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Have you ever had headaches or dizziness slow you down? With vestibular migraines individuals can unfortunately have a recurring problem with both.

What are Vestibular Migraines?

A vestibular migraine (aka migrainous associated vertigo) is a condition involving the brain that causes symptoms of dizziness.

Are vestibular migraines a neurological disorder?

Yes, vestibular migraines are considered a neurological disorder, but structurally the brain is fine. Rather, a vestibular migraine is thought to be due to the brain having an adverse reaction or sensitivity to a certain stimuli.

What causes a vestibular migraine, or why do I get vestibular migraines?

That is a great question that no...

Do you ever find it difficult to see the torsional component of nystagmus with the Dix-Hallpike test? At times we have, and it can be concerning given the possibility of the  vertical nystagmus being indicative of a central vestibular disorder. There is, however, a clinical trick to help tease out any torsional component. 

It's All About Semicircular Canal Orientation

As the video in this blog reviews, the nystagmus with BPPV is in the same plane as the semicircular canal that is affected. So, with being able to understand the orientation of the canals we can bias the nystagmus to reveal the torsional component and if need be the vertical component.

To see more of the...

Over the past decade, there has been a significant increase in research published regarding concussions. This information has allowed care providers to better understand the pathophysiology and natural history of concussions. Treatment protocols have also been published to assist care providers in the management of concussions.

As with anything, with this increase in published information, there is a corresponding increase in misinformation and/or poor quality research. This has lead to conflicting information and confusion for both the health care provider and the patient.

Given this, we have decided to clear up some of this confusion in regards to concussions by getting “back to...

We are all familiar with vital signs such as heart rate, blood pressure, blood oxygen levels, respiration rate, and body temperature. How accurate are these signs at determining health or predicting future health? Are there other signs that we should consider as a vital sign? If you could add another vital sign what would it be? Mine would definitely be, with no reservation, “gait speed”.

What Is Gait Speed?

The time one takes to walk a specified distance on a level surface.

Why Gait Speed Should Be Considered a Vital Sign?

The reason I believe gait speed should be considered a vital sign is that it packs more information than just determining the need for a...

When you get to shore after a long day of boating with the family or friends do you ever feel like you are still in motion despite you are sitting or standing totally still? Then when you move this feeling is less noticeable? This sensation is called Mal de Débarquement and is a normal experience that resolves rather quickly. Mal de Débarquement Syndrome on the other hand presents in a similar manner, but lasts at  least 48 hours. 

Clinically, at North 49 we never see individuals with Mal de Débarquement, but will see those with Mal de Débarquement Syndrome. In this blog we will cover the 5W’s of Mal de Débarquement Syndrome (MdDS). I...

This past fall we were asked by a university program in the USA to help them deliver an online course for their students in regards to vestibular therapy. Traditionally this course and the labs were taught by faculty or guest lecturers in person, but COVID-19 has made this a challenge. 

To address this, we thought that our Understanding Dizziness 101 online course would be the best fit. This course was initially created with the clinician in mind. However, given the demand for online training this course seemed the best option to help students with their board exams and eventual life in the clinical setting as it builds a framework, for the course...

North 49 is a physical therapy clinic, but it is interesting as over half of the patients we see have dizziness. We see more patients each month with dizziness than back pain, neck pain, shoulder pain, knee pain or any pain for that matter combined. It is also interesting to note that our patient population is similar to what the literature finds in that with dizziness the most common cause is due to BPPV. 

So what is BPPV? Let’s review some of the basics.

What BPPV Stands For

BPPV is short for Benign (non life threatening), Paroxysmal (sudden, uncontrollable), Positional, Vertigo (sense of spinning).

What Is BPPV?

Ear Anatomy

To understand what BPPV is we...

Nystagmus What Does It Mean?

At North 49 our team of vestibular therapists look for nystagmus in determining one’s cause of dizziness. So, what is nystagmus? It is simply repetitive, uncontrolled eye motion. It usually affects both eyes. Depending on the cause it may be constant or intermittent. It can also be temporary or permanent.

Nystagmus how to pronounce?

nuh-stag-muhs

Nystagmus what does it look like?

It will look like a stuttering motion of the eyes. This motion can be linear (upward, downward, or laterally), rotary, or a combination. Sometimes it can be seen in room light while other times it cannot. Health care providers therefore use infrared goggles to make...

So why did we do this?

As therapists, all of us at the North 49 Balance & Dizziness Centre have been on a journey. Over the years we have seen individuals who reported being dizzy, but were not quite sure how to deal with it. To be honest some of us oldies were actually told in physical therapy school not to treat dizziness along with the other "5D's" which consisted of dizziness, dysarthria, dysphagia, double vision, and drop attacks. Interesting now, as over half of of our caseload at North 49 consists of people who are having their quality of life affected by vertigo and other forms of dizziness. 

With the lack of training early in our careers and the frequency of seeing...