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Vertigo

Admini Si - Friday, March 08, 2019

Vertigo is the false sensation of motion causing you to experience the feeling of spinning , dizziness, light headedness and being unsteady. You may also feel nauseous. It is as a result of problems with the balance mechanisms in your inner ear known as the vestibular labyrinth.  Within this there are 3 semicircular canals at right angles to each other. As you move your head this causes fluid in the canals to move which in turn causes tiny hairs to move, triggering the firing off of nerve messages to the brain. This gives the brain information about what position the head is in and of movement. This is reinforced by nerve input from the eyes, joints and muscles of the body.

There are a number of different causes of vertigo one of the most common is Benign Paroxysmal Positional Vertigo [BPPV].

                   


Cause

Minute calcium carbonate crystals can be dislodged from their normal location in the inner ear and either float in the semicircular canal or get stuck in the canal where they are not suppose to be. This causes the brain to think you are moving. However your eyes and body provide your brain with different information causing a mismatch of input resulting in the sensation of dizziness.

Symptoms

  • Sudden onset of spinning sensation.
  • May have woken up with it or noticed it when turned in bed
  • Can occur when bending forward or looking up
  • May feel nauseous
  • Terrible feeling whilst spinning occurs but settles within seconds
Stemetil and Sec settle nausea but do not change dizziness

Diagnosis

A simple test called the Dix Hallpike is used to determine which ear and canal are affected.

If this is positive there is a sensation of dizziness with involuntary movement of the eyes called nystagmus.

Treatment

The vertigo resulting from BPPV can be dramatically relieved by specialist techniques performed by physiotherapists skilled in this area. This involves moving the head through a series of positions in order to reposition the crystals back where they will no longer cause any problems. This is known as a canal repositioning manoeuvre or Epley.

80% of people will respond to one treatment. If symptoms persist a second treatment may be required one week later.

Some people may need to perform positioning exercises at home.


OTHER CAUSES OF VERTIGO

  • Cervical Vertigo – caused by change in input from the joints of the neck.
  • Menieres – episodes of vertigo with fullness of the ear, some hearing loss and tinnitus.
  • Vestibular neuritis – Viral infection causing inflammation of the vestibular nerve with sudden onset of severe dizziness, vomiting and tinnitus.
  • Vestibular labyrinthitis – Viral infection causing inflammation of the labyrinth with sudden onset of dizziness and unilateral hearing loss.
  • Acoustic neuroma – a slow growing tumour causing a feeling of imbalance, unilateral hearing loss and tinnitus.
  • Vestibular migraines - a feeling of motion sickness that can last a few hours to days with or without a headache and other migraine symptoms. Psycho Physiological Dizziness Syndrome – dizziness brought on by conditions such as anxiety, depression and panic attacks. 

Vestibular Rehabilitation can help with some but not all of these. It involves specific exercises of the head and body including the eyes to try to recalibrate the balance and reduce the dizziness.

If you are currently experiencing vertigo feel free to book an appointment to see our Specialist Physiotherapists at Macquarie Street Physiotherapy and they will assess you to see if they are able to help your particular type of vertigo.


Macquarie Street Physio