Dizziness or Vertigo

Vertigo/Dizziness is the sensation of spinning ,swaying.That is the feeling of you or your environment moving.Also you may feel loss of balance.

Vertigo can be experienced mostly during morning and night,specially when you getup from the bed while turning your head,due to change in the vestibular system.

Vestibular system is mainly responsible for balancing our body.When we shift our head form one position to another usually the particles in the vestibular system also move,and it will stimulate our brain regarding our body/head position.

When there is an issue with those particles in the vestibular system,you may experience dizziness or vertigo. 

Vertigo is a symptom rather than a medical condition. Other symptoms that can accompany vertigo includes: 

• Hearing loss
• Tinnitus (Ringing sensation in the ear), 
• Nausea, vomiting 
• Feeling of fullness in the ear
• Loss of balance 

This rotational dizziness have two main causes: disturbance in either,

•       The balance organs of the inner ear (Peripheral vertigo)
•        Parts of the brain or sensory nerve pathways (Central vertigo).

PERIPHERAL VERTIGO

The inner ear causes include 

1) Labyrinthitis - This is the inflammation of the inner ear labyrinth; a structure that contains the organs of the senses of hearing and equilibrium.

  2) Vestibular Neuronitis - An infection of the vestibular nerve in the inner ear which causes the vestibular nerve to be inflamed, disrupting the sense of balance.

3) Meniere’s disease - Vertigo caused due to the high pressure of a fluid in a compartment of the inner    ear.

      4)  B.P.P.V - Benign paroxysmal positional vertigo occurs when micro-sized calcium crystals on the       utricle of the inner ear gets displaced which creates a false signal to the brain causing vertigo.

CENTRAL VERTIGO

It involves the central nervous system due to a disturbance in one of the following areas

1.      Parts of the brain (brainstem or cerebellum) that deals with the interaction between the senses of vision and balance.

2.      Sensory messages to and from the thalamus (part of the brain).

TREATMENT

Epley Maneuver

If your vertigo comes from your left ear and side:

1.      Sit on the edge of your bed. Turn your head 45 degrees to the left (not as far as your left shoulder). Place a pillow under you so when you lie down, it rests between your shoulders rather than under your head.

2.      Quickly lie down on your back, with your head on the bed (still at the 45-degree angle). The pillow should be under your shoulders. Wait 30 seconds (for any vertigo to stop).

3.      Turn your head halfway (90 degrees) to the right without raising it. Wait 30 seconds.

4.      Turn your head and body on its side to the right, so you're looking at the floor. Wait 30 seconds.

5.      Slowly sit up, but remain on the bed a few minutes.

If the vertigo comes from your right ear, reverse these instructions. Sit on your bed, turn your head 45 degrees to the right, and so on.

Do these movements three times before going to bed each night, until you've gone 24 hours without dizziness.

Semont Maneuver

For dizziness from the left ear and side:

1. Sit on the edge of your bed. Turn your head 45 degrees to the right.
2. Quickly lie down on your left side. Stay there for 30 seconds.
3.  Quickly move to lie down on the opposite end of your bed. Don't change the direction of your head. 
4. Keep it at a 45-degree angle and lie for 30 seconds. Look at the floor.
5.   Return slowly to sitting and wait a few minutes.
6. Reverse these moves for the right ear. 
7. Again, do these moves three times a day until you go 24 hours without vertigo.

Half-Somersault or Foster Maneuver

Some people find this maneuver easier to do:

1. Kneel down and look up at the ceiling for a few seconds.
2. Touch the floor with your head, tucking your chin so your head goes toward your knees. Wait for any vertigo to stop (about 30 seconds).
3. Turn your head in the direction of your affected ear (i.e. if you feel dizzy on your left side, turn to face your left elbow). Wait 30 seconds.
4. Quickly raise your head so it's level with your back while you're on all fours. Keep your head at that 45-degree angle. Wait 30 seconds.
5. Quickly raise your head so it's fully upright, but keep your head turned to the shoulder of the side you're working on. Then slowly stand up.

You may have to repeat this a few times for relief. After the first round, rest 15 minutes before trying a second time.

Brandt-Daroff Exercise

Here’s what you need to do for this exercise:

1. Start in an upright, seated position on your bed.
2. Tilt your head around a 45-degree angle away from the side causing your vertigo. Move into the lying position on one side with your nose pointed up.
3. Stay in this position for about 30 seconds or until the vertigo eases off, whichever is longer. Then move back to the seated position.
4. Repeat on the other side.

You should do these movements from three to five times in a session. You should have three sessions a day for up to 2 weeks, or until the vertigo is gone for 2 days.

Note:

• Reduce your salt intake
• For the rest of the day after doing any of these exercises, try not to tilt your head too far up or down. 
• If you don't feel better after a week of trying these moves, talk to your doctor/audiologist again, and ask him/her what he/she wants you to do next.
• You might not be doing the exercises right, or something else might be the cause of your dizziness.

                                                           Special thanks to 

                                                                Rhiya Grace

                                        ( Speech Language pathologist and Audiologist )