Since we have been talking about balance and falls, we need to talk about what can often lead to falls: vertigo. Let’s start with the basics. True vertigo is having a feeling of spinning or movement such as the sensation of swaying. If you’ve ever been sea sick, this is a bit like the swaying sensation. If you ever got “the spins” in your younger years after too much fun with alcohol, that is similar to the spinning that some people experience.
There are also two types of vertigo: Inner ear vertigo and Central vertigo. However, inner ear vertigo is more common and we even treat patients with this type of vertigo. Central vertigo is related to damage to the region of the brain that controls balance. This includes things like strokes, MS and Parkinson’s. People with central vertigo tend to feel more unbalanced or unsteadiness in general versus having sudden attacks of spinning. Today I want to focus on inner ear vertigo. People with inner ear vertigo have very specific symptoms. Typically, they have a hard time turning their heads rapidly and walking in busy environments like a busy supermarket. Certain positions may also cause a sudden sensation of spinning, which can be pretty scary at times. These positions include tipping the head back, bending forward, lying down in bed, or rolling over in bed.
So what’s really going on? Do you remember when you were a kid and you would spin in circles until you got really dizzy and fell over? The reason you felt dizzy after spinning is that you were moving the fluid around that’s in your inner ear canals. You have a set of 3 canals on each side. Normally, when your head moves, the fluid in the canals also moves, and when you stop moving your head, the fluid stops. This gives your brain information about the position of your head in relation to gravity. When the fluid flow is interrupted, it confuses your brain resulting in the spinning sensation and the general feeling of being off-balance.
The most common type of inner ear dysfunction that will cause this spinning sensation is called “BPPV.” This stands for Benign Paroxysmal Positional Vertigo. Focus on those last 2 words: positional vertigo. As I mentioned, certain positions or head movements will result in vertigo. When the fluid moving through your inner ear canals is obstructed on one side, the information to your brain gets mixed up, and your brain gets confused. Have you ever had a friend tell you they had “rocks loose in their ears”? This is the simple way to look at BPPV. Basically, small rocks or crystals from adjacent ear organs get dislodged. When they float over into the canals on one side, they can slow down or block the fluid movement on that side. And when the 2 sides start sending conflicting information to your brain, this results in confusion and the sensation of spinning.
While the spinning sensation is usually short in duration (lasting around 20-45 seconds), it can be very intense and is quite unpleasant. Luckily, this type of vertigo can be easily addressed in our clinic with some specific “repositioning” maneuvers. We test for BPPV by having you lie down quickly on one side with your head turned a specific direction; we watch your eyes and rely on
your feedback for specific symptoms. Then, we wait for 30 seconds before we have you turn again. Essentially, the different head and body positions we place you in will move those “rocks” or “crystals” in the ear canals which can be confirmed by your eye movement and by which side you feel symptoms/dizziness on. Finally, based on that information, we can give you specific “repositioning” exercises to do to get those rocks/crystals into the correct position. When that happens for good, you no longer send the wrong message to your brain, and the dizziness is relieved. Usually this only takes a few sessions.
That’s it from me this week, I’ll be back next week to talk more about balance, falls and osteoporosis. Until then, have a great week! As always, if you have any questions about balance, falls or osteoporosis, you can call (360) 456-1444 or email info@penrosept.com
