Vestibular therapy vs neuro-optometrist
 

Hi all.

I've been having some dizziness issues lately which I never had at the start of my PCS. So I'm taking steps to try and solve it.

I have an initial appointment with a vestibular therapy clinic later this week. Then early next week i have an initial appointment with a neuro-optometrist.

My question is a bit silly:
Should I try one first for a while before i try the other? Is it ok to go see both of these specialist back to back within a span of a few days?

I started with the vestibular therapy first, and that really hit me hard and fast. I couldn't function for several days after my first two visits. In retrospect, I am fairly sure, that this therapy was too aggressive for me - even though I had a therapist that truly cared about my outcome.

I've recently started with the vision therapy at an eye dr's office, and it is more structured/tailor made for what the eye dr saw with my eyes during the initial eval.

Just my opinion, but I don't think you should see both at the same time. I do think you will be shocked at how some seemingly simple eye exercises can cause your brain to go on overload.

Vision contributes a lot to balance. The vestibular therapist should check you for eyes open and eyes closed balance. If your eyes closed balance is close to normal but your eyes open balance is poor, it suggests you need to get the vision issue resolved. A behavioral optometrist can be helpful. Health Care Locator Custom

Neuro-ophthalmologists do not have a good track record based on posts on NT. But, every neuro-ophthalmologist is different.

You could start your exam with the VT by asking, Is my balance problem mostly caused by a vision problem ?

Thanks for that. I will certainly ask that question to the VT.

Do you have any theories on why dizziness would start a month and half into PCS? Like i said in the other thread, I wasn't really dealing with much dizziness at the start but the since the hot bath on thursday, I've been dealing with dizziness and balance issues. My theory is that the blood pressure drop etc from the hot bath was too much for the concussed mind to handle and was a bit of a relapse and lead to dizziness.

In your experience, do you know how long relapses last for and go back to "normal" before the relapse event?

I used to plan on relapses from over-stimulation or over-doing it to last a week to 2 weeks. I just laid low for a while and eased back into life.

Thanks. I will hope i get back to my "normal" PCS state in a week or two like you stated.

An important part of recovering from setbacks, I would never fret or worry about when. I learned to just go with the flow. Anxiety will only make the return to normal PCS take longer.

Thanks. I'm trying to work on my anxiety.

As for the dizziness, does that usually resolve on its own for most people or is VT or Nero-Optimitrist intervention necessary?

I have one more question for you Mark.

Should I wait to see if my dizziness symptoms get better by itself after the setback? Or should I go to the Vestibular Therapy right away? I'm a month and half into my PCS recovery/journey for your reference.


I'm a little torn on what to do right now. Any input would be appreciated?

I don't have an answer for you. You may be paying too much attention to your symptoms.

How dizzy do you get ?

When do you get dizzy ? What kind of activity or movement causes dizziness ?

It appears the the dizzy spell from the hot bath never went away. BUT, the hot bath could cause a dizzy spell for people without a concussion just due to how it causes blood flow to change for a short while. I've experienced that many times from hot tubs and saunas. That dizziness resolves once the body cools down and the person starts moving.

I think it is likely that the hot bath dizziness got you focused on any amount of dizziness. Anxiety about dizziness will make even minor dizziness much worse.

My suggestion is to get on with your life and if you get a moment of dizziness, deal with it by stopping for a moment and then move on. Chances are that by not focusing on it, it will diminish over time.

A vestibular therapist may be helpful but it is crap shoot. If you exhibit minor vestibular issues, will she emphasize them or down play them. If she is looking for a patient to bill, she may emphasize minor issues. Nobody can say.

Have you looked into the Epley Maneuver ? It helps reorient the crystals in the inner ear than can be out of place. That should be the first assessment before any other treatment. You can get self-help instructions for Epley and similar techniques on YouTube.

If you see the VT, ask for an Epley assessment first. Then, vision related balance, eyes closed vs eyes open balance.

At less than 2 months, you could still spontaneously get better. Nobody can say. But, focusing on minor symptoms does not help you get better.