This is our red light or green light system to treat or refer. This is by far the most important decision that comes out of a clinical evaluation and is especially important with neurological symptoms. The most common benign cause of vertigo is benign paroxysmal positional vertigo (BPPV). There are specific subjective and objective findings that are crucial to ruling in BPPV in the dizzy patient. A physical therapist trained in vestibular rehabilitation is well aware of these findings and do a splendid job at helping people! We are actually very good at differential diagnosis and use the latest research to help refine our clinical exam! In some instances, patients who are having dizzy/vertigo symptoms seek out help from physical therapists with thought they are having BPPV but instead it is an early sign for a stroke. Early diagnosis and intervention are crucial for successful treatment in patients with acute ischemic stroke because prompt thrombolytic treatment improves outcomes. We also do not want to propel a spontaneous dissection through a mechanical input, such as with manual therapy, Dix-Hallpike testing or even range of motion. In fact, ischemic changes affecting the vestibular artery in patients with BPPV could precede a full-blown ischemic stroke. These ischemic changes affecting the vertebrobasilar system could initially produce vestibular symptoms, such as BPPV. Here are a three factors for the vestibular therapist to know about BPPV and stroke:
CERVICOGENIC DIZZINESS COURSES AND CERVICAL VERTIGO COURSESYou can learn more about the screening and treatment process of Cervicogenic Dizzinesss through Integrative Clinical Concepts, where the authors (husband–a manual therapist a wife—a vestibular specialist), teach a very unique course combining both the theory and practice of vestibular and manual principles in their 2-day course. Pertinent to this blog post, the entire weekend includes the most up-to-date evidence review from multiple disciplines to diagnose through the “Optimal Sequence Algorithm” and treat through the “Physio Blend.”If you would like to host a course for your staff (either a vestibular, neuro, sports or ortho clinic), please do not hesitate to contact me at [email protected] for prices and discounts. Authors Harrison N. Vaughan, PT, DPT, OCS, Dip. Osteopracic, FAAOMPT Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts Danielle N. Vaughan, PT, DPT, Vestibular Specialist Instructor: Cervicogenic Dizziness for Integrative Clinical Concepts
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This article was originally posted on Modern Manual Therapy Blog
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