Dizziness Combined With Anxiety, A Common Problem Not Well Recognized In Healthcare – And What Can Be Done? Part 2

Video Transcript

References

Part 1 introduced a common but poorly known disorder which occurs when a person suffers a severe attack of dizziness or vertigo(1-4) and what results is a neurological problem that can be very debilitating(3)(5)(6) and can last for months or years(3) even with young(1)(2)(3)(6)(7) healthy people.
The good news is brain scan studies in the past few years have been showing the actual physical changes in the brain when people suffer from this condition.(1)(8)
This condition is called PPPD (Persistent-Postural Perceptual Dizziness), recently recognized by the World Health Organization(9) which is a combination of several disorders scientists have been studying the past several decades with names such as “phobic postural vertigo”, “chronic subjective dizziness,”“psychogenic gait disorders”, and others.(9)
The good news about this disorder is it is quite treatable,(10) and recognizing that there is a physical neurological cause(1)(7)(8)(11)(12) is the first step to getting better. (12)
From there, it is all about bringing back normal movement(6) and a vestibular specialist (inner ear balance specialist) is the healthcare provider that can help you on the path to getting better.(10)(13)

To Read Part 1 Click Here

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Health Advice Disclaimer
We make every effort to ensure that we accurately represent the injury advice and prognosis displayed throughout this blog. However, examples of conditions and their prognosis are based on typical representations of those conditions that we commonly see in physical therapy. The information given is not intended as representations of every individual’s potential condition. As with any injury, each person’s symptoms can vary widely and each person’s recovery can also vary depending upon background, genetics, previous medical history, psychological status and history, motivation to follow physical therapy advice and various other factors.
It is impossible to give a 100% complete accurate diagnosis and prognosis
without a thorough physical examination and likewise the advice given cannot be deemed fully accurate in the absence of this examination from a vestibular specialist.
Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied in this blog.
References
1. Wurthmann S, Naegel S, Steinberg BS, Theysohn N, Diener HC, Kleinschnitz C, et al. Cerebral gray matter changes in persistent postural perceptual dizziness. Journal of Psychosomatic Research. 2017;103:95-101.
2. Yan Z, Cui L, Yu T, Liang H, Wang Y, Chen C. Analysis of the characteristics of persistent postural-perceptual dizziness: A clinical-based study in China. International Journal of Audiology. 2017;56(1),33-37.
3. Huppert D, Strupp M, Rettinger N, Hecht J, Brandt T. Phobic postural vertigo. A long-term follow-up (5 to 15 years) of 106 patients. J Neurol. 2005;252:564-569.
4. Godemann F, Siefert K, Hantschke‐Bruggemann M, Neu P, Seidl, Ströhle A. What accounts for vertigo one year after neuritis vestibularis—anxiety or a dysfunctional vestibular organ? J Psychiatr Res. 2005;39:529–534
5. Wuehr M, Pradhan C, Novozhilov S, Krafczyk S, Brandt T, Jahn K, Schniepp R. Inadequate interaction between open-and closed-loop postural control in phobic postural vertigo. J Neurol. 2013;260:1314-1323.
6. Schniepp R, Wuehr M, Huth S, Pradhan C, Brandt T, Jahn K. Gait characteristic of patients with phobic postural vertigo: effects of fear of falling, attention, and visual input. J Neurol. 2014;261:738-746
7. Bittar RS, Sohsten Lins EM. Clinical characteristics of patients with persistent postural-perceptual dizziness. Braz J Otorhinolaryngol. 2015;81:276-82.
8. Indovina I, Riccelli R, Chiarella G, PetroloC, Augimeri A, Giofre L, Lacquaniti F, Staab JP, Passamonti L. Role of the Insula and Vestibular System in Patients with Chronic Subjective Dizziness: An fMRI Study Using Sound Evoked Vestibular Stimulation. Front Behav Neurosci. 2015;9:334
9. Popkirov S, Staab JP, Stone J. Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness. Pract Neurol. 2017; 0:1-9.
10. Obermann M, Bock E, Sabev N et al. Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study. J Neurol . 2015;262(9):2083–2091.
11. Riccelli R, Passamonti L, Toschi N, Nigro S, Chiarella G, Petrolo C, et al. Altered Insular and Occipital Responses to Simulated Vertical Self-Motion in Patients with Persistent Postural-Perceptual Dizziness. Front Neurol. 2017;8:529.
12. Shaaf H, Hesse G. Patients with long-lasting dizziness: a follow-up after neurotological and psychotherapeutic inpatient treatment after a period of at least 1 year. Eur Arch Otorhinolaryngol. 2015;272:1529-1535.
13. Geser R, Straumann D. Referral and final diagnoses of patients assessed in an academic vertigo center. Frontiers in Neurology. 2012;3(169):1-5.

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Matt Langford

Physical Therapist

Hi there! I'm Dr. Matt Langford. I have been working as a physical therapist in DFW for three years. My wife, our golden doodle named Birdie, and I love to spend our time going on different adventures whether it be hiking the Trinity trail or traveling to new places. I also love playing golf, pickleball, and serving at our local church in Fort Worth. My goals in life include learning more about the field of physical therapy so I can provide better care to individuals, pursuing my faith in a way that helps others know about Christ, and making as many memories as I can.

Kasondra Woodruff

Client Liaison

Kasondra is a mother and a pet lover, she loves spending time outdoors with her children and furry friends. With years of experience in client relations, her passion is ensuring that every client is heard and taken care of. As our Client Liaison, Kasondra takes pride in building strong relationships with our clients, ensuring that their needs are met and that they feel comfortable and confident throughout their time with us.

Jason Livas

Physical Therapy

Jason joined the Optimove team November 2023. He earned a Bachelor of Science in Exercise Science from the University of Texas at Arlington in 2012 followed by an Associate of Applied Science in Physical Therapy from Navarro College in 2019.
Jason’s clinical interests include neuromuscular training for healthy aging and longevity of the older adult, orthopedic rehabilitation and strength and conditioning. Jason also maintains certifications as a Certified Strength and Conditioning Specialist (CSCS) and trigger point dry needling (Cert DN).
Outside of work, Jason enjoys cooking, reading, strength training and spending time with his beautiful wife and kids.

Connie Thomason

Occupational Therapist

Connie holds a Master of Occupational Therapy from Texas Woman’s University (1997) and boasts over 26 years of experience as an Occupational Therapist. Her expertise lies primarily in neurological rehabilitation within a hospital-based outpatient setting. Throughout her career, Connie has worked across various healthcare settings including Acute, SubAcute, Skilled Nursing, and In-Patient Rehab.
Her specialization in Vestibular Rehabilitation since 2005 has equipped her to effectively treat a wide array of conditions, including BPPV, Vestibular Migraine, Meniere’s Disease, acute and chronic hypofunction, Acoustic Neuroma, PPPD, balance disorders, central vestibular disorders, concussion, and Superior Canal Dehiscence.
Connie holds numerous certifications, including the 360 Neuro Health Certificate of Competency in Vestibular Rehab, Emory University Vestibular Rehabilitation Competency-Based Course, 360 Neuro Health V2FIT for concussion, Lee Silverman Voice Therapy (LSVT) BIG for Parkinson’s patients, Neuro Developmental Treatment (NDT) for stroke patients, and NASM Corrective Exercise certification. She is also certified in the Montreal Cognitive Assessment (MoCA).
Active in professional communities, Connie is a member of the American Occupational Therapy Association and the Vestibular Disorders Association.
Outside of her professional endeavors, Connie enjoys spending time with her husband of 30 years, along with their two rescued bulldogs. Her hobbies include riding motorcycles, traveling, running, painting, and reading extensively about health, wellness, and vestibular research.

Andy Altmoyer

Operations Manager

Andy grew up as part of a military family, living all over the country and abroad. He is so glad to have finally landed back in Texas. He earned a bachelor’s degree in Secondary Social Studies Education, minoring in Vocal Music and Theater from West Liberty University in West Virginia. Since then he has used his outgoing nature, education background, and organizational skills in healthcare management and operations. When he isn’t working he enjoys spending time with his family and dogs, reading Marvel comics, and cooking.
During Andy’s first venture into healthcare, while living in Ohio, he worked for a practice focused on Orthopedics where he spent time managing their Physical Therapy front desk across multiple locations as well as being a group fitness instructor for seniors, folks with special needs, and those who have had total join replacements. It’s here that he realized his deep love of helping people navigate the healthcare system and connecting them with those can meet their mobility needs.
Sad to leave that company after over 7 years, Andy and his family moved to Dallas where Andy spent 3 years as Operations Manager for a large Neurology practice. He continued helping people connect with top tier healthcare providers, navigating the pandemic, and moving the practice’s location in stride. It was during this time that Andy met Dr. Guild. The Optimove Team became a favored referral source for some of the physicians on staff and Andy got to work with their team closely as they coordinated care for the patients.
This collaboration led to Andy joining the Optimove Team in August of 2021. Andy has a unique blend of experiences not only professionally but personally as well. He has been able to assist so many people reach the correct providers to have their needs met and provides valuable insight to the workings of the healthcare system at large and how to make it work better for our clients. This also comes from helping his mother navigate worker’s compensation and disability as well as assisting his family setting up his grandparents with memory care, assisted living, physical therapy, and other services. Andy has often been quoted as saying, “I may not be the one laying the healing hands but connecting folks to the right people who can help them makes me feel like I’m a part of something great and makes me feel good.”
Andy would like to be a part of your journey towards independence and wellness. He loves getting to know our clients and being one of their biggest cheerleaders throughout their journeys. Give him a call and take the first steps to achieving your goals.

Peter Langlois

Physical Therapy

Peter keeps our clients laughing, and the whole Optimove Team as well. Hand-picked by Jeffrey from their previous rehabilitation work, when he is not being “The Joint Whisperer” and making the seemingly impossible happen, Peter is MacGyvering up some gadget for our clients to help them move better.
Peter is originally from Rhode Island. He received his bachelor’s degree from the University of Rhode Island where his first career was as a ship captain, where he travelled the world and experienced many different cultures. Peter later developed a passion for physical therapy from his running career as a long distance runner doing marathons and ultramarathons. This led him to switch careers as he wanted to learn more about injury prevention and rehab. Peter has worked in various facilities over the last 8 years as a therapist throughout the metroplex including skilled nursing, outpatient orthopedics, and home health. He now enjoys working with our clients on various movement disorders, gait mechanics and balance issues. In his spare time Peter enjoys chopping wood and going for long trail runs with his family.

Jeffrey R. Guild, PT, DPT, (Former CSCS)

Owner, Therapist

When Dr. Jeffrey Guild is not working as business owner and clinician, he is dedicating time to his wife and children. His other hobbies include working out (Mainly in the weight room), music (Listening, playing, & researching), history, science, and studying business and successful people.
Jeffrey is originally from Bettendorf, Iowa and went to The University of Iowa and graduated with a bachelor’s degree in Health Promotion (Minors in Integrative Physiology & Psychology). He also worked as a Strength & Conditioning intern with The University of Iowa for 3 years and volunteered in cardiac rehabilitation at The University of Iowa Hospitals & Clinics. Upon arriving to Texas, he interned at the Cooper Aerobics Center.
Jeffrey’s first career was as a strength & conditioning professional and personal trainer. Even in the fitness industry he specialized in working with people who were older and with physical limitations. His particular emphasis as a personal trainer was identifying basic movement problems to prevent injuries BEFORE the training started, which gave him a greater understanding about human movement and was a natural segway towards Physical Therapy.
Jeffrey graduated with a Doctorate Degree in Physical Therapy at The University of North Texas Health Science Center in Fort Worth in 2013. He received the Dean’s research Award for the Allied Health Department and got published in multiple journals. After physical therapy school he started his career by receiving mentoring for over a year working in a vestibular/neurological specialty outpatient practice. Since then he has worked in a number of areas of physical therapy including inpatient rehabilitation, acute care, skilled nursing, memory care, and even pediatrics. In 2018 he started his own practice with the name “Optimove” with the emphasis on a combination of “optimal movement” and “optimism.”