Vestibular Fellowship: A letter from Dr. MacArthur
July 2, 2013
As a provider with a diplomate in Chiropractic Neurology, I noticed that many of my patients would arrive complaining of dizziness and vertigo symptoms. Although I had a lot of training in these areas with my degree in neurology already, I felt there was more to ascertain about this particularly interesting subject. I had also noted that there were limited treatment options by other providers in this particular subject. This prompted me to take additional courses relevant to the field of vestibular rehabilitation. After sitting for his board exam in 2010, I was able to pass without hesitation and continue treating this cohort of vestibular patients with a great degree of success. Through careful evaluation, I was able to diagnose the particular cause to their condition and thus develop treatment plans to restore normal patterns of vestibular function.
There are many causes of vertigo, the most common being BPPV, which is a condition in which the calcium carbonate crystals in the Ampulla become dislodged and travel to the semicircular canals, inappropriately stimulating that region and causing dizziness with movement. However, what I also noticed is that many individuals had another type of vertigo, which did not classify as meniere’s or other types, and could be classified as more of a functional neuritis. This particular issue often had cervicogenic (cervical/neck) attributes, but also had patterning issues in the communication pathways between the cervical spine, vestibular apparatus, cerebellum, brain stem and cortex. Essentially, these normal lines of communication had broken down. Able to combine my chiropractic care, neurology diplomate and vestibular fellowship, these patients were able to restore normal communication and patterns, fully restoring function and becoming symptom free. This is known as neuroplasticity, and is a very important piece of the vertigo/dizziness presentation.
Dr. Aaron Macarthur, DC, DACNB, FABVR