Why do I feel dizzy?

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo in individuals of all ages, but especially for those over the age of 50. Vertigo is typically reported and described as a sensation of spinning/the environment around them is moving.  Some individuals may also report a sensation of motion sickness and imbalance that makes them feel as though they are leaning more to one side or feel that they are going to fall over.  Vertigo should not be confused with the sensation of dizziness. Dizziness is the sensation of feeling woozy or lightheaded. Typically individuals with dizziness report a feeling of spinning within their head, but do not report the sensation that the environment around them is moving. Dizziness is provoked by movements of objects within the individual’s visual field whereas vertigo is aggravated by movements of the head.

BPPV is caused by an imbalance in the vestibular system located within the inner ear that helps us maintain our balance.   The inner ear is composed of 3 semicircular canals and at the end of the canals there are crystals (otoconia). These crystals are responsible for sensing head movements and relaying those movements to the brain to be processed.  When they crystals (otoconia) are displaced and go further into the canals, they disrupt the balance within the vestibular system. Now, with a disruption in the system, when you move your head the dislodged crystals move in a different direction. This change in direction of the movement of the crystals causes the brain to perceive that the head is moving in one direction, while the head is actually moving in another direction causing the sensation of the room spinning known as vertigo.

Besides vertigo, individuals with BPPV may experience nausea, difficulty concentrating, and difficulty keeping their balance. Symptoms of BPPV typically last less then one minute, but can be disruptive to your everyday life. The intensity, duration, and frequency of BPPV vary for each individual.  BPPV is commonly brought on by movements of the head like looking up or positional changes like rolling over in bed or going from lying down to sitting up.

The most common cause of BPPV in individuals younger then 50 years old is head trauma that displaces the crystals located in the inner ear. For individuals over the age of 50, the cause of BPPV is often idiopathic, meaning it occurs without any real known reason.  Although it can be caused by no known reason, the good news is that BPPV can easily be treated.

BPPV is diagnosed based on a patient’s complaints, medical history, physical exam, and special tests used to determine if there are dislodged crystals within the semicircular canals. Physical therapist or physicians can perform specific maneuvers to elicit the symptoms you feel and determine if you have BPPV. Different maneuvers are performed to determine what canal the crystals are located in.  Once it is determined that an individual has BPPV, the physical therapist or doctor can perform additional maneuvers to help move the crystals back to their proper spot.  Many patients report a relief in symptoms, after the initial maneuver is performed. Typically it takes 1-3 visit for the symptoms to completely resolve. If any other balance deficits are noticed during the visit, the physical therapist will address them and incorporate additional balance related exercises.  For more information visit www.totalperformancept.com.


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