap Inventory & Activity Specific Balance Confidence Scale: Functional Outcome Measures Explained

Dec 29, 2023

If you're among those healthcare providers who have yet to dive into the world of Functional Outcome Measures (FOMs) when working with vestibular patients or would like to see what other healthcare providers are using, we got you covered.

In this blog we will delve into two trusted measures that have stood the test of time—ones that we've consistently relied on at North 49 being the Dizziness Handicap Inventory (DHI) and the Activity Specific Balance Confidence Scale (ABC). Over the years these measures have offered insight into how disabling patients perceive their vestibular condition to be, aiding us in designing more targeted and effective treatment plans.


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Blue Light Blocking Glasses for Concussion & Vestibular Migraine: Shedding Light on the Evidence

Dec 09, 2023

As a physiotherapist, the decision to use a particular treatment often rests on a delicate balance between using something as there is strong research behind it or not. This holds true with the use of blue light blocking glasses to treat concussion and vestibular migraine. Some optometrists we have talked to indicated that they do not endorse the use of these glasses due to a lack of research. Then, on the other hand we hear from people who say these glasses were "game changers" for managing their symptoms. Is there something behind these glasses, are they a placebo, or a bit of both?

Let's explore the rationale for considering the use of blue light blocking glasses.

Blue Light Blocking...

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What is Alice in Wonderland Syndrome (AIWS)?

Nov 11, 2023

Have you ever wondered why Lewis Carroll's "Alice in Wonderland" seems like such a trippy and surreal journey? Well, there's a fascinating theory that connects this whimsical tale to a peculiar phenomenon known as "Alice in Wonderland Syndrome" or AIWS. This syndrome is closely associated with migraines and can offer a curious glimpse into the world of distorted perceptions. It has been said that Lewis Carroll himself had migraines, so this may be a tale expressing what he was experiencing personally.

What is Alice In Wonderland Syndrome or AIWS?

Alice in Wonderland Syndrome (AIWS) is a rare and intriguing neurological condition, often linked to migraines. But, it can also be triggered by...

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Vitamin D, the Sunshine Vitamin & Its Impact on BPPV Risk

Oct 05, 2023

As healthcare providers, our primary goal is to enhance the health and well-being of our patients. One intriguing area of research that has gained attention in recent years is the connection between vitamin D and the risk of Benign Paroxysmal Positional Vertigo (BPPV). BPPV is the most common cause of vertigo, and understanding the role of vitamin D in its development can be crucial in both prevention and treatment. In this blog, we will explore the potential link between these two and discuss how healthcare providers can address this connection in their patient care.

The Importance of Vitamin D

Often referred to as the "sunshine vitamin," it plays a vital role in maintaining our overall...

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