Post-Stroke Dizziness: How Vestibular Therapy Can Help
Sep 29, 2020
Post-Stroke Dizziness: How Vestibular Therapy Can Help

Dizziness is a common symptom in stroke survivors, but it is rarely addressed as the main concern in rehabilitation programs. Consequently, many people are left with dizziness that lingers beyond recovery and affects day to day activities.

Dizzy man clutching head
Post-stroke dizziness can leave survivors sidelined from their regular routines. 

Feeling dizzy after a stroke can be caused by different factors. To understand more about post-stroke dizziness, let’s take a deeper look at factors that may be involved and which treatments can help.

Dizziness After Stroke: Your Questions Answered

  • Why do people experience dizziness after stroke?
  • How does a brainstem stroke cause dizziness?
  • What treatments are available for post-stroke dizziness?
  • How can vestibular therapy help with post-stroke dizziness?
  • What is the prognosis for post-stroke dizziness?

Why do people experience dizziness after stroke?

Post-stroke dizziness can be a consequence of different medications, long periods of inactivity, or sudden changes in blood pressure when we change positions. People can also experience dizziness if the stroke affected certain structures in the brain. This specific type of stroke is known as a brainstem stroke.

brain diagram
Major parts of the human brain include the four lobes of the cerebral cortex, the brainstem, and the cerebellum.

A brainstem stroke occurs when blood flow to the brainstem is disrupted. The brainstem, which is responsible for maintaining the body’s automatic functions, is located near the base of the skull and found deep within the brain. It is home to several important structures and connections that allow our bodies to perform vital functions without conscious thought, also known as involuntary activities. Simple involuntary activities like eating, breathing, and controlling our heart rate are regulated in the brainstem.

You can also think of the brainstem as a bridge between higher-level brain activity and the rest of the body. Because of its location and important role in sustaining life, any injury or trauma to the brainstem can have profound effects on the body.

How does a brainstem stroke cause dizziness?

Any disruption in the blood flow to the brainstem can also affect a nearby structure known as the cerebellum. The cerebellum is responsible for creating and coordinating movement after receiving information from our inner ear, eyes, and sensory receptors in the body. Dizziness can occur when the brain is unable to correctly interpret the information which, in turn, affects eye movements and/or balance.

What treatments are available for post-stroke dizziness?

Treatment for post-stroke dizziness depends on the cause. Certain medications may be prescribed, or your healthcare provider can show you specific strategies to help decrease dizziness that results from position changes. Vestibular therapy can also be an effective treatment for post-stroke dizziness that originates from the brainstem and/or cerebellum.

How can vestibular therapy help with post-stroke dizziness?

Vestibular therapy, a specialized form of physical therapy, addresses problems that may arise in the vestibular system. For stroke survivors, vestibular therapy can be helpful in reducing dizziness with head movements, sensitivity to busy environments, and loss of balance.

Post-stroke dizziness
A bustling grocery store can provoke dizziness for those sensitive to busy environments. 

The vestibular system is an elaborate network of information that sends signals to our brain related to motion, head movements, and body awareness. While that information is processed, the vestibular system makes sure that the body remains balanced and stabilized, also commonly referred to as equilibrium.

When you are a passenger in a moving vehicle, your vestibular system is working hard to process visual information about the passing vehicles and scenery while making sure your body remains upright within the car.

When the vestibular system is not working properly, many people will report dizziness with head and/or eye movements, loss of balance, feeling dizzy in busy environments like a grocery store, or a false sensation of movement that can occur at any time. Others may feel a heightened sense of anxiety in crowds or motion sickness on a moving platform, like an escalator or elevator.

Vestibular therapy uses specific exercises using head and eye movements to retrain the vestibular system and decrease sensitivity to visual movement. Doing this helps to reteach the body how to coordinate movement and balance while the head is moving. Vestibular therapy uses two strategies, known as habituation and adaptation, to create these changes and improve your ability to perform everyday activities or complete work responsibilities.

 vestibular therapist may instruct a patient through a series of head-turning exercise
A vestibular therapist may instruct a patient through a series of head-turning exercises as part of an adaptation program to reduce dizziness.

Here is one way to test your vestibular system. Stand and hold your thumb in front of you at an arms-length away. While keeping your eyes on the tip of your thumb, slowly move your head back and forth like you are telling someone “no.” You should be able to shake your head and maintain clarity of your thumb without feeling dizzy or off-balance. If so, then a part of your vestibular system, known as the Vestibulo-Ocular Reflex, is working properly!

What is the prognosis for post-stroke dizziness?

With the right treatment approach, stroke survivors can see improvements in post-stroke dizziness. Vestibular therapy can play a large role in helping patients to regain independence and decrease symptoms of dizziness and imbalance with everyday activities.

Other prognoses for post-stroke dizziness unrelated to the vestibular system will vary, depending on the cause of dizziness and available treatments. In these cases, vestibular therapy may not be effective, especially if the vestibular system is working properly. Your healthcare provider will be able to provide more information on treatment options that are specific to you and your needs.

Further Reading:
How do I know if I have a vestibular disorder?
Find a vestibular therapist in your area

Looking for more ways to improve balance after stroke? Check out the Neofect Smart Balance! Call (888) 623-8984 or email for more information.


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