Vertigo two months post-concussion?

Posted by mrhodes @mrhodes, Apr 26, 2022

I'm trying to figure out if an intense episode of vertigo could be a post-concussion symptom. I thought symptoms from 3/3/22 injury had resolved but went to yoga 7 weeks afterward, did a headstand, and felt fine. Last night, about 36 hours later, I started to experience intense vertigo during a mellow yoga class. I took an anti-nausea med for the first time in over a month. It's hard to know when it's safe to resume certain activities… it seems like I only know after I've tried something. Is this a typical course for recovery?

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Hello @mrhodes

I'm glad that you posted your concern about vertigo. For those of us who deal with vertigo, we know that it is an unpredictable problem. I've had vertigo for a number of years and I understand how frustrating it is to think that you are all over it and then have it return with certain activities.

Have you talked with your doctor regarding the return of the vertigo symptoms?. If not, I strongly recommend that you do so. Are you aware that there is a type of physical therapy (called Vestibular Therapy) that can help with vertigo symptoms?

I would encourage you to talk with your doctor and see if you can get a referral to a vestibular therapist. Vertigo can be a chronic issue that needs lots of attention and therapy.

What other types of therapies have you had to deal with your concussion?

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@hopeful33250

Hello @mrhodes

I'm glad that you posted your concern about vertigo. For those of us who deal with vertigo, we know that it is an unpredictable problem. I've had vertigo for a number of years and I understand how frustrating it is to think that you are all over it and then have it return with certain activities.

Have you talked with your doctor regarding the return of the vertigo symptoms?. If not, I strongly recommend that you do so. Are you aware that there is a type of physical therapy (called Vestibular Therapy) that can help with vertigo symptoms?

I would encourage you to talk with your doctor and see if you can get a referral to a vestibular therapist. Vertigo can be a chronic issue that needs lots of attention and therapy.

What other types of therapies have you had to deal with your concussion?

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Thank you for your response. I haven't yet spoken with my doctor about the vertigo but plan to make an appointment. It was only triggered a couple other times and these were much earlier on (it's been almost 2 months since my injury)… so I assumed it was a "normal" part of early recovery. I wasn't aware there's a specific type of vestibular PT!
My one and only experience with a PT, with whom I was scheduled about three weeks after my concussion, was awful. The PT didn't do much of an evaluation, at least as far as I could tell. He had me do three quick visual tasks with small balls/beads on a string. These went fine and he announced we'd pretty much done the PT he specializes in. He then took me to a different room asked me to stand in front of a large screen and touch different sized and colored circles as they appeared and then as they moved within a larger circle that rotated in the opposite direction. This triggered an extreme episode of vertigo and nausea that knocked me out of work for two days.
I suspect (??) there was a scheduling error because this was my initial contact with this particular complete care center for head injuries. I called the PT to share what happened when I left after the half hour session. I played phone tag with the lead PT at the center, and also let my referring physician know what happened. I left messages asking for suggestions for follow up but didn't hear back from either provider. After last night's episode of vertigo I decided it's probably worth trying again to connect with a PT. I will inquire about Vestibular Therapy and am grateful you mentioned it. Thank you!!
I haven't really noticed any other recurrent symptoms, thankfully.

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I wonder if you dislodged crystals in your ear, which is callled Benign Paroxysmal Positional Vertigo. This is easily diagnosed by a provider, either PCP, neurologist or physical therapist, observing your eye movements after doing certain physical movements.

There are exercises for BPPV online, but a physical therapist can get you started and some PCP's do them too. Make sure you ask for a PT who evaluates BPPV. Some have special equipment (a headset that monitors eyes and a computer screen that displays them.)

For other types of vertigo, like labyrinthitis or vestibular neuritis, there are different exercises so it helps to get a diagnosis.

I don't see how a concussion could cause labyrinthitis or neuritis but BPPV is a very common factor in symptoms after a concussion. I believe a concussion can also cause "central vertigo" which is brain-based but BPPV is very likely for you. Hope this helps!

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@mrhodes

Thank you for your response. I haven't yet spoken with my doctor about the vertigo but plan to make an appointment. It was only triggered a couple other times and these were much earlier on (it's been almost 2 months since my injury)… so I assumed it was a "normal" part of early recovery. I wasn't aware there's a specific type of vestibular PT!
My one and only experience with a PT, with whom I was scheduled about three weeks after my concussion, was awful. The PT didn't do much of an evaluation, at least as far as I could tell. He had me do three quick visual tasks with small balls/beads on a string. These went fine and he announced we'd pretty much done the PT he specializes in. He then took me to a different room asked me to stand in front of a large screen and touch different sized and colored circles as they appeared and then as they moved within a larger circle that rotated in the opposite direction. This triggered an extreme episode of vertigo and nausea that knocked me out of work for two days.
I suspect (??) there was a scheduling error because this was my initial contact with this particular complete care center for head injuries. I called the PT to share what happened when I left after the half hour session. I played phone tag with the lead PT at the center, and also let my referring physician know what happened. I left messages asking for suggestions for follow up but didn't hear back from either provider. After last night's episode of vertigo I decided it's probably worth trying again to connect with a PT. I will inquire about Vestibular Therapy and am grateful you mentioned it. Thank you!!
I haven't really noticed any other recurrent symptoms, thankfully.

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Hello @mrhodes

I appreciate the additional information about your history of PT. It certainly is unfortunate that your experience was not a good one.

You might do well to seek out a certified vestibular therapist. These folks have been trained in methods to deal with vertigo. You will probably find certified vestibular therapists in major medical centers or a university hospital center.

Here is some information from the University of Michigan about vestibular problems and therapy for post-concussion problems. https://www.med.umich.edu/1libr/Neurology/NeuroSport/VestibularTherapyForConcussion.pdf

Here are some samples of VT exercises,
https://www.med.umich.edu/1libr/PMR/Vestibular/VisualGazeStabalizationVORx1.pdf
https://www.med.umich.edu/1libr/PMR/Vestibular/VORX2.pdf
As you can see, these exercises can make your vertigo seem worse for a while. It can take several days or weeks before it gets better.

Do you live near a university medical center or another major medical center?

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@hopeful33250

Hello @mrhodes

I appreciate the additional information about your history of PT. It certainly is unfortunate that your experience was not a good one.

You might do well to seek out a certified vestibular therapist. These folks have been trained in methods to deal with vertigo. You will probably find certified vestibular therapists in major medical centers or a university hospital center.

Here is some information from the University of Michigan about vestibular problems and therapy for post-concussion problems. https://www.med.umich.edu/1libr/Neurology/NeuroSport/VestibularTherapyForConcussion.pdf

Here are some samples of VT exercises,
https://www.med.umich.edu/1libr/PMR/Vestibular/VisualGazeStabalizationVORx1.pdf
https://www.med.umich.edu/1libr/PMR/Vestibular/VORX2.pdf
As you can see, these exercises can make your vertigo seem worse for a while. It can take several days or weeks before it gets better.

Do you live near a university medical center or another major medical center?

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Just want to note that those exercises are for vestibular problems, including labyrinthitis, vestibular neuritis and possible brain-based (central) vertigo.

But they are different from the exercises for Benign Paroxysmal Positional Vertigo. https://www.healthline.com/health/exercises-for-vertigo#:~:text=1%20Brandt-Daroff%20exercises.%20Brandt-Daroff%20exercises%20use%20gravity%20to,%E2%80%94%20even%20after%20doing%20just%20a%20single%20movement.?msclkid=fb500086c6dd11ec8a97dbc0ed0ed96b

Many PT's can test vertigo to see whether it is BPPV or another kind of vertigo. You can also try the BPPV exercises to see if they help, using online resources, but be careful of your neck!

I have done both kinds of exercises for different problems and they work, but you do feel worse at first right afterwards!

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I appreciate you sharing this information about the different vestibular exercises for vertigo, @windyshores! Have you experienced vertigo for a long time?

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Yes, and a few different kinds. My elderly mother and daughter too. So unfortunately lots of experience. I have also had a couple of pretty bad concussions.

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@windyshores

Yes, and a few different kinds. My elderly mother and daughter too. So unfortunately lots of experience. I have also had a couple of pretty bad concussions.

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I would add that it takes a long time to recover from a concussion. Some recovery happens more quickly. I would say I was still improving even three years out. Vertigo two months out would not be unusual, and could be BPPV (crystals in ear dislodged) or central ( brain-based/neurological).

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@windyshores

I would add that it takes a long time to recover from a concussion. Some recovery happens more quickly. I would say I was still improving even three years out. Vertigo two months out would not be unusual, and could be BPPV (crystals in ear dislodged) or central ( brain-based/neurological).

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Yes, my primary provider and a PT explained the BPPV and suggested this is the likely cause of the vertigo. I'm going to start vestibular therapy and hope this helps.

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@mrhodes

Yes, my primary provider and a PT explained the BPPV and suggested this is the likely cause of the vertigo. I'm going to start vestibular therapy and hope this helps.

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It will help! I hope they show you the exercises to do at home. I do the simplest one which involves sitting on the edge of my bed, looking straight, then turning my head to the right and quickly lying down sideways on my left side, staring at the ceiling, until I am dizzy. I count to 30, then sit straight up and look ahead, and again count to 30. Then the other side. Sometimes BPPV is both sides, sometimes just one.

Then there is the "x" on the wall: stare at it and move your head side to side, increasing speed. Or hold two cards in front of you and look from one to the other, side to side horizontally and then up and down vertically.

It is very empowering to have exercises you can do yourself. I do them a few times/day when I am having that kind of vertigo (and after my concussions). You feel worse for a bit but these work!!!!

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