Dr. Vaishali Sangole | Treatments of Vertigo

Treatments delivered are :

1. One staged Therapeutic Manouvres

The Epley’s maneuver
Semont maneuver
Guffoni maneuver
Yacovino maneuver

2. Vestibular Rehabilitation Therapy

Vestibular Rehabilitation Exercises

Vestibular compensation is a process that allows :-

The brain to regain balance control and minimise dizziness symptoms when there is damage.
If their is imbalance between, the right and left vestibular organs (balance organs) in the inner ear conditions the vestibular compensation is benifit.

Essentially, the brain copes with the disorientating signals coming from the inner ears by learning to rely more on alternative signals coming from the eyes, ankles, legs and neck to maintain balance.

In bed or sitting

Eye movements

Up and down
From side to side
Focusing on finger moving from three feet to one foot away from face

Head movements

Bending forwards and backwards.
Turning from side to side.
Stretch your arms out infront with your thumb pointing upwards. Now turn your head to the left and the right while keeping your eyes fixated on your thumb.

Sitting

Shrug and circle shoulders
Bend forward and pick up objects from the ground
Bend side to side and pick up objects from the ground

Standing

Eye, head and shoulder movements, as 1 and 2
Change from a sitting to a standing position with eyes open, then closed (please note this is not advised for the elderly with postural hypertension)
Throw a ball from hand to hand above eye level
Throw a ball from hand to hand under the knee
Change from a sitting to a standing position, turning around in between

Moving about

Walk up and down a slope
Walk up and down steps
Throw and catch a ball
Any game involving stooping, stretching and aiming (for example, bowling)

Gaze stabilization exercises

The aim of gaze stabilisation exercises is to improve vision and the ability to focus on a stationary object while the head is moving. Your therapist should assess you and say which exercises are suitable for you. Look straight ahead and focus on a letter (for example, an ‘E’) held at eye level in front of you. Turn your head from side to side, keeping your eyes focused on the target letter. Build up the speed of your head movement. It is crucial that the letter stays in focus. If you get too dizzy, slow down. Start doing the exercise for a length of time that brings on mild to moderate symptoms (you could use the number rating scale). This might only be for 10 seconds. Over time, you can build up to one minute (the brain needs this time in order to adapt). Build up gradually to repeat three to five times a day.

3. Fundoscopy Reports from Retina Specialist

Normal Fundus

Diabetic Retinopathy

Hypertensive Retinopathy

Glaucoma

Optic Neuritis

Equipage partnering with Dr Vaishali Sangole’s Headache and Vertigo Clinic - for FUNDOSCOPIC EXAMINATION.
FUNDOSCOPY EXAMINATION without Dilatation
Why get your Fundus Examined?
1.Preventable blindness / Preventive blindness- an initiative for elimination of avoidable blindness - in collaboration with Equipage Health Pvt Ltd.
2.Higher Prevalence of Blindness - Visual impairment and Blindness disproportionally affecting larger populations in present days.
3.Systemic diseases - Hypertension causing hypertensive retinopathy and Diabetes causing diabetic retinopathy ( eye sight may be normal till advanced stage of the diseases ) are the various causes of irreversible vision impairment and blindness.
4.Use of phones ,Laptops ,TV screens - especially during lockdown because of work from home and in children with online schooling -dryness is eyes,blurring of vision and headaches have become common symptoms.
5.Raised CSF Pressure - Raised intracranial pressure in Vertigo patients or related to other intracranial conditions.
6.Trauma - Damage to optic nerve, retinal tear or detachment secondary to trauma . 7.Raised pressure of eye - Glaucoma (which is excessive pressure in your eye), causes slow progressive vision loss which is irreversible hence needs screening, typically side or peripheral vision is affected first hence goes undetected.
8.Age related - Macular degeneration (a loss of vision in the center of your visual field) is a common cause of visual loss in older aged groups.
9.Infection of eye- Cytomegalovirus (CMV) retinitis (an infection of your retina)
10.Tumours - Melanoma (a type of skin cancer that can spread to your eyes.

4. Yoga and meditations

Yoga asanas can help in strengthening the nervous system, increase blood circulation and supply of oxygen to the brain and body.

Following are 5 most beneficial yoga asanas to get rid of vertigo:

Pranayama - This yoga pose helps in blood circulation in the body, and strengthens the nervous system. The deep breathing exercise enhances blood with oxygen supply and opens up the nerves.Pranayama can help in strengthening nervous system.
How to do it
Step 1. Sit comfortably with your legs crossed and back straight.
Step 2. Close your right nostril with your right thumb and inhale from your left nostril.
Step 3. Hold your breath and seal your left nostril with your ring finger of the same hand and release right nostril and exhale slowly.
Step 4. With your left nostril closed, inhale from right nostril.
Step 5. Then again, while holding your breath close your right nostril and release your left and exhale.
Paschimottanasana (seated forward bend) - This yoga practice releases stress, anxiety, and fatigue. It is found to beneficial in curing vertigo.
How to do it
Step 1. Sit in an upright position with your legs stretched straight in front of you and your toes upright facing the ceiling.
Step 2. While inhaling deeply, raise your hands slowly over your head with your palms facing forward. Stretch.
Step 3. Exhale and slowly bend forward with your arms, spine, and neck aligned.
Step 4. Stretch your hands and try to touch your feet.
Step 5. While stretching, try to keep your knees on the ground and try to touch your head to your knees.
Step 6. Then slowly come back to your rest position and repeat.
Shavasana - This asana brings profound and meditative state of rest, which helps in releasing stress and strengthening the nervous system.Shavasana can help in reducing symptoms of vertigo.
How to do it
Step 1. Recline yourself on a comfortable mat. Lie in a comfortable position with your legs slightly apart from each other.
Step 2. Put your arms in a resting position away from your body and your palms facing upwards.
Step 3. Close your eyes and focus on your breathing.
Step 4. Your chest should expand as you inhale and vice versa.
Shanmukhi Mudra - This mudra helps to calm your mind and nervous system. It also helps in reducing anxiety and irritation.
How to do it
Step 1. Sit straight with your back erect and shoulders pulled backward.
Step 2. Raise your elbows at your shoulder level and close your ears with your thumbs.
Step 3. Close your eyes and gently place your index fingers on your eyelids.
Step 4. Seal your nose with your middle fingers.
Step 5. Encircle your lip area with your ring and small fingers. In this process make sure your fingers gently seal the gates.
Step 6. Inhale heavily through your nose, hold the breath and release.
Step 7. Concentrate on the breathing process and come to your rest position after you are done.
Halasana - This pose helps strengthen back muscles, neck, shoulders. It relaxes and strengthens the nervous system and can also help in dealing with vertigo.
How to do it
Step 1. Recline yourself on a comfortable mat with your arms beside you and palms facing downwards.
Step 2. While inhaling, lift your feet up and raise legs vertically at 90 degrees.
Step 3. Then slowly, with the support of your hands at the back, sweep in your legs at 180 degrees over your head till your feet touch the ground.
Step 4. Remember to keep your back at 90 degrees to the ground.
Step 5. Hold this pose till you can and then come back to your relaxing position.

5. Diet

Diet To Help You With Your Vertigo | Dizziness

Food rich in sodium like soy sauce, chips, popcorn, cheese, pickles, papad and canned foods are to be avoided. You may replace your regular salt with low sodium salt as sodium is the main culprit in aggravating vertigo. Nicotine intake/Smoking. Nicotine is known to constrict the blood vessels.
Ginger may ease vertigo associated symptoms, like nausea, lightheadedness and vomiting. Ginger roots are counted as the best foods for vertigo. Drinking ginger tea daily is quite effective in treating vertigo.
Vitamins B12 deficiency in prevalence is a commoner cause of systemic and central Vertigo. To increase the amount of vitamin B12 in your diet, eat more of foods that have enriched Vitamin B12 like Beef, liver, and chicken, fish and shellfish such as trout, salmon, tuna fish, and clams. Fortified breakfast cereal. Low-fat milk, yogurt, cheese and Eggs.
Iron deficiency anaemia is a common cause of giddiness with fainting episodes. These foods to your diet to get more iron and help fight iron deficiency anaemia: Leafy greens. Leafy greens, especially dark ones, are among the best sources of nonheme iron, Meat and poultry, all meat and poultry contain home iron, Liver, Seafood, Fortified foods, Beans.

Treatments of Vertigo

Treatments delivered are :

1. One staged Therapeutic Manouvres

2. Vestibular Rehabilitation Therapy

3. Fundoscopy Reports from Retina Specialist

4. Yoga and meditations

5. Diet

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