Quick Answer
A thorough vestibular assessment can uncover the true cause of dizziness when home exercises alone haven’t helped. In this case study, a client’s ongoing symptoms were traced to vestibular migraine after previous rehabilitation gave no diagnosis, showing why getting the right answer matters as much as doing the exercises.
Why might vestibular rehabilitation exercises not work for everyone?
Vestibular exercises are genuinely effective for many causes of dizziness, particularly conditions like BPPV or reduced function in the inner ear. But exercises are only ever as good as the diagnosis behind them. If the underlying cause hasn’t been correctly identified, even a well-designed and diligently followed programme may bring little relief. This case study looks at what happened when one of our clients found himself in exactly that position.
What brought Richard to angli-EAR Hearing?
Richard came to us with ongoing dizziness and intermittent headaches. He’d already sought help elsewhere, working with a vestibular therapist at another clinic who gave him a home exercise programme. He followed it carefully, but months on, his symptoms hadn’t meaningfully improved and he still didn’t have a diagnosis to explain what was happening to him. Understandably keen for answers, he decided to get a second opinion and booked a comprehensive assessment with our vestibular specialist, Shreya Tiwari.
What did the in-depth assessment reveal?
Shreya’s evaluation looked more closely at Richard’s symptoms and history, and the picture that emerged pointed to vestibular migraine rather than the issue his earlier exercises had been designed to address. Vestibular migraine can cause dizziness and balance problems with or without a headache present at the same time, which makes it easy to miss without a detailed assessment. Shreya advised Richard to see a neurologist to confirm the diagnosis, and put together a vestibular rehabilitation programme tailored specifically to his condition.
“To treat dizziness successfully, you need to know exactly what’s causing it. There are so many different triggers, and treating it without a proper diagnosis usually doesn’t work.”
Shreya Tiwari, Vestibular Specialist
What happens after a vestibular migraine diagnosis?
Getting the right diagnosis changes what comes next. Rather than continuing with an exercise plan that wasn’t matched to his condition, Richard now has a rehabilitation programme designed around vestibular migraine specifically, alongside a referral to confirm the diagnosis with a neurologist. That combination gives him a much clearer path forward, built on an accurate understanding of what’s actually causing his symptoms.
What does this case study show us about dizziness and diagnosis?
Richard’s experience is a good example of why an accurate diagnosis matters so much when it comes to dizziness. Vestibular exercises can make a real difference, but only when they’re addressing the right condition. If symptoms persist despite following a home exercise programme, it may be worth asking whether the underlying cause has been fully investigated, rather than assuming the exercises themselves aren’t working.
If you’ve been experiencing dizziness, imbalance or unsteadiness, whether or not you’ve tried exercises before, a comprehensive assessment is the best place to start. Book a Free 15-Minute Vestibular and Balance Health Check with our team to talk through your symptoms, or go straight ahead with an Initial Vestibular and Balance Appointment for a full evaluation.
Frequently asked questions
Can dizziness be caused by something other than an inner ear problem?
Yes. Dizziness can come from several different sources, including vestibular migraine, which affects the balance system without always causing a headache. This is why a broad assessment matters rather than assuming one specific inner ear cause straightaway.
Is vestibular migraine the same as a regular migraine?
Not quite. Vestibular migraine is a specific type of migraine where dizziness and balance symptoms are the main feature, and a headache doesn’t always happen alongside them. It’s diagnosed based on the pattern of symptoms as a whole, usually with input from a neurologist.
Why didn’t the home exercises help before the diagnosis?
Vestibular exercises are designed around a specific underlying cause. If the exercises given don’t match the real reason for the dizziness, they’re unlikely to bring much improvement, however consistently they’re followed.
What happens during a vestibular and balance assessment at angli-EAR Hearing?
Our vestibular specialist takes a detailed history of your symptoms and carries out a series of tests to understand what’s causing your dizziness or balance issues. From there, we can recommend the right next steps, whether that’s a tailored rehabilitation programme, a referral for further investigation, or both. Find our more in our blog: Your first vestibular assessment — what to expect and how to prepare
Not sure this is the right path for you? We offer a free 15-minute Balance Health Check as a first step: a short, no-obligation conversation with Shreya, in person, by phone or over video, to help you work out whether a full assessment is likely to help with what you’re experiencing.
