Positional Vertigo
This is a very common and easily treatable form of dizziness. It is called Benign Paroxysmal Positional Vertigo (BPPV). With BPPV people often report very short lived spells of spinning vertigo with certain movements such as turning over in bed, getting out of bed in the morning, on bending over or looking up. The symptoms are often associated with nausea and can be quite frightening. People often manage their problem by avoiding the irritable movements. The problem of BPPV relates to calcium crystals known as otoconia. In people with BPPV, the otoconia are dislodged from their usual position within the utricle (in the vestibular system of the inner ear) and they migrate over time into one of the semicircular canals, which then cause disrupted messages to the brain.
Image of the Vestibular system in one ear
- semicircular canals and otolith organs
A normal functioning vestibular system is key to our sense of balance, motion and body position. The Otolith senses the direction and speed of lineal acceleration and the position (tilt) of the head. The semicircular canals allow us to sense the direction and speed of angular acceleration such as turning the head.
When there is disruption to the vestibular system, for example by otoconia in the semicircular canals, messages become mixed as they go up to the brain. The result is vertigo, loss of balance and disorientation. Normally to balance we rely on the messages to the brain from the vestibular system, the eyes and nerve receptors in our joints. If one or more of these systems are reduced our physical balance is affected.
Vestibular Hypofunction
People who have an episode of severe vertigo from problems such as an inner ear infection, vestibular neuritis or labrynthitis can be left with ongoing balance and dizziness problems. The initial attack can last a few days (often causing severe dizziness and sickness), but once these severe symptoms settle, a milder form of dizziness can continue. People may report a more constant mild dizziness or light-headedness which can be made worse with different activities such as fast head movements, on bending, on increased levels of activity and in busy situations such as in the supermarket. They may also report that the dizziness feels worse when they close their eyes. People often start to limit their activities to avoid making their symptoms feel worse. People may have symptoms of BPPV as well.
Vestibular Rehabilitation Therapy (VRT) - THE Epley Manoeuvre
The treatment of vertigo depends on your diagnosis. With BPPV a manoeuvre known as the Epley Manoeuvre may be performed which moves the calcium crystals through the semicircular canal back to the utricle, through some specific neck and body turning movements. This is a very successful form of treatment and in most cases symptoms will resolve in 1-2 treatments.
People who have vestibular hypofunction following an acute vertigo attack benefit from specific desensitisation, habituation and substitution exercises, often known as Cawthorne Cooksey Exercises. These, when performed regularly, enable the brain to compensate for the unequal balance in the ears. These exercises take longer to work but again are very successful in resolving all symptoms of vertigo.
The principles behind VRT often lead to a temporary increase in symptoms of dizziness, but by doing this it is working towards resolving the problem.
Call Linda on 01344 861891 to arrange an appointment for help with your dizziness or visual vertigo.