Posted by: seattledizzygroup | August 31, 2019

Be a Chronic Illness Ally

Ways to Better Support the Chronically Ill

About half of people currently have a chronic condition of some sort.  So, the likelihood is that if you are not personally chronically ill, someone you love is living with a chronic illness (which may not be obvious to others).

Even if the symptoms and impacts of chronic illness sometimes seem “invisible”, one of the very best things that friends and family can do to support a chronically ill loved is to tell them “I believe you.”

These articles share great suggestions for how to be a better chronic illness ally as well as ways to offer help and support to chronically ill loved ones:

8 Ways to Be an Ally to Someone with an Invisible Illness

Choose to Be a Better Ally to the Chronically Ill & Disabled 

How to Be an Ally to Sick People

100 Ways to Show Up for People with a Chronic Illness 

How to Help a Loved One with Chronic Illness

7 Ways to Be a Better Friend to Someone with Chronic Illness (and 3 Things You Should Never Do)

How to Be There for a Friend Who is Going Through an Incurable Medical Condition

Key Ways to Offer Support to a Friend with Chronic Illness

5 Things to Know about Supporting Your Chronically Ill Friend 

5 Things the Chronically Ill Want “Healthy People” to Know

5 Things to Say to Your Friend with Chronic Illness

5 Important Things to Know if You Have a Chronically Ill Spouse

“But You Don’t Look Sick” Understanding Invisible Illness Infographic

Learn to See Invisible Illness

Understanding Invisible Illness

Chronic Illness Facts

Ways to Maintain Healthy Relationships & Social Activity Despite the Challenges of Living with Chronic Illness


Show Your Support for People Living with Vestibular & Balance Disorders!

September 15-21, 2019 is Balance Awareness Week! This is a great opportunity to help raise awareness for vestibular and balance disorders and show your support as a chronic illness ally!

Find out how you can get involved at

Help Raise Awareness with Seattle Dizzy Group!


In celebration of Balance Awareness Week, Seattle Dizzy Group will host our Annual Walk for Balance Event on Saturday, September 21, 2019 (12-2:30 pm at Green Lake).  Join us for this fun community event where we will “Walk a Mile in Dizzy Shoes” together to help create greater awareness for vestibular and balance disorders and show our support for people living with chronic dizziness and imbalance–in Seattle and beyond.

Event details:

(Also, find out how Seattle Dizzy Group is Making a Difference for Balance Awareness)


Walk for Balance TM



© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | July 31, 2019

Overcoming Summertime Vestibular Challenges

Summer Tips for Vestibular Disorders

The hot weather, outdoor activities, and travel adventures of summer can be challenging for those living with a chronic vestibular or balance disorder. 

These articles offer helpful tips for managing dizziness and imbalance during summer:

Summer Challenges for Vestibular Patients

Managing Summer Activities and Vestibular Disorders

Summer Heat and Migraine Dizziness

Summer Survival Strategies

Ways to Combat Motion Sickness

Traveling with Dizziness (Adventures in “Dizzyland”)


Ways to Stay Cool with a Vestibular Disorder

By Julie Grove MPT of Cascade Dizziness & Balance PT

    • Heat and warmth can increase sensations of nausea.
    • When dizziness, vertigo, anxiety, or nausea/vomiting occur quickly apply cold towels to neck/head.
    • Move to a cool space, if safe, or feel the tactile (touch) receptors against a building wall.
    • Use cool/cold sensations to distract you (your brain) from the strong feelings of nausea.
    • Use natural anti-nausea foods: ginger and peppermint.
    • Reduce your body’s autonomic nervous system reactionary fight/flight to nausea/dizziness.

(Info from Calm Cool and Compensated blog post)


© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | June 30, 2019

Ways to Explain the Energy Limitations of Chronic Illness

Helpful Analogies to Explain the Energy Impacts of Activity when Living with a Chronic Illness

It can be challenging to explain to healthy friends and family about the energy limitations of living with a chronic illness and how fatigue impacts daily activity choices.  Those who are chronically ill have a very limited amount of energy each day as compared to those who are healthy.  It can be difficult to accomplish much when every activity costs energy and too quickly brings on fatigue.

These infographics illustrate The Spoon Theory and The Battery Analogy to explain the energy impacts of activity when living with a chronic illness:



These articles offer various ways to explain to others how symptoms and fatigue impact the activity level of the chronically ill:

The Spoon Theory

Warning: Low Battery (what living with chronic fatigue is really like)

Are You an Unchargeable or a Spoonie?

How I Talk to my Friends about my Chronic Illness: The Watering Can Analogy

16 Metaphors for Chronic Illness

Balancing Activity and Rest



© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | May 31, 2019

Health Benefits of Nature

Nature Green Space 4

“Green Up” for Your Health & Well-Being

Getting outdoors and into nature has many health benefits!  For example, spending time in green spaces can reduce your stress, calm your anxiety, boost your mood, improve your cognition, and strengthen your immune system. 

Even those living with a chronic illness who may struggle to get outside due to lack of energy or mobility can find ways to “green up” their days for a better quality of life. If you are housebound, having indoor plants, decorating with photos or artwork of nature, or just looking out your window at trees and flowers can bolster your well-being.

More Info about Nature’s Health Benefits & Ways to “Green Up”:

The Top Health Benefits of Green Space

16 Ways Green Space Improves Your Life

5 (Scientific!) Reasons Getting Outside is Good for You

The Life-Changing Health Benefits of Grounding

The Benefits of Therapeutic Gardens

Do You Need a Nature Prescription (Ecotherapy)?

Why You Should Get Your Daily Nature Fix (Even When You’re Housebound)

See Also:

Soak Up the Sun for Vitamin D


© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | April 30, 2019

Cervicogenic Dizziness

Cervicogenic Dizziness image 3

Cervicogenic Dizziness

by Kaela Pauly, DPT

of Cascade Dizziness & Balance Physical Therapy 

 (Presented to Seattle Dizzy Group on 4/13/19)

This presentation gives an overview of cervicogenic dizziness including common causes (such as neck, head, or brain injury), signs and symptoms, and how physical therapy can help.

What Is Cervicogenic Dizziness?

Cervicogenic Dizziness (CD) is dizziness associated with neck dysfunction and/or pain caused by direct injury to the neck. To understand CD, a basic understanding of the anatomy and pathophysiology of the neck is required.

  • The Neck Is Composed Of:
    • Seven vertebrae (bones of the neck)
    • These bones come together and form joints of our neck called facet joints
    • In-between these joints, nerves exit
    • Our neck has deep and superficial muscles


  • How Does Our Neck Help Us Balance?
    • Within our muscles and joints we have small sensors that send information about where our head/body is in space.
    • This information travels up the neck, through our nerves and into our brain.
    • These sensors are activated when our muscles stretch and shorten, or when our joints bend with movement.
    • This system is called proprioception.

Neck muscles

Possible Pathophysiology Of Cervicogenic Dizziness

  • It is believed that injury to the neck may interfere with the balance system by damaging muscles, joints, or nerves that send proprioception information to the brain.
  • Proprioception is one of many systems that help us maintain balance.
  • Our brain uses multiple systems/senses to help us balance:
    • Vision
    • Touch
    • Vestibular (inner ears)
    • Proprioception
  • All of these systems must come together in a process called “sensory integration” for us to balance properly.
  • If one system, such a proprioception, is sending inaccurate information or contradicts the information from other systems, this can trigger dizziness.
  • It is important to note that currently the pathophysiology of CD is theoretical and mostly based off of animal studies.

Balance sensory integration

What Are Common Causes Of Cervicogenic Dizziness?

Mechanical forces that cause inflammation or irritation of nerves, muscles, or facet joints in our neck, which may cause altered proprioception signals.

  • Common Causes:
    • Chronic neck pain: creating general neck stiffness and muscle tension
    • Whiplash Associated Disorders (WAD)
    • Concussion
  • Gate Control Theory of Chronic Pain:  Before they can reach the brain, pain messages encounter “nerve gates” in the spinal cord that open or close depending upon a number of factors (possibly including instructions coming down from the brain). When the gates open, pain messages “get through” more or less easily and pain can be intense. When the gates close, pain messages are prevented from reaching the brain and may not even be experienced. Pain messages may be overridden/modulated by other signals/inputs such as massage, heat, cold, TNS (transcutaneous nerve stimulation), acupuncture, etc. (Information from:
  • Whiplash:  Neck injury due to forceful, rapid back-and-forth movement of the neck
    • This “whiplash” motion occurs during motor vehicles accidents, unexpected falls, or any direct blow to the head.
    • The quick “whip” like motion of the neck can cause muscle and joint damage.
    • Common symptoms of Whiplash Associated Disorders (WAD):
      • Neck pain, stiffness, muscle guarding, tension
      • Abnormal posture and movements:  moving “on block” or very rigid
      • Dizziness and instability
        • Dizziness correlates with high levels of neck pain
        • Only a small portion of patients suffering from WAD will experience dizziness


  • Concussion/Traumatic Brain Injury (TBI):  An injury to the brain that results in temporary loss of normal brain function.
    • There are two different mechanisms for sustaining a concussion:
      • Coup:  Occurs at the location of the initial impact
      • Counter Coup:  Occurs opposite of the initial impact due to momentum pushing the brain into the skull
    • Concussion may be caused by rapid head movement (without any direct hit/impact).
    • Head injuries may have concomitant neck injuries due to the high forces of the direct blow causing joint and muscle damage.
    • Often times prolonged concussion symptoms may be caused by undiagnosed neck dysfunction, including WAD and CD.

Concussion Traumatic Brain Injury TBI

Concussion VEDA infographic

Symptoms Of Cervicogenic Dizziness

  • Whiplash and Concussion/Traumatic Brain Injury may cause “sensory integration” problems resulting in vestibular symptoms such as:
    • Dizziness
    • Imbalance
    • Headache/Migraine
    • Vision Problems
    • Brain Fog
  • The onset of vestibular symptoms may be delayed 1-2 weeks after injury.

How Physical Therapy Can Help

  • Head and neck injuries as well as sensory integration problems may be improved with physical therapy exercises.
  • Usual recovery with physical therapy is about 3-6 weeks (for about 50% of patients).
  • If regular activity is resumed too quickly prior to fully recovering from injury and sensory integration problems, the patient may decompensate and experience a relapse of symptoms.


More Information About Cervicogenic Dizziness

Cervicogenic Dizziness Article from the Vestibular Disorders Association

Seattle Dizzy Group Meeting April 2019 Cervicogenic Dizziness Kaela Pauly

Kaela Pauly, DPT

of Cascade Dizziness & Balance PT

Kaela has a Doctorate in Physical Therapy (DPT) from the University of Colorado. While in school, Kaela developed a strong interest in vestibular rehabilitation when she completed a clinical rotation in an outpatient neurologic clinic. Since that time, she has continued to evolve in her expertise in this area through coursework, mentorship and self-study.

With a natural sense of adventure, Kaela has worked as a traveling physical therapist in remote areas such as Alaska, rural Colorado and towns throughout the Pacific Northwest. Those opportunities provided her with invaluable experience in outpatient, inpatient and home health settings and she was able to see how balance and vestibular disorders effect people of all ages and backgrounds.

“I love working with balance and vestibular disorders because every patient is different in how they present and each require their own unique treatment.”


Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | March 31, 2019

Functional Neurology and Neuroplasticity

Functional Neurology

Functional Neurology & Neuroplasticity

Help Your Brain, Help Your Body

by Dr. Daniel Hanson, D.C.  D.A.C.N.B

of Hanson Chiropractic Neurology 

 (Presented to Seattle Dizzy Group on 3/16/19)

This presentation gives an overview of functional neurology including how brain-based therapies work to promote natural healing through neuroplasticity which can help improve balance and reduce chronic vestibular symptoms such as dizziness, headache, and brain fog.

What is Functional Neurology?

Many people with neurological or vestibular/balance disorders suffer from debilitating imbalance and dizziness/motion sickness (feeling of being on a boat, spinning of the room, abnormal sensations of movement, etc.).  Functional neurology utilizes chiropractic techniques and specialized therapies to restore balance in the musculoskeletal, cerebellar, vestibular, and cortical system. Personalized functional neurology exercises create neuroplasticity which helps to alleviate a patient’s chronic symptoms and improve their balance issues.

  • Conditions Functional Neurology Can Treat:
    • Balance Problems
    • Dizziness
    • Headache
    • Brain Fog
    • Chronic Pain or Fatigue
    • Mal de Debarquement Syndrome


What is Neuroplasticity? 

Neuroplasticity is the ability of the brain to reorganize itself, both in the structure and how it functions.

  • How does it work?
    • “The brain that fires together, wires together”
    • Cellular Immediate Early Gene Production
      • Leads to mitochondrial production of protein (i.e. “the building blocks of life”)
  • How do we implement this?
    • Brain-based therapies in clinic and functional neuro exercises specific to the individual for homework

What are the Benefits of Functional Neurology & Neuroplasticity?

  • Long Term Results
    • Works best with intensive programs
  • “Plastic” Change
  • Overall brain health improved
  • Influence any aspect of your life!

Nueroplasticity 2

What is Breaking Down in the Body Causing Symptoms?

The Brain

Brain parts

  • Parts of the Brain:
    • Frontal Lobe
    • Parietal Lobe
    • Temporal Lobe
    • Cerebellum
    • Brain Stem

Brain Frontal Lobe

  • Frontal Lobe
    • Irritability
    • Mood Changes
    • Anxiety
    • ADHD/ADD
    • Working Memory Loss
    • Impulse Control Issues
    • Inhibitory Control Issues
      • Brain Inhibitory Pathway Compromise
  • Parietal Lobe
    • Balance
    • Eye Movements (Pursuits)
    • Pain Receptors
    • Somatosensory Cortex

Brain Parietal Lobe

Brain Temporal Lobe

  • Temporal Lobe
    • Long Term Memory
    • Entorhinal Corex
      • Memory
      • Navigation
      • Perception of Time
    • Hippocampus
      • Memory Relay Station
        • Frontal Lobe to Temporal Lobe
    • Emotional Modulation

Brain Cerebellum

  • Cerebellum
    • Primary area affected by head injuries or whiplash
    • “The Little Brain”
    • Modulates and Coordinates all Movement and Thought
    • Main communication body to the cortex
    • Involved with:
      • Balance
      • Posture
      • Motion
      • Eye Movement Integration
      • Inhibition of the Vestibular Output

Brain Stem

  • Brain Stem
    • Mid Brain (Mesencephalon)
    • Pons
    • Medulla Oblongata
    • Cranial Nerves are located in the region and are directly impacted by concussions as well as vestibular disorders, balance problems, and dizziness
    • Autonomic Control
      • Sympathetic
      • Parasympathetic
      • Gut-Brain Axis

The Vestibular System

  • What is the Vestibular System?
    • Controls reflexes of the eyes
    • Controls reflexes of the body
  • If the Vestibular System Malfunctions:
    • Bad function can mean perceiving too much, too little, or the wrong direction of movement
    • Vestibular Rehabilitation Therapy
      • Uses habituation exercises in order to promote compensation

How the Vestibular Otolith Organs WorkVestibular System How It Works

The Vestibular-Brain Connection


Assessing Vestibular/Cerebellar Function

  • Eye Movements
  • Gait
  • Balance
  • Limits of Stability
  • Reactions to Perturbation
  • Cortical Cerebellar
    • Integration
    • Evaluation

Brain Fog 6

How Can Functional Neurology Help?

  • Total Brain Solution Program
    • The V3 Exam System
      • V1: Cortical Integration
        • Functional Neurological
      • V2: Vestibular/Cerebellar
        • Balance and Function
      • V3: Musculoskeletal
        • Structure
    • Eye Tracking & Posturography  Right Eye System Logo
      • Right Eye Testing & Balance Tracking System (FDA cleared)
        • Measures:
          • Brain Stem – Gaze fixation
          • Frontal Lobe – Saccadic eye movement
          • Parietal Lobe – Pursuit eye movement
          • Cerebellar – Eye movement monitor and control
          • Pons – Burst activity of eye movement
          • Vestibular Apparatus – Canal and otolith VOR reflexes and associated eye movements and integration
    • Functional Neurology
      • Brain Based Therapies
      • Drug Free, Surgery Free Therapies
    • Create Neuroplasticity in the weak pathways

Example of Post Treatment Patient Improvements

  • Being able to walk quicker at ease, more free to walk down stairs and less trip prone going up
  • Deeper night’s sleep
  • Less pain when sleeping on side
  • Tightness and locked up feeling around neck, behind ear and around the jaw extremely lessoned
  • Ability to work scheduled shifts with less pain or neck or shoulders locking up
  • Able to hold clarity of vision for long periods, blurry vision is less intense and light and sound is less extreme
  • Able to enjoy her love of music again, sometimes able to start singing with it again
  • Family, friends, and coworkers noticed her spirits and big smile come back
  • Able to track and process cars in front and around her
  • Able to handle windshield wipers and light sensitivity to brake and blinker lights
    • Before the patient felt confused in the space around her, having a foggy feeling with difficulty processing what’s around her
  • Can drive at night without dark shade sunglasses
    • Even able to endure high beams

Brain of Individual

Individualized Specialized Treatment

Every person is an individual!

  • Each case is unique
    • Different focuses
    • Different reactions
    • Different status before the symptoms
    • Different abilities to recover (genetic influences)
  • Treatments should be individualized as well
    • Different functional losses
    • Different symptoms
    • Different mechanisms

Old You New You Exit Signs

How Patients Get Started

  • Free Consultation
    • To make sure you are a great fit!
  • Functional Neuro Exam
    • Frontal Lobe, Parietal Lobe, Temporal Lobe, Cerebellum, Vestibular System, and Brain Stem integration
      • Testing, Measurement and Analysis
  • Blood Lab Analysis
  • Metabolic Assessment Forms
  • Brain Assessment Forms

Dr Daniel Hanson Functional Neurology Chiropractor

Dr. Daniel Hanson, D.C.  D.A.C.N.B

of Hanson Chiropractic Neurology

Dr. Hanson is one of only a few Board Certified Functional Neurologists in Washington State that focuses his expertise in chiropractic neurology. He has been in practice for 22 years and specializes in neurological, musculoskeletal and pain disorders without drugs or surgery.

“If you are suffering from numbness, pain, or other symptoms that are debilitating, progressing and affecting your life negatively then I would value the opportunity to help you. I find it very rewarding to help people with these symptoms and functional neurological problems. I see this daily in practice and will do everything I can to help you improve your symptoms and life.”

  • Board-Certified Functional Neurologist
  • Diplomate of the American Chiropractic Neurology Board since 1997
  • 500+ hours of training specialized in functional neurology
  • Practicing in Redmond, Washington for 23 years working with brain conditions and brain injuries on a daily basis




Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | February 28, 2019

Ideas for When You Are Housebound with Chronic Illness

Housebound edit

Things To Do When You Are Stuck At Home With Chronic Illness

It can be challenging and sometimes impossible to get out of the house when living with chronic illness.

These articles offer ideas for the chronically ill who are housebound:

Things to Do When You’re Mostly Housebound

When Your Chronic Illness Leaves You Housebound

Activities for Housebound People

28 Fun Things to Do When You’re Bored and Sick at Home

39 Things to Do Instead of Watching TV When You Have a Chronic Illness

Why You Should Get Your Daily Nature Fix (Even When You’re Housebound)

Enjoying Nature When You’re Housebound with Chronic Illness

What Exercise Can I Do While Stuck in Bed?

12 Ways to Help a Homebound Senior Stay Involved in Life

10 Ways to Make Money From Home with a Chronic Illness

Coping with the Isolation and Loneliness of Chronic Illness

Getting Through Difficult Days with Chronic Illness


© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | January 31, 2019

Together We Can Do So Much In 2019

Together We Can Do So Much in 2019!

Seattle Dizzy Group is a respected leader in the vestibular and balance disorders patient support community with increasing national and global reach. (Read about our 2018 Highlights below). We hope you will join us in 2019 and help us continue to grow, provide community, and offer support to people living with chronic dizziness and imbalance–in Seattle and beyond.  With your help, we can continue to expand community outreach and involvement (including hosting professional speakers on various vestibular/balance topics and connecting with local health providers/resources) and also increase our advocacy efforts to raise awareness about vestibular and balance disorders (including participating in Balance Awareness Week with our annual Walk for Balance Event, see Making a Difference for Balance Awareness).

Get Involved!

Seattle Dizzy Group is organized entirely by volunteers (the majority who are personally impacted by chronic dizziness and imbalance). Together we can do so much in 2019! We invite you to contribute to our group however you are able. Spread the word about Seattle Dizzy Group and invite others to join us. Share Seattle Dizzy Group information and resources with others. Participate in online discussions. Help with hosting in-person meetings and activities (be a greeter, assist with room set-up and take-down, bring snacks, provide transportation, etc.). For more info, email:

We are an independent, self-supporting not-for-profit group funded solely through donations. As we continue to grow and expand our outreach efforts, we are naturally incurring more expenses. Our goal is to continue to offer at no charge support and resources to those in need in the vestibular community–in Seattle and beyond. Please consider supporting Seattle Dizzy Group with a financial gift to help us keep growing and thriving in 2019!  (Any donation amount is greatly appreciated!).

Ways your financial gift helps Seattle Dizzy Group:

  • Provides materials, supplies, and hosting for monthly support group meetings.  (Each meeting costs about $25, or about $300 annually).
  • Provides thank you gifts for guest speakers. (As funds allow, we strive to honor speakers with about $25 value gift, or about $100 annually).
  • Provides administrative support, online services/resources, and website hosting, etc.  (Administrative costs are about $500 annually).
  • Provides funding for Balance Awareness Week event(s) and other group activities.  (Costs may be about $50-$100 or more per activity).
To give Seattle Dizzy Group a donation of any amount by credit card or PayPal, click the “Donate” button below.

PayPal Donate

(Gifts to Seattle Dizzy Group are not tax deductible at this time)

THANK YOU for your support!

2018 Highlights

  • In September, we hosted our Eighth Annual Walk for Balance Event in celebration of Balance Awareness Week and Falls Prevention Awareness Day/Week with a goal of raising awareness for vestibular and balance disorders and showing our support for people living with chronic dizziness and imbalance. We started the event with a yoga warm-up activity and then invited others to “Walk a Mile in Dizzy Shoes” with us at Green Lake.  We increased our impact during our walk by wearing blue, Seattle Dizzy Group gear, balance awareness t-shirts, and Walk for Balance badge stickers as well as carrying balloons, flamingos (balance “mascots”) and balance awareness signs. After walking together, we honored event participants with our fourth annual Dizzy Spirit Awards. As a part of the celebration, we enjoyed food and giveaways. We also had a balance awareness Information Fair throughout the event. It was a fun day that hopefully helped lift spirits and build momentum for the cause. We received wonderfully positive feedback from participants, and we are excited to continue to grow the event in 2019!
  • In October, we celebrated 12 years together as a support group!

  • In 2018, we continued to expand the Seattle Dizzy Group website/blog and online services/resources and reached thousands of people around the globe. (For example, our website/blog was viewed over 10,000 times in 2018 by visitors from over 100 different countries worldwide!). Additionally, we gained followers on Facebook and  Twitter, and increased membership of our MeetUp Group.  We appreciate everyone who connected online with Seattle Dizzy Group in 2018 and are especially grateful for all those who helped get the word out about our group and shared our posts/resources with others.

See also: Past Annual Highlights

© Copyright 2019, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | December 31, 2018

Choosing Positivity Despite Chronic Illness

Something Good in Every Day quote

Strategies for Having a Positive Outlook While Chronically Ill

Living with chronic illness is a struggle, but focusing on the positive can help lower stress, increase ability to cope with symptoms, and improve overall quality of life.

Every day may not be good, but there is something good in every day! Practice looking for something positive in each day, even if some days you have to look a little harder.

These articles discuss the benefits of choosing positivity and offer strategies for having a positive outlook despite chronic illness:

The Power of Positivity: How to Maintain a Positive Attitude While Dealing with a Chronic Illness

5 Steps to Find the Bright Side When Coping with Illness

Keeping a Positive Outlook When Dealing with Chronic Illness

5 Tips for Staying Positive Despite Chronic Illness

10 Ways to Be Happier Despite Chronic Illness

The Brighter Side of Living with Chronic Illness: 6 Amazing Things You Know Better Than Most

Turning Negatives into Positives When You’re Chronically Ill

Mental Contrasting: A Smart Alternative to Positive Thinking

Seeing with New Eyes: How to Find the Good in Every Day


Post Updated January 2019.

© Copyright 2018, Seattle Dizzy Group. All rights reserved.

Posted by: seattledizzygroup | November 30, 2018

Advancements in Restoring Balance & Hearing with Prostheses

Cochlear implant

Treating Chronic Vestibular & Hearing Loss with Cutting Edge Implanted Devices

by James Phillips, PhD

Director of the Dizziness & Balance Center at University of Washington Medical Center 

 (Presented to Seattle Dizzy Group on 11/10/18)

This presentation gives an overview of vestibular and auditory prostheses including how the University of Washington Medical Center is currently evaluating these cutting edge implanted devices which will hopefully help to improve the quality of life for many with chronic vestibular and hearing loss.

What is the Vestibular System?

  • The vestibular system includes the structures in the inner ear that contribute to balance and orientation.
  • It includes the nerves that relay balance and orientation information from the inner ear to the brain.
  • It includes the neurons in the brain that make sense of that information, by combining information from a variety of sources:
    • different parts of each inner ear
    • from both ears
    • from the visual system
    • from the muscles and joints

Balance System

What Parts of the Inner Ear are Parts of the Vestibular System?

  • Semicircular canals
    • Posterior canal
    • Lateral canal
    • Anterior canal
      • Detect turning
  • Otolith organs
    • Utricle
    • Saccule
      • Detect front-back, right-left, up-down
      • Detect tilt
  • Vestibular Ganglia

The Internal Ear

What are the Semicircular Canals?

  • 3 canals (posterior, lateral, anterior)
  • Orthogonal
    • Fluid filled
  • Ampula
    • Location of hair cells.  (Our sense of balance starts with hair cells!).
      • Like the hair cells in the cochlea for hearing
    • Neural transduction
      • Convert movement into neural signals

How Do the Semicircular Canals Work?

  • When you turn your head fluid moves in the semicircular canals.
  • Each ampula contains a cupula, which billows when the fluid moves, which in turn bends the hairs of the hair cells.
    • Gelatinous tongue
    • Embedded hair cells
    • Sense rotational acceleration

How Do the Otolith Organs Work?

  • The otolith organs contain a gelatinous cap (otolithic membrane) and otoliths (otoconia, calcium carbonate crystals).  They also contain hair cells.
  • When we slide or tilt, the gelatinous cap deforms, and the hairs of the hair cells bend.
    • Shear
    • Sense of tilt and linear acceleration

Otolith Organs

What Happens When the Inner Ear Vestibular System Fails Bilaterally?

Both ears fail to work:

  • No whirling vertigo
  • Significant Disorientation
    • Swimmy headed feeling
  • Nausea and fatigue
    • Conflicting sensory input
  • Anxiety
  • Cognitive Impairment
  • Oscillopsia
    • Failure to stabilize your eyes when you turn your head
    • The visual world moves when you move
    • Reduces your vision
  • Postural and Gait Instability

Is There Compensation for Inner Ear Vestibular Loss?

  • YES
  • Over time we can compensate well for vestibular loss
    • Especially true of children
    • Our brains are designed to adjust for loss of input
  • Compensation is dependent on learning:
    • not to misinterpret sensory cues from a non-working vestibular system
    • to use contextually appropriate cues
    • to develop a general strategy that is adaptive over a range of situations
    • to substitute useful information from other sensory systems:
      • Somatosensory System
      • Visual System
  • Compensation requires sensory stability
    • Defeated by change of fluctuation

Can We Replace the Inner Ear Vestibular System?

Yes, with a vestibular prosthesis!

Vestibular Prosthesis

Who Could Be Treated with a Vestibular Prosthesis?

  • Not patients with a single acute transient loss of function.
  • Patients with bilateral loss of balance function.
    • Often iatrogenic
      • Exposure to ototoxic drugs
  • Patients with uncompensated unilateral loss of balance function.
    • Large numbers of patients do not adapt to a loss from one ear
  • Patients with fluctuating balance function.
    • Meniere’s Disease
      • Extreme intermittent vertigo
        • Destructive therapy
          • Injected ototoxin, surgical ablation, nerve section
          • These devices would take the place of a labyrinthectomy
  • Usher Syndrome patients:
    • Bilateral loss of balance dysfunction
    • Combined with hearing loss
      • Usher Syndrome patients may already have inner ear implants (cochlear implants for hearing loss).
    • To effectively treat Usher Syndrome vestibular loss requires a combined vestibular and auditory implant.

UWMC Road to Human Trials

  1. Design a device to stimulate vestibular afferent fibers.
    • Leverage a highly developed existing technology
      • Cochlear implant
    • Modify the software and hardware
      • Create a minimally invasive electrode technology
      • Create appropriate stimulation strategies
        • FM not AM
    • Partner with an existing Cochlear Implant manufacturer
  2. Develop a simple surgical approach with the right target.
    • Three semicircular canals
      • Coherent rotational information
  3. Construct prototype devices.
    • Identical to the final production device

UWMC Road to Clinical Trials

  1.   Evaluate the device in animal model.
    • Implanted devices in 14 rhesus monkeys
      • Similar inner ear anatomy to humans
      • Test in intact and lesioned animals
        • Ideal model for unilateral and bilateral loss
      • Evaluate risk
        • Longitudinally evaluate inner ear function
          • Using identical clinical tests to those that are used diagnostically in humans
      • Evaluate efficacy
        • Longitudinally evaluate prosthetically elicited function
          • Using clinically relevant behavioral and physiological measures
  2. Test the device in human patients with vestibular loss.
    • In 4 Meniere’s Disease patients
      • Can the device restore vestibular function lost from the destructive treatment?
  3. Modify our devices to create a combined cochlear and vestibular prosthesis.
  4. Test the new device in rhesus monkeys.
  5. Modify our existing FDA IDE to test patients with hearing and vestibular loss with the new combined implant.
  6. Test the new device in human patients with combined hearing and vestibular loss (2 additional patients, 6 total).

Turning the Implanted Device On

  • Electrical stimulation with biphasic pulse trains
  • Produces:
    • Eye movements – eVOR (Vestibulo-Ocular Reflex)
    • Body sway
    • Sensation of motion
  • Effective vestibular stimulation does not produce:
    • Nausea
    • Pain
    • Sound sensation
    • Facial nerve activation

UWMC Research Team Conclusions

  • We know that a vestibular implant works!
  • We have tested such a device in animals and humans.
  • We have an existing approval to test these devices in patients.
  • We have built a combined vestibular and cochlear implant.
  • We are currently testing it in monkeys.
  • We are working with the FDA to modify our existing human trial to test this new device.
  • We are not the only ones doing this!  (John Hopkins is researching similar implanted devices).

*This material regarding vestibular and auditory prosthetic technology is the intellectual property of the members of the device research team, the University of Washington, and Cochlear Ltd.*

More Information:

Conquering Vertigo article by James Phillips, PhD


James Phillips PhD UWMC

James Phillips, PhD

Director of the Dizziness & Balance Center

University of Washington Medical Center

James Phillips, PhD, joined the faculty at the University of Washington in 1998 and is currently a research associate professor in the Department of Otolaryngology-Head and Neck Surgery. He is also the director of the Dizziness and Balance Center at the UW Medical Center, the Vestibular Diagnostic Laboratory at UWMC, and the Roger Johnson Clinical Oculomotor Laboratory in the Division of Ophthalmology at Seattle Children’s Hospital. Prior to joining UW, he earned a PhD in psychology and in physiology from the University of Washington. Dr. Phillips teaches in the Departments of Otolaryngology-HNS, Ophthalmology, and Speech and Hearing Sciences. He is a faculty research affiliate of the National Primate Research Center, the Virginia Merrill Bloedel Hearing Research Center, the Center on Human Development and Disability, and the Autism Center at the University of Washington. He is also a faculty affiliate of the Center for Navigation and Communication Sciences at the University of Rochester and the Center for Integrative Brain Research at Seattle Children’s Research Institute. He is on the Medical and Scientific Advisory Board of the Vestibular Disorders Association.

More information:


Presentation information is not meant to be taken as medical advice.

Presentations posted online may include discussion notes, links, images, and other information added by Seattle Dizzy Group.


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