Functional Dizziness or Vertigo?

 

What exactly is functional dizziness?

Recurrent attacks of vertigo or prolonged vertigo, other balance system disorders give rise to functional dizziness.

Eg. I have dizziness on looking at moving cars or traffic

I have dizziness on looking at moving lights

I have dizziness on looking down or bending to pick something up

How is vertigo different from functional dizziness?

Vertigo is a sudden attack of dizziness with imbalance caused due to specific position of head.

Eg. Having dizziness on turning on left side and getting up. It usually goes away within a minute. If I close my eyes, the nausea reduces. I feel like surrounding moves. I feel imbalance while walking.

So what does this mean?

This implies that everytime I have dizziness, the cause is may not be vertigo. It should be properly diagnosed by a Physiotherapist or a Doctor. You should not take medication without proper advice because you maybe taking medication to cure something which is not the cause.

Then why does functional dizziness happen?

The brain receives inputs from eyes, balance system in the ear and joint position sensors and then it matches all 3 inputs. Eg. If you tilt your head to the right and walk, inputs will be given by eyes, ear and neck joint sensors that everything is tilted. Each input will be matched with each other and then the brain will give command to body to balance itself, otherwise you would go sideways to the right and fall

In prolonged vertigo, this mismatch between all these 3 systems happens repeatedly and you become used to interpreting everything wrong. Hence, moving cars, moving visuals, etc. give you dizziness. Any psychogenic disorders like anxiety, depression are know to provoke functional dizziness.

What can we do about it?

There is definitely a solution for this! Vestibular rehabilitation along with exercises which train your visual and ear balance system inputs are given to improve the mismatch.

There is a variety of exercises which can be given depending on personal symptoms and requirements. The treatment needs to be customised and cannot be generalized. Since there is a psychogenic factor to functional dizziness, Cognitive Behavioural Therapy (CBT) helps as well.  CBT is a gradual process that helps a person take incremental steps toward a behaviour change.

Combination of vestibular rehabilitation with CBT can help patients escape a cycle of maladaptive balance control, recalibrate vestibular systems, and regain independence in everyday life.

For details about vertigo and its physiotherapy treatment, please refer to our previous blog on vertigo: https://rehabstationpune.blogspot.com/2022/02/blog-post.html

Dr. Sukanya Dandekar (PT)

Neuro Physiotherapist

Rehab Station, Pune