Dizziness is a common
occurrence after stroke. It is particularly common with brainstem stroke.
Many survivors struggle with dizziness. It is often caused by a problem with the
Within the first year after my brainstem stroke in 1993, my PT wanted me to
consult with a specialist in “Vestibular Equilibrium Disorders.” I had
complained of seemingly constant dizziness. Initially, I couldn’t even move
without everything spinning, so I didn’t care what she was known for; I just
wanted to get rid of the constant sense of nauseating imbalance.
She asked me questions about when and where I felt dizzy. Up until then I
had not analyzed the problem. It was an instructive exercise, though,
because I realized for the first time, for example, that I was not dizzy
whenever I was sitting. I also learned that I had developed lots of
techniques to compensate. These included moving only my eyes instead of
turning my head to focus, wooden-like, because it was more comfortable. She
asked about my sleeping patterns, and told me that my habit of sleeping only
on my back with several pillows under my head was my way of compensating in
bed. She said that dizziness is a common problem for brainstem stroke
Testing my tolerance, she told me to watch as she twirled a huge
black-and-white checkered poster in front of me. She then asked me to lie on
a hard examining table, first on my stomach and then on my back with no
pillows. These were awful experiences, but she assured me that the empty
wastebasket nearby could be my vomit receptacle. When I didn’t lose it
despite the discomfort, she suggested that I would likely drive again one
day (highly doubted up until then).
She proceeded to teach me exercises to perform daily both with my physical
therapist and on my own with the hope of habituating my responses enough
that my dizziness would substantially diminish. They worked in time with a
lot of repetitive practice. I remember that I did each about 10 minutes
daily over several months, gradually increasing complexity as I mastered the
first exercises. I detail them here in the hopes that they might give others
some relief for a similar cause, but I can only claim that they helped me.
The specialist couldn’t explain whether these exercises would work or, if
they did, why. Her caution, though, was unequivocal: always to err on the
side of SAFETY in attempting anything. These exercises sound easy to someone
who does not experience discomfort moving the head, but they were at first
very difficult for me.
1. Move head,
left/right, up/down, diagonally while standing. For safety, stand in a
corner facing the back of a high-backed substantial chair, holding onto the
chair back while moving head around, repeat.
2. Move head, left/right while walking. For safety, do with someone at your
side or holding onto your therapy belt. Practice moving the head side to
side while slowly walking. As this gets easier, naturally swing arms. As you
feel more comfortable, do this while walking up/down stairs, always holding
on to the railing.
3. Move head, left/right, up/down while lying in bed. Using one finger, move
it from 1 to 3 feet away and back again. Repeat.
4. Move head from side to side, leaving body facing forward, while sitting.
5. Stand up/sit down, repeat. Sit/stand/turn upper torso to one side, repeat
turning upper torso to other side.
6. Turn head toward ceiling/down to floor, while sitting. Repeat.
7. Bend from waist/extend arms over head, moving head up/down with body
while sitting or standing. Repeat.
8. Stoop, reach with big ball between hands, moving head with ball,
Always, stroke survivors should begin any treatment by finding out what may
be causing their dizziness or imbalance. It may be a common problem, but it
may also be more complicated. Also there are lots of web sites (keywords:
vestibular equilibrium, balance, dizziness) and past newsletter articles
that may also help.
For me, 14 years after my stroke, my dizziness is thankfully only a memory.
And, yes, I drive. I also do low-impact water exercises daily to help
maintain balance, which I highly recommend.
From the StrokeNet archive:
Balance: A View From A Survivor, May 2005
The Stroke Network,
P.O. Box 492
Abingdon, Maryland 21009
All rights reserved.