Vertigo

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What is Vertigo?

Vertigo is a symptom, rather than a condition itself. It’s the feeling that you’re moving when you’re not. Or it might feel like things around you are moving when they aren’t. Vertigo can feel similar to motion sickness. People experiencing vertigo generally describe the sensation as “feeling dizzy” or feeling as if the room is spinning. Vertigo is not the same as lightheadedness.

There are two categories of vertigo. Peripheral vertigo occurs as a result of a problem in the inner ear or the vestibular nerve. The vestibular nerve connects the inner ear with the brain.

Central vertigo occurs when there is a problem in the brain, particularly the cerebellum. The cerebellum is the part of the brain that controls coordination of movements and balance.

Causes of Peripheral Vertigo

About 93 percent of vertigo cases are peripheral vertigo, caused by one of the following:

  • Benign paroxysmal positional vertigo (BPPV) is vertigo brought on by specific changes in the position of your head. It’s caused by calcium crystals floating in the semicircular canals of the ear.

  • Meniere’s disease is an inner ear disorder that affects balance and hearing.

  • Acute Peripheral Vestibulopathy (APV) is inflammation of the inner ear, which causes a sudden onset of vertigo.

Causes of Central Vertigo

  • Stroke

  • A tumor in the cerebellum

  • Migraine

  • Multiple sclerosis

Feeling of vertigo may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks.

Other symptoms associated with vertigo may include:

  • Loss of balance – which can make it difficult to stand or walk

  • Feeling sick or being sick

  • Dizziness

Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making normal life very difficult.

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What is Benign Paroxysmal Positional Vertigo?

Benign paroxysmal positional vertigo (BPPV), or “loose crystals,” is a very common cause of vertigo and is due to a mechanical change in the inner ear.

When crystals become dislodged and travel into one of the semicircular canals, it disrupts the fluid creating a false sense of movement.

This is why alterations in head position such as looking up or down, lying in bed, or rolling over will cause dizziness, feeling off balance, or difficulty walking.

Studies have shown that 2 to 3 percent of the population is at risk for loose crystals.

Not all forms of vertigo come from BPPV, but it can be diagnosed and treated. A physical therapist can determine if you have BPPV.

How Is BPPV Treated?

Physical Therapy is the No. 1 treatment for BPPV. It can usually be treated with a non-invasive treatment that has very positive outcomes.

The repositioning maneuvers used in physical therapy, are very specific movements which loosen the crystals.  These treatments work by allowing the free-floating particles from the affected semicircular canal to be relocated by gravity back into place, resolving vertigo approximately 90-95 percent of the time.

Medications called vestibular blocking agents are also useful for treating vertigo and include:

Once BPPV is resolved through appropriate treatment, patients will follow up with balance training tailored for inner-ear problems ensuring safe recovery.