What it is
A short, honest summary.
- —The vestibular system — the balance organ of the inner ear — tells the brain where the head is in space.
- —Vestibular neuritis, labyrinthitis, Meniere's disease and vestibular migraine each disturb that signal differently.
- —The brain can re-calibrate around a damaged vestibular system — and that re-calibration is what rehabilitation drives.
What families notice
The signals worth taking seriously.
- 01Dizziness or unsteadiness that lingers for weeks after an initial spinning attack
- 02A sense that the floor is moving, or that you are on a boat
- 03Blurred or jumpy vision when you turn your head
- 04Tiredness and 'brain fog' from the constant effort of staying upright
- 05Avoiding busy, visually-crowded places — markets, malls, traffic
My approach
How the work is structured.
- —A proper bedside assessment to separate inner-ear causes from migraine and central causes.
- —Gaze-stabilisation and habituation exercises that retrain the brain's response to movement.
- —Graded balance work — firm ground to soft, eyes open to closed, quiet to busy.
- —Pacing and trigger education so daily life rebuilds without constant setbacks.
What recovery looks like
A plain-language picture.
“Most vestibular conditions improve substantially with consistent rehabilitation. The inner ear may not fully heal, but the brain learns to compensate — and steadiness returns.”
FAQ
Common questions, answered briefly.
- I was told it's just anxiety. Is it?
- Anxiety and vestibular problems often travel together, but persistent head-movement-triggered dizziness usually has a treatable vestibular cause. A proper assessment separates the two.
- How long does vestibular rehabilitation take?
- Most people feel meaningful change within six to eight weeks of daily exercises, though the full picture can take a few months.
For clinicians
Clinical detail, assessment and evidence.
Clinical summary
The picture in clinician register.
Peripheral vestibular hypofunction (neuritis, labyrinthitis, post-ablative) and conditions such as Meniere's disease and vestibular migraine produce dizziness, oscillopsia and imbalance. Central compensation is trainable: gaze-stabilisation, habituation and graded balance work drive it. Accurate differentiation from central and migrainous causes guides the programme.
Terminology
Terms worth being precise about.
- Vestibular hypofunction
- Reduced or absent function of one or both vestibular organs.
- Central compensation
- The brain's re-calibration around a vestibular deficit — the target of rehabilitation.
- Oscillopsia
- The visual world appearing to move with head motion.
- PPPD
- Persistent postural-perceptual dizziness — a chronic functional pattern often co-existing.
Assessment & measures
What the first sessions measure.
- —Head Impulse Test; Dynamic Visual Acuity.
- —Dynamic Gait Index and balance testing.
- —The Dizziness Handicap Inventory; screening for migraine and PPPD features.
Red flags
Signs that need urgent escalation.
- An acute vestibular syndrome with central signs — a HINTS-positive-for-central pattern; escalate.
- Progressive unilateral hearing loss with imbalance — refer to exclude a retrocochlear lesion.
Referral & MDT
When and to whom to refer.
ENT or neuro-otology. Neurology where migraine or central features predominate; audiology.
Evidence
References and guideline anchors.
- Vestibular rehabilitation for unilateral hypofunction — PLACEHOLDER — verify against current guidelines before launch.