The Dizzy Patient
Types of Dizziness
We all know that feeling after spinning around quickly and stopping while the world continues to spin around you. While this feeling may be fun to induce as a young child, this similar feeling of dizziness can happen to individuals at random times. Often times, this dizziness is a very frightening feeling and can be very difficult for people to determine when it is going to come on and understand exactly why it is happening. This dizzy feeling, though, is occurring because of a disruption within the vestibular system of our bodies, which is the system in charge of our balance and orientation to the space around us. This tiny system is located in our inner ear and is made up of 3 circular canals that each contains fluid inside of them. Each of these canals are positioned differently so that as we move our head in different directions, the fluid inside the canals also moves in different directions, which in turn tells our bodies where we are in space. The reason that we become dizzy after spinning around and around as children, is because the fluid inside of the canals continues to move even after our heads & bodies have stopped. Once the fluid calms down, we stop feeling dizzy.
Dizziness can also be caused from a disruption in a different part of the vestibular system, located at the base of the 3 canals. This area of the system contains small crystals, called otoconia, that lay on top of hair cells and help us to determine how our head is positioned. As we move our heads in different directions, these crystals start to slide (because of gravity) and pull on the hair cells, which sends signals to our brain telling it which way we are moving. Although these crystals are normally very helpful, sometimes they can get dislodged from the hair cells and get stuck in one of the semicircular canals. When this happens, intense dizziness can start to occur. This type of dizziness, or vertigo, is known as Benign Paroxysmal Positional Vertigo (BPPV), and it is the most common form of vertigo.
Symptoms and Treatment of BPPV
In addition to dizziness, other symptoms of BPPV include imbalance, difficulty concentrating, and nausea. Activities that bring on symptoms can vary in each person, but symptoms are caused by changes in head positioning. Common problematic head movements include looking up, or rolling over and getting out of bed. Symptoms can also vary in frequency, duration, and intensity. Although, BPPV can be very disruptive to someone’s life, the good news is that it is not life threatening and it can be treated by performing specific maneuvers. These maneuvers involve a series of patterned head and body movements that can be performed in a physical therapist’s office in about 15 minutes. Many individuals who have suffered from BPPV find resolution of symptoms after 1-3 treatments of these maneuvers. Physical therapy can also provide exercises that further help to decrease dizziness.
