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Understanding Dizziness After Stroke: What Causes It & How to Treat It

caregiver comforting a stroke survivor at home after a dizzy spell

Dizziness after stroke can occur for a wide variety of reasons, such as low blood sugar or a balance disorder. Balance disorders are more likely to occur when a stroke affects certain structures in the brain that contribute to balance, such as the cerebellum.

Due to the complex nature of this symptom, it’s important to work closely with your medical team to identify the cause and tailor a treatment plan to address it.

To help you have an informed conversation with your doctor, this article will discuss the causes and treatments for dizziness after stroke. You’ll also learn how vestibular therapy might be able to help (if the vestibular system is the culprit).

Use the links below to jump straight to any section:

Causes of Dizziness After Stroke

Dizziness after a stroke looks and feels different for everyone. Some people can feel as though the entire room is spinning, while others might momentarily lose their sense of balance.

Dizziness has many different causes, and each requires a different specialized treatment. This is why a medical assessment is necessary.

Some various causes of dizziness after stroke include:

  • Migraines
  • Dehydration
  • Low blood pressure
  • Low blood sugar
  • Medications such as blood pressure or anti-seizure drugs
  • Balance disorders caused by a stroke in an area of the brain that contribute to your sense of balance

Cerebellar strokes in particular are known to result in balance disorders, which can cause sensations of dizziness and vertigo (more on this soon).

However, strokes in other areas of the brain such as the occipital lobe or brain stem (which is connected to the cerebellum) can also cause dizziness. Every stroke is different, so there are no hard lines to draw in regards to which area of the brain can cause dizziness if damaged.

The best thing you can do is work with your medical team to determine the specific cause and best course of treatment for you.

Symptoms of Dizziness (What It Feels Like)

It’s important to describe your dizziness in detail for your doctor, because it can provide important insight.

Dizziness often feels like lightheadedness, feeling faint or unsteady, or a loss of balance. You may also feel a spinning sensation, which is known as vertigo.

When dizziness occurs after a stroke, sometimes it can be triggered by too much movement in your environment, such as being in a crowded store. Or it can be triggered when you are in motion, such as when you stand up or ride in a car.

Pay attention to the intensity and onset of your dizziness, too. If dizziness occurs with sudden intensity, seek emergency medical attention because it could be an uncommon sign of a stroke.

Also pay attention to your physical activity level and diet. You may notice that you feel dizzy after a long day which could be caused by dehydration; or you may feel dizzy if you recently started a new diet that caused low blood sugar.

You are the expert on your body. Pay close attention to how you feel and what you are doing when dizziness after stroke occurs. And as always, exercise diligence if dizziness comes on suddenly and seek emergency medical attention to be safe.

Next we’d like to answer a frequently asked question in regards to dizziness after cerebellar stroke.

How Long Does Dizziness Last After Cerebellar Stroke?

As previously mentioned, a stroke in the cerebellum is particularly known to be associated with dizziness after stroke. The cerebellum is primarily responsible for voluntary muscle activation and coordination. This helps the body make important postural adjustments to maintain balance.

Through signals from the vestibular receptors and proprioceptors, the cerebellum commands motor neurons to compensate for shifts in body position, allowing the person to remain upright and steady.

However, after a cerebellar stroke occurs, these signals can become disrupted. As a result, the patient can lose their sense of balance, which may contribute to sensations of dizziness.

Sometimes spontaneous recovery occurs where symptoms such as dizziness go away on their own. Other times, rehabilitation is necessary to spark healing in the brain.

Because every stroke is different, every recovery will be different. This means it’s impossible to predict how long dizziness will last for any particular person.

However, just because recovery time is hard to predict does not mean you have to feel powerless. Proactively seek help from your medical team and follow through on any therapeutic exercises that they provide. This will help maximize your chances of recovery.

How to Treat Dizziness After a Stroke with Vestibular Therapy

There are effective ways to help restore your sense of balance and reduce symptoms of dizziness after stroke, and vestibular therapy is one of them.

Vestibular therapy targets the body’s vestibular system, which provides your sense of balance. It’s an elaborate sensory system that provides the brain with information about motion, head position, and spatial orientation.

If the vestibular system is not functioning properly, many patients can report sensations of dizziness, eye movement problems, and false senses of motion.

By engaging the brain’s natural neuroplasticity, vestibular therapy can help repair the vestibular system and therefore reduce dizziness after stroke.

Neuroplasticity is how the brain creates and strengthens neural pathways. After a stroke has disrupted some of the highways that communicate your body’s sense of balance, neuroplasticity allows you to rebuild these paths.

With hard work, survivors can often regain their abilities — including sense of balance — through therapy and rehabilitation.

Vestibular Therapy Exercises to Help Improve Equilibrium

Practicing vestibular therapy exercises can provide the brain with the stimulation it needs to rewire itself and recover from a balance disorder.

Consistent experience with vestibular therapy helps create and strengthen new neural pathways in an efficient manner. This provides the most benefits for reducing dizziness after stroke.

There are three primary exercise routines that can be used as part of a vestibular therapy program:

  • Gaze stabilization exercises. The vestibular system plays an important role in our vision, and gaze stabilization exercises help restore the Vestibulo-Ocular Reflex (a reflex that, when impaired, can cause disorientation and vertigo).
  • Habituation exercises. These exercises help reduce dizziness by exposing the person to the movement that bothers them, such as bending over to pick something up off the ground. The goal is to increase tolerance so that those movements no longer affect your balance.
  • Balance and exertional training. When your dizziness has improved enough, you can graduate to practicing balance and cardio exercises to increase your endurance. The goal of exertional training is to eventually build up the person’s stamina to the level it was before their stroke, or as close as possible.

For this to be effective, work alongside a specialty-trained vestibular physical therapist to get started.

Consistency and repetition are key ingredients for rewiring the brain. Therefore, to get the most benefit, ask your therapist to send you home with exercises to do on your own, too.

Overcoming Dizziness After Stroke

Dizziness after stroke could have a wide variety of causes, from unwanted medication side effects to disruption in the vestibular system.

It’s important to work closely with your medical team to diagnose the cause of your dizziness and plan an appropriate course of action, which may involve vestibular therapy.

Remember that sudden onset of dizziness could indicate another stroke, so always proceed with extreme caution and seek emergency medical attention when necessary.

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