Brian Werner, PT (Dizziness Expert)

The Low-Pass Filter and the Origins of Mal de Debarquement Syndrome (MdDS). Are you trying to understand MDDS? This is a crucial video.

This is called a Look Optokinetics - which way would this turn you?

Can you see the vection in this image? Which way are you moving?

What is crucial with this image is the concepts of Optokinetic Nystagmus and the torque it produces on the vestibular system. Did you know you can use this to induce postural sway of a patient?

Crucial to understand is the concept of the direction of flow with your patients with BPPV - this is ampullofugal flow in each canal. What type of nystagmus would you see if this were a right inner ear disorder?

When we talk about BPPV in the horizontal canal, What type of nystagmus would you see with each type of flow?

This is the classic Head Impulse Test - which ear is the affected ear?

Review this nystagmus - why is this the Anterior Canal on the right side?

What do you see with this patient and their Sensory Mismatch? Look at "3," and you see that optokinetic flow (red) caused increased sway. On "4" you see green on all the trials, but they are low. This means a subtle surface dependency. On "5" and "6" you see falls. If I said this patient has a VVM Sensory Mismatch, what does that mean for your treatments?

What do you see? This is a classic form of BPPV - which canal is likely the cause?

When we talk about neuroplastic change, we have two forms - functional and structural.

Understanding Bilateral Vestibular Weakness (BVW): Diagnostic Mastery And Emerging Therapeutics open.substack.com/pub/brianwerne…

Understanding Bilateral Vestibular Weakness (BVW): Diagnostic Mastery And Emerging Therapeutics open.substack.com/pub/brianwerne…

A paradox with dizziness is the idea that if I just push harder, I will get better, but in fact, you might be reinforcing a maladaptive sensory strategy.