Dizziness and Vertigo: Two Symptoms You Shouldn't Ignore

This may come as a shock to you, but we all have rocks in our heads. Actually the "rocks," tiny crystals of calcium carbonate, are deep inside our ears and help us to sense and respond to motion. Sometimes the crystals (called otoconia) shake loose and float to other parts of the inner ear. The result is Benign Paroxysmal Positional Vertigo (BPPV) and it's awful.

I know because it happened to me. My BPPV is the result of an accidental blow to my jaw bone. It wasn't a big blow, just enough to shake up things. Within an hour I was feeling dizzy. Eight hours later I was lying in bed and moaning. My entire world was out of whack.

The bed felt like it was spinning and the room felt like it was spinning, too. I was so dizzy I couldn't take a step, let alone walk. In addition to these symptoms I had bouts of sweating, followed by bouts of chills. Light bothered my eyes and I tried covering them with a blanket, but the blanket made my vertigo worse so I uncovered them again. Constant nausea was the worst symptom and I thought I would throw up at any minute.

Mayo Clinic lists symptoms of BPPV on its Website, http://www.MayoClinic.com, and I had most of them: dizziness, vertigo, lightheadedness, unsteadiness, loss of balance, and nausea. Blurred vision after quick movements was the only symptom I didn't have have. Health experts describe BPPV as a "balance and dizziness disorder," a "bothersome" and "temporary" condition. These words don't tell the real story.

Benign Paroxysmal Positional Vertigo is debilitating. I've had it several times and it knocks me flat.

Because I'm a health care journalist I decided to learn more about BPPV and looked it up on the Internet, using the words "canalith repositioning maneuver." More than 1,450 references popped up and the most comprehensive is by Timothy C. Hain, MD, "Benign Paroxysmal Positional Vertigo." Reading it was like reading my own case history.

According to Hain, head injury is the most common cause of BPPV in people under 50 years of age. This statistic includes kids. "About 50% of all dizziness is due to BPPV," Hain goes on to explain. Rolling over in bed and getting out of bed can cause BPPV, Hain says, and it can return after a visit to the beauty shop or dentist - things that also happened to me.

What can you do about BPPV? If you have a mild case you can wait it out and hope the "ear rocks" go back to their original place or dissolve naturally. And if you wait it out Hain recommends using two pillows at night, not sleeping on your "bad" side, getting up slowly, and sitting on the edge of the bed a few minutes before walking.

Your other options are office treatment, home treatment, and in severe cases, surgical treatment. Fortunately, my husband is a physician and knew what to do. He helped me with the Canalith Repositioning Procedure, described by John M. Epley, MD in 1992. Only a trained professional should perform this procedure, according to The Vestibular Disorders Assocciation.

Scary as it may sound, the procedure is quite simple and Mayo Clinic has posted a slide presentation about it on its Website, http://www.MayoClinic.com. As Mayo Clinic explains, the goal of the procedure is "to move particles from the fluid-filled simicircular chambers of your inner ear to a tiny bag-like structure (utricle) where these particles don't cause trouble."

During the procedure your physician watches your eyes closely. The movement of your eyes tells him or her which ear has the loose crystals.

After the procedure you must sit up for 48 hours. If you lie flat while you're sleeping the procedure has to be repeated and you go back to square on on time. Even if you do it right the Canalith Repositioning Procedure may have to be repeated. The Vestibular Disorders Association describes the procedure as "very effective, with an approximate cure rate of 80%."

The procedure helps me, but it isn't a quick fix, and I usually repeat it. At night I sleep on the couch, with pillows behind my back to prop me up and a small pillow at my neck to hold it in a vertical position. Your doctor may recommend a neck collar to hold your neck in place.

Trained health professionas may perform other procedures to ease your BPPV. Again, The Vestibular Disorders Association says these procedures "must only be performed by a professional who is trained in the maneuvers and safeguard against possible neck or back injury . . . ."

Have you had sudden dizziness or vertigo? Don't ignore these symptoms and get a checkup now. Your physician will conduct and/or order tests to rule out detaching retina, esophageal reflex, brain tumor, and other diseases. Watch for symptoms of BPPV if your child is hit in the head.

Having BPPV has made me appreciate things I used to take for granted, like keeping my balance and walking straight. I'm amazed by the spiral design of the ear and its "ear rocks." Yes, I have rocks in my head an I'm glad of it!

Copyright 2005 by Harriet Hodgson