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Vestibular Migraine

History: J.L. is a 36 year old female that came to The Center for Balance with complaints of dizziness and balance deficits during activities of daily living and work. J.L. stated her dizziness ranges in intensity from 4-8/10 (10 being severe dizziness, 0 being no dizziness) that is aggravated by positional changes, varying lighting situations, walking in halls at school (employed as school counselor), and at the end of her work day. J.L. stated her episodes of dizziness and vertigo can last from a few minutes to a few days in length. “When my dizziness is bad I have to touch something to help with my balance”. Patient also has a history migraine related headaches, neck/head pain, and had recently stopped taking birth control. J.L. also stated she has decreased her activity levels significantly since her symptoms began.

Examination: J.L. demonstrated positive vestibular ocular reflex testing for vestibular related dizziness. Patient also demonstrated decreased active range of motion of her head and  neck and demonstrated limited cervical joint mechanics with stiff neck musculature. Patient also demonstrated decreased functional balance testing.

Treatment: J.L. underwent an individualized treatment program consisting of manual cervical techniques to promote proper cervical mechanics and decrease neck pain and stiffness. Patient also performed vestibular stimulating exercises, functional static and dynamic balance exercises, trunk control exercises, and was given a home exercises program to perform on her own.

Results: Upon discharge from physical therapy, J.L. was able to perform activities and work with minimal dizziness, “I am so much better”. Patient functional balance score goals were met and her cervical joint mechanics were normal without pain or stiffness. J.L. was able to increase her activity levels without increased dizziness or fear of falling.