Many of us will remember that feeling as a child of spinning around and round in the playground until the point of dizziness and even when we stopped turning, it seemed like everything around us is still spinning? That's exactly what it feels like to have vertigo.
Vertigo is a common symptom reported by adults during visits to their doctors. The average rate of vertigo is 3 percent in people under 60 years old and 1 in 10 people over the age of 60 years. The recurrence rate rates between 40-50% within a 5 year period. Almost everyone experiences a few seconds of disorientation at some point- but frequent episodes of vertigo-whether only for a few seconds or days on end-are a primary sign of vestibular dysfunction, especially when linked to changes in head position. Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction. About 1 in 5 people who have dizziness will have BPPV. This number increases in the elderly or in at risk populations. Dizziness is a sensation of light-headedness, lackness, or unsteadiness. Unlike dizziness, vertigo has a rotational, spinning component, and is the perception of movement, either of the self or surrounding objects. Disequilibrium simply means unsteadiness, imbalance that is often accompanied by spatial disorientation.
Vestibular System 101:
The vestibular system includes the parts of the inner ear and brain that process sensory information involved with controlling balance and eye movements. If disease or injury damages these processing areas, vestibular disorders can result. The vestibular apparatus, a series of canals located inside the ear, includes a structure that contains tiny crystals of calcium carbonate. These crystals help the body detect gravity, tilting and speed changes in linear motions like stopping and starting at a traffic light. BPPV occurs when some of the crystals escape from their normal chamber and get into one or more of the canals. Vertigo symptoms are essentially caused by a confusion of signals to the brain.
Benign Paroxysmal Positional Vertigo (BPPV) Checklist:
– My dizziness lasts only seconds to minutes, never hours or days.
– I can bring on the symptoms by certain head positions.
– It feels like either the room or my body is spinning.
– My dizziness is not associated with a change in my hearing or a noise in my ears.
The causes of vertigo are either central, related to the brain or central nervous system, or peripheral, related to the organs of the inner ear. Central causes are associated with the brain itself such a tumor or stroke or are related to outside conditions which affect the brain indirectly like drugs and alcohol. Other disorders which affect the brain indirectly include heart disease and rhythm abnormalities which interrupt the supply of oxygen to the brain and can cause dizziness.
Peripheral causes include:
Benign Paroxysmal Positional Vertigo (BPPV) – common in seniors, or following head trauma and motor vehicle accidents. BPPV is characterized by a sense of spinning, or vertigo, which occurs with certain movements of the head, and lasts for several seconds or minutes. This is caused by small crystals floating free in the semicircular canals, sending signals of movement to the brain.
Vestibular system degeneration -With age, the function of the inner ear decreases, which can cause problems such as loss of balance, or disequilibrium. This can be complicated by mobility problems such as arthritis, resulting in falls. Good balance relies on three body systems working together: the eyes, the inner ear, and the joints (ankles, knees, hips and neck). Therefore, if one area is under performing, it can be helped by the other two.
Vestibular dysfunction caused by infection (labrynthitis, vestibular neuritis Meniere's disease), ototoxicity (from medicine), barotraumas (such as explosion), vascular insufficiency or acoustic neuroma. The brain receives confusing signals which can result in symptoms such as nausea, or motion sickness.
Head injury, and whiplash are the single most common causes of vestibular disorders in people under 50 years of age.
Aging blessings own own set of challenges to the vestibular system. In many cases, the undering cause of a vestibular disorder can not be determined.
Vertigo is often the presenting symptom in multiple sclerosis. Migraine, a severe form of headache, may also cause vertigo. Complications from diabetes can cause arteriosclerosis (hardening of the arteries) which can lead to reduced blood flow to the brain, causing vertigo symptoms.
The most common treatment, called the Epley Manoeuvre, involves rotating the patient's head and body through four specific movements at different times, each held for about 30 seconds. The patient's head and body are manipulated so that the dislodged crystals are moved along the canal and drop back into the correct chamber of the inner ear. The treatment is 98.4 per cent effective after three treatments.
Cognitive deficiencies such as poor concentration, issues with spatial perception and coordination as well as short-term memory loss are known by clinicians to occur frequently among patients with vestibular abnormalities. Vestibular dysfunction has also been correlated with many disorders including ataxia; low back pain; neck pain; cervico-brachial syndromes; ankle instability; knee instability and osteoarthritis.
Medication and nutraceuticals can also aid in the reduction of motion sickness, dizziness and nausea. This may include antihistamines, anticholinergics and benzodiazepines of either a nutraceutical or pharmaceutical approach. Dietary changes may include increasing water intake and less consumption of beverages that contain alcohol and caffeine.
Home Safety Tips:
Get rid of area rugs and anything that may cause you to slip
Install grab bars and shower seats in the bathroom area
Sleep in a slightly flexed position (use extra pillows). This will help prevent your head from resting on an angle that further aggravates your condition
Get in and out of bed very slowly
Walk as if you have a book on your head. This minimizes head movement and helps avoid moving the crystals