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Central Causes of Dizziness

JM Furman, MD, PhD, is Professor, Departments of Otolaryngology, Neurology, Bioengineering, and Physical Therapy, University of Pittsburgh, Pittsburgh, Pa.
SL Whitney, PT, PhD, ATC, is Assistant Professor, Departments of Physical Therapy and Otolaryngology, University of Pittsburgh, and Director, Physical Therapy Vestibular Rehabilitation Program, Centers for Rehab Services, Pittsburgh, Pa

Address all correspondence to Dr Furman at Department of Otolaryngology, University of Pittsburgh School of Medicine, 203 Lothrop St, Suite 500, Pittsburgh, PA 15213 (USA) (furman@pitt.edu)

Key Words: Balance disorders • Disequilibrium • Rehabilitation • Vertigo • Vestibular system

Because this article has no abstract, we have provided an extract of the full text and any section headings.

	Introduction

 
Vestibular physical therapy has become a mainstay in the management of patients with balance disorders manifesting as dizziness and disequilibrium. Numerous concept papers,^1–20 case studies,^21–29 case series with no controls,^30–44 and controlled studies^45–49 support the use of rehabilitation techniques for patients with peripheral vestibular disorders. There is less evidence supporting the use of rehabilitation techniques for patients with central vestibular disorders. Several concept papers,^{6,9,17,50–54} case studies,^4,23,55–59 and case series with no controls^{17,23,30,31,33,36,38–40} have been published regarding central vestibular disorders. In addition, 2 textbooks on the subject of vestibular rehabilitation^60,61 provide ample evidence that this treatment for patients with balance disorders appears to be very promising (Tab. 1). Only a few controlled studies,^45–49 however, have addressed the efficacy of physical therapy for patients with peripheral vestibular disorders, and none of these controlled studies have addressed patients with central vestibular pathology. Articles that specifically addressed benign paroxysmal positional vertigo^62–65 are . . . [Full Text of this Article]

	Migraine

 

	Trauma

 

	Brain-Stem Stroke and Vertebrobasilar Insufficiency

 

	Cerebellar Degeneration

 

	Conclusion

 

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