Suffering from Vertigo?
“The room hasn’t spun that much since the last time I got really drunk”
This was basically the description my patient Sara gave me yesterday of her symptoms. It started two days ago after she tilted her head under a lamp to check its price. On standing up again she felt all dizzy and the room wouldn’t stop spinning. She would get the same sensation when she tried to lie down.
I explained it sounded like she was suffering from Vertigo (BPPV – Benign Paroxysmal Positional Vertigo to be precise). The brief episodes of spinning that occur when you change the heads position are as a result of a disorder within the inner ear.
Symptoms are often only short lived though can be intense and patients often describe feeling nauseous during the ride!!!
It is thought that the cause is small calcifications or crystals which dislodge from the vestibule of the inner ear and float in the labyrinth – if they remain here they tend not to cause an issue. Problems arise when these fragments pass into the semi-circular canals. Normally when we move the head the natural movement of fluid against the cilia hairs within the canals provides information to the brain via the vestibular nerve as to the position of the head. If the fragments brush past these delicate, sensitive hairs the nerves send extra messages to the brain bombarding it with signals that conflict those from the other canals, the opposite ear, eyes and body causing the altered perception of position.
Following a few other tests and the Dix-Hallpike position to determine which ear was the problem we used the Epley manoeuvre. A series of head movements using gravity to encourage the particles back into the vestibule. We had a bit of a bumpy ride but within a couple of repetitions the symptoms are improving. She has her homework to continue the manoeuvre herself and we may need to do a follow up next week. If the Epley manoeuvre hasn’t worked we may need to move on to the Brandt-Daroff to treat the other semi-circular canals in the ear.
We’ve obviously explained she can expect recurrences over the years but some top up treatments should be enough. But for now she can reduce the roller coaster ride she’s been on.
If you are suffering with Vertigo, then give us a call to book in for a treatment.
Case Study Blog by
Ben Wallis – Specialist MSk Physiotherapist & Therapy Lead