Visual Vertigo

What is visual vertigo?

Visual vertigo is a sense of movement or imbalance associated with the movement of objects around you, even when you are not moving. It differs from more common vertigo-type presentations because symptoms are aggravated by visual motion rather than physical motion. Many people with visual vertigo will report nausea and disequilibrium (unable to find balance/ feeling of uprightness). when they are exposed to visually challenging situations  

Motion sensitivity

Motion sensitivity is a sense of dizziness that is provoked by repetitive or moving visual environments of visual patterns.

What cause visual vertigo?

It is thought that the combination of a vestibular or proprioceptive disorder and subsequent visual dependence causes visual vertigo. Impaired ability to spatially and physically orient yourself using primarily the vestibular system can lead to excessive reliance on the visual pathways of the brain and overload them, which can lead to vertigo-like symptoms from visual stimulus.

Certain conditions may contribute to developing visual vertigo including migraine, traumatic brain injury, concussion/post-concussive syndrome, cervicogenic dizziness, whiplash, as well as panic/anxiety disorders.

Signs and symptoms

Symptoms typically include episodic dizziness, pallor, sweating, fatigue, salivation, nausea, vomiting, imbalance, vertigo and disorientation. Symptoms may be provoked by passive movement (e.g. riding in a car, boat or plane) or motion of the surrounding environment (e.g. large objects moving such as traffic, clouds, trees, or viewing a large motion picture screen).

Diagnosis

Your therapist will perform an assessment that first aims to rule out any other causes to your dizziness via an oculomotor and vestibular-ocular function and positional assessment.

Other tests can be performed to assess your balance and quantify the degree of motion sensitivity.

Treatment

Treatment for both visual vertigo and motion sensitivity involves vestibular rehabilitation, education and compensatory strategies.

Habituation exercises may decrease symptoms of motion provoked dizziness. They are selected by the therapist depending on your symptom provocation during different movements and positions identified during the assessment. 

Over time, symptoms diminish with repeated motions, and new exercises or movements are progressively introduced. This occurs as the brain is rewired through a process of neuroplasticity to allow movements to be performed without symptoms.

Visual vertigo exercises are a type of habituation exercise but involve the observation of movements while you are sitting still, rather than provoking movement. They may involve looking at different pattern combinations or watching different types of video clips depending on your degree of visual sensitivity.

Optokinetic exercises, that involve following rapid and successively moving targets, may also be beneficial as they provoke the conflict between the visual and vestibular systems that requires the brain to adapt to.

A helpful video training resource for these types of exercises can be found here - however you should discuss with your doctor or physiotherapist before beginning any sort of new treatment.

If you’d like more information on any of the information above or would like a better understanding of how movement can be medicine for you, keep an eye out for more content like this or get in touch to book an appointment for a personalised plan of action today.

Adapted from Gold Coast Hospital & Health Service.