If you are seeing patients with vestibular disorders, it’s likely you have patients with motion sensitivity. There are two types of motion sensitivity: (1) visually induced dizziness (AKA Visual Vertigo) and (2) true motion sickness.
Visually induced Dizziness (ViD) is when a person experiences dizziness from complex visual environments. Commonly, patients report increased symptoms in a grocery store, scrolling on the phone or computer, and large crowds. True motion sickness, on the other hand, results in noxious symptoms caused by passive motion. Triggers of motion sickness usually include riding in a car, boat, airplane, or roller coaster.
Your patient may report both types as well as an array of symptoms, such as the following:
Patients commonly report an increase in anxiety as well. Both types of motion sensitivity are thought to be caused by abnormal sensory weighting due to a high reliance on visual inputs, more specifically optic flow. Optic flow is defined by the surrounding environment moving on the retina and provides a strong signal to the brain about self-motion. Over relying on optic flow can cause perceptual ambiguity, or the false sensation of movement. In short, the patient’s expectations do not match reality.
Several vestibular conditions have been associated with motion sensitivity: Persistent Postural-Perceptual Dizziness (PPPD), Migraine Associated Vertigo (MAV), Mal de Debarquement Syndrome (MdDS), Concussion, and Meniere’s Disease.
Targeted therapy includes activities for increasing the brain’s reliance on sensory inputs for spatial awareness and balance through sensory reweighting. Therapy also includes activities that promote desensitization through habituation. The literature recommends optokinetic training that begin in short increments and gradually progressing the dosing over time. Supervision and a clearly defined treatment program are critical for successful outcomes. It is equally important to provide expectations for recovery, customize the program to the individual, and promote autonomy for the patient.
To learn more about assessment and treatment of motion sensitivity – and, so much more – join us for our Virtual Vestibular Health Summit from April 27, 2020, through May 2, 2020. We look forward to seeing you there. Stay safe!
Please click here for home program for a patient with motion sensitivity.