Many individuals perceive their vestibular problems to be unpredictable. One of my clients stated, "The unpredictability is a killer!" My client was not referring to a life threatening problem. However, dizziness can be a sign of a life threatening problem. Individuals with undiagnosed dizziness should either call their Medical Doctor or go to the Emergency Department. Clients who make these types of comments are referring to the terrible, controlling and inconvenient nature of dizziness. I think what clients mean by "unpredictable" is the way vestibular dysfunction may come and go at any time for no reason. This part of vestibular dysfunction is definitely unpredictable. That aspect of vestibular dysfunction can be terrifying for many. Over the years, however, I have noticed that the unpredictability of the problem seems to be more predictable than one might recognize.
With many of my clients (not all), the way their problem returns is fairly predictable. For instance, the spells usually last about the same amount of time. The intensity seems to either stay the same or even become less. The nausea, over time, may actually become less. The movements that cause the problem remain consistent. It even seems that I notice patterns of when the problem may return and when it may go away on it's own. If vestibular rehab worked once for an individual, it seems as though it is likely to work again should their problem return.
We have to be careful not to give more power to vestibular dysfunction than it deserves. I know that in the moment, the problem is horrendous. However, the greater our brains perceive vestibular dysfunction as a threat, the greater our sympathetic nervous systems will respond. This will cause a stronger response in our bodies. We must be honest about how "unpredictable" these spells actually are so that we do not have as intense of a response when the problem returns.
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