Dizziness and vertigo are symptoms that patients present to me with on a regular basis. Sometimes it is the primary complaint but often it is mentioned alongside other problems such as headaches or neck/shoulder pain.
Firstly it is important to make the distinction between dizziness and vertigo.
Dizziness usually refers to feelings of unsteadiness like you are losing your balance, or lightheadedness like you feel you are going to faint. True vertigo, however, is the distinct sensation that either you, or the world around you, is spinning or swaying, when no movement is actually taking place.
Vertigo can be quite a distressing and debilitating condition and can be further complicated by additional symptoms such as nausea and vomiting, as well as the increased risk of injury from falls.
What causes Vertigo?
There can be a variety of different causes of vertigo, most of them involving impairment of the inner ear which houses the vestibular system that is vital for our sense of balance.
Trauma, certain infections as well as inner ear disorders such as Menieres’ disease can all disrupt this system, leading to vertigo.
But by far the most common cause of vertigo is a condition called ‘benign paroxysmal positional vertigo’ or BPPV for short. It is a long complicated name but basically it is just a fancy way of saying that it is vertigo that comes on in short sudden bursts, usually due to movement of the head and neck, and it is not due to an aggressive or life threatening cause. It can affect adults of any age but is more common as we get older, and the symptoms are usually worse with rotation of the head towards the affected ear and when rolling over in bed at night.
Benign Paroxysmal Positional Vertigo (BPPV) explained..
Within the inner portion of the ear we have three little canals filled with fluid. When we move our head, such as doing a head check in the car or looking down at our phones, the fluid in the canals also moves which tells our brain that movement has occurred. In BPPV what happens is that tiny little calcium crystals that are normally tucked away securely in a certain part of the ear become dislodged and make their way into those canals. This can happen due to damage from trauma or infection, from increasing age or sometimes for no discernable reason.
Once those cheeky crystals are in the canals they cause movement of that fluid, the movement of the fluid tells the brain “hey the head and neck are moving”. At this point the brain gets understandably confused, it has one ear saying that movement is happening but the eyes and the unaffected ear saying that no movement is happening. This mixed up information been transmitted to the brain results in disorientation and the classic spinning sensation.
Still with me? Good, follow the link to the next article to see what can be done about BPPV?
