Dizziness after stroke can occur for a number of reasons. In most cases, dizziness should fade on its own over time, but sometimes interventions are required.
To reduce post-stroke dizziness, it’s critical to identify the cause and tailor the treatment to address it. This article will discuss just that.
At the end of this post, we will also offer a brief introduction to vestibular therapy, which remains one of the best ways to reduce dizziness after stroke, if the vestibular system is the culprit.
Causes of Dizziness After Stroke
Not all dizziness after a stroke looks or feels identical. Some forms of dizziness can cause you to feel as though the entire room is spinning, while others might simply cause you to lose your sense of balance.
Each type of dizziness has a different cause, and therefore requires specialized treatment. Some various causes of dizziness after stroke include:
- Medications, such as blood pressure or anti-seizure drugs
- A cerebellar stroke, which damages the part of your brain responsible for balance.
- An occipital lobe stroke, which damages the region of the brain that controls eye movement and vision.
- Low blood pressure
Your doctor can examine you and help you determine the specific cause and best course of treatment for your dizziness.
Perhaps the most complicated cause of dizziness to treat is a cerebellar stroke. Below, we will discuss why a cerebellar stroke can cause dizziness and what steps you can take to reduce it.
How the Cerebellum May Impact Post-Stroke Dizziness
The cerebellum (Latin for “little brain”) is located on the base of the brain, directly above the brain stem. It is primarily responsible for voluntary muscle activation and coordination. This helps the body make important postural adjustments to maintain balance.
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.
Fortunately, there are effective ways to restore these signals and reduce symptoms of dizziness after stroke.
Using Vestibular Therapy to Reduce Dizziness After Stroke
If your post-stroke dizziness is caused by issues such as low blood pressure or migraines, your physician may be able to treat it by adjusting your medication.
However, if your dizziness stems from a cerebellar or occipital lobe stroke, treatment can sometimes be more complex. One effective method developed by therapists to treat these causes of dizziness is vestibular therapy.
Vestibular therapy targets the body’s vestibular system, an elaborate sensory system responsible for providing 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.
There are three primary exercise routines that can be used as part of a vestibular therapy program: gaze stabilization exercises, habituation exercises, and balance and exertional training. We’ll discuss each type in the sections below.
1. Gaze Stabilization Exercises
The vestibular system plays an important role in our vision. This relationship is seen most clearly in the vestibulo-ocular reflex. This is what allows you to stay focused on an object even if your head is moving.
After a stroke, this reflex can become damaged, which can cause disorientation and vertigo.
Gaze stabilization exercises were designed to help restore the vestibulo-ocular reflex. They involve several exercises of increasing difficulty. The following is a sample exercise:
- Sit upright in a chair.
- Draw an X in the center of a piece of paper.
- Hold the paper in your hand at arm’s length, or tape it to a wall. Keep it at eye level.
- While focusing your eyes on the X, turn your head side to side. Start with slow head movements and start to increase speed, but make sure the X is not getting blurry.
- Do the same thing as above, but move your head up and down while looking at the X, instead of side to side.
- Do each of these for 2 minutes or as long as you can handle. When you can do the exercises for two minutes without experiencing dizziness, try them again while standing.
For the most improvement, you must practice gaze stabilization exercises several times per day. The more you exercise, the more you will activate neuroplasticity, which will allow your brain to re-establish a connection to your vestibular system and reduce your dizziness.
2. Habituation Exercises
For stroke patients who mostly experience dizziness when they move around, a therapist might prescribe 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.
Your therapist can design an exercise routine that challenges you but remains manageable. Some examples of habituation exercises you might try include:
- Transitioning from a sitting position to flat on your back
- Stand up and sit back down repeatedly
- While sitting up, bend forward until your head is between your knees
Like gaze stabilization exercises, the more you practice, the faster you can reduce your dizziness after stroke. Keep in mind that these exercises should be done with a therapist who will be spotting you for balance, to make sure you don’t fall.
3. 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.
It’s important to challenge yourself during training, but not to overdo it. If you notice your dizziness flaring up while exercising, take a break. Pushing yourself too hard can cause a setback.
But if you find the right balance between exertion and fatigue, your brain can start to repair itself and you should begin to notice your symptoms fading.
Overcoming Dizziness After Stroke
Dizziness after a stroke is often a temporary problem. If it does not resolve on its own, there are still other options available to you.
If the dizziness does not appear to be due to medications, blood pressure issues, or dehydration, then the best option for stroke patients suffering from chronic dizziness is to schedule a visit with a vestibular specialist who can determine the cause.
If there are no specialists near you, your physical and/or occupational therapists should be familiar with all the exercises in this article. Therefore, make sure to ask them if they can help you reduce your dizzy spells.
With the right exercises and maneuvers, it’s possible to recover from dizziness after stroke and find your balance again.
Featured Image: ©iStock/fizkes