Have you been suffering from constant vertigo? If you have been experiencing constant, recurring bouts of dizziness, nausea, motion sickness, & disbalance, then it’s likely that you are suffering from some type of vertigo. There are primarily two types of vertigo: Central Vertigo, & Peripheral vertigo. While Central Vertigo is caused by a problem with the brain or the central nervous system, Peripheral vertigo is caused by a problem with the inner ear, & as a result, the vestibular system.
Central Vertigo is usually chronic in nature, although remission is possible in some cases. Peripheral vertigo, once the exact cause is diagnosed, is usually easily treatable with vertigo medications, exercises, & some lifestyle changes. Although in some cases, even peripheral vertigo can be chronic in nature, especially if an exact cause for the vertigo is not available. A vertigo specialist can usually figure out the exact type of vertigo you’re suffering from by looking at your vertigo symptoms, medical history, and your vertigo test results.
Vertigo symptoms differ from one person to another, & every individual case of vertigo is different. However, there are some vertigo symptoms that are similar across all vertigo patients.
These symptoms include:
- Dizziness, usually occurring suddenly
- Feeling disbalanced or disoriented
- Swaying or tilting to one side of the body
- Difficulty maintaining balance & posture
- Nystagmus, abnormal jerking movements of the eye
- Ringing in the ears, also known as tinnitus
- Temporary hearing loss, usually prominent or occurring in only one ear
- Migraine headaches
- The feeling of pressure inside the ear
If you’ve been feeling one or more of the above for a considerable amount of time, & especially if the episodes seem to occur at regular intervals of time, then the possibility of you suffering from BPPV is quite high.
What is BPPV?
Benign Paroxysmal Positional Vertigo, also known as BPPV, is a type of vertigo that occurs when the tiny calcium crystals inside the middle ear, called otoconia, break loose & deposit into the semicircular canal of the inner ear. There, the crystals cause problems with maintaining balance & posture of the body, as they are motion-sensitive. BPPV is usually caused by an inner ear problem that interferes with the natural functioning of the body’s vestibular system.
Some of these inner ear problems include:
- Meniere’s disease, an inner ear disorder in which fluid accumulates inside the ears making it difficult for the vestibular organs to function properly.
- Vestibular Neuritis, an infection or inflammation in the vestibular nerve responsible for carrying balance signals from the inner ear to the brain & vice-versa
- Labyrinthitis, an infection or inflammation in the labyrinth, an organ inside the inner ear that houses the vestibular system. This causes disruption in the functioning of the vestibular system & leads to falls, dizziness, & disorientation.
- Ear infections or injury to the inner ear
- Inner ear surgery
Sometimes, BPPV occurs without any known cause at all. In these cases, it is usually an age-related issue or is caused by an injury to the head/neck that went unnoticed for too long. One of the most common signs of BPPV is a sudden dizzy feeling, accompanied by a sensation of the surroundings moving or spinning out of control. These ‘episodes’ can also be accompanied by nausea, motion sickness, vomiting, & migraine headaches & can last for a few minutes to a few hours.
How is BPPV diagnosed?
Your doctor will usually take a full medical history, along with your presenting symptoms, any medications you’re taking, any recent surgeries you might have had, & any accidents or falls in the recent months. Most times, a doctor can tell simply by looking at your symptoms & their intensity + periodicity to ascertain whether it is BPPV or not. At other times, they may give you an in-clinic test known as the Dix-Hallpike maneuver to check if you have BPPV. The test also helps them figure out which of your ears is affected by BPPV.
To perform the test, your doctor will ask you to sit on an upright examination table with your legs stretched out & your head tilted to one side. They will then lower your head & your body keeping your legs stretched in front of you, & your head stretched off to the edge of the examination table at a 45-degree angle with one ear turned down. By this time, you will suffer a bout of Vertigo if you have BPPV.
Your doctor will also check your eyes for any signs of nystagmus (abnormal jerking movement of the eyes in response to the head movements), & will ask how you’re feeling generally to look for further symptoms of Vertigo. If you don’t experience any symptoms on one side, your doctor will perform the test on the other side. Based on the results observed in the Dix-Hallpike test, your doctor will make an appropriate diagnosis & decide on an adequate vertigo treatment plan for you.
BPPV often goes away on its own, without the need for any specific medical intervention. However, in some cases, medical treatment might be necessary, especially if the condition doesn’t seem to improve on its own & causes some major issues to you.
BPPV treatment generally includes:
Vertigo exercises like the canalith repositioning maneuvers including Epley Maneuver, the Brandt-Daroff exercises, the Semont-Foster maneuver, etc. help the patient rebalance themselves & provide relief from their vertigo symptoms. Vertigo exercises can also be a part of your specialized vestibular rehabilitation therapy programme, which your doctor will specifically design for you keeping in mind your particular needs & requirements. Vestibular Rehabilitation Therapy programme can also include exercises like Yoga, Tai Chi, & general balance movements to help patients regain their balance & coordination. Vertigo exercises are usually supposed to be performed a number of times per week for a certain length of time to get the best results.
Vertigo medicines also help patients get relief from their symptoms. These medications include anti-dizziness medicines, anti-nausea medicines, antihistamines, anticholinergics, & anti-anxiety medicines. Some of the most commonly prescribed vertigo medicines include Meclizine tablet, Vertin tablet, Stemetil MD tablet, Stugeron-Forte tablet, etc.
In some cases, especially if your BPPV symptoms don’t improve after repeated exercises, medications, & other efforts, surgery might be needed. During BPPV surgery, your doctor will attempt to remove the dislodged calcium crystals from your inner ear back to the middle ear. Surgical intervention is usually the last line of vertigo treatment, & is only recommended if no other vertigo treatment option works for you. Surgery usually provides permanent relief from vertigo symptoms for vertigo patients.
In addition to these, certain lifestyle changes like drinking less caffeine, reducing your intake of alcohol, stopping smoking, taking less salt, & indulging more in exercises that help your balance & posture, can also help in constant vertigo treatment.