Dizziness

What can I do about my dizziness?

The first challenge is to understand what you mean by feeling dizzy. The sensation that you or the space around you is whirling or spinning around is called vertigo.

It makes a difference:

1. what you are doing when this occurs
2. how long it lasts
3. how often it occurs
4. is the vertigo associated with nausea, ringing in the ear, ear pressure, visual changes or a change in hearing? Some people only have a brief lightheaded feeling, perhaps when they stand up quickly, but others have a brief episode of vertigo when they simply roll over in bed. There still others who have a persistent feeling of disorientation or unsteadiness without vertigo.

It is helpful to understand that there are three sources of information that your brain uses unconsciously to make you feel at home in the world: the specialized nerves in the inner ear (vestibular system), your vision and the pressure sensors on the bottom of your feet. If any one of these sources is supplying poor information, your brain may get confused. This is why it is easy to lose our balance in the dark or when we are on a rolling boat. Finally, the brain itself can have a problem processing information even when there is normal information being supplied from the sensory organs. This is particularly common as the body ages.

Common problems that can affect the inner ear are benign positional vertigo, Meniere’s disease, viral vestibulopathy and migraine vestibulopathy.

Benign positional vertigo is a sudden, but often persistent cause of a spinning sensation that lasts only seconds, but can be associated with nausea. This vertigo is precipitated by a body movement, such as turning over in bed or looking up to change a light bulb. It is caused by a displacement of the microscopic “stones” that the inner ear normally uses to sense the effect of gravity on these tiny mineral collections.

Meniere’s disease is a problem in the normal fluid balance in the inner ear. The inner ear is a complex chamber that contains specialized nerves that let us hear sounds (the cochlea) and to sense movement and gravity (the vestibule). They both contain two different fluids that are kept separate by a delicate membrane. If the body mistakenly produces too much of one fluid, the membrane will stretch like a balloon and finally burst. When the two fluids mix, it causes a temporary poisoning of the specialized nerves. Usually within 24-48 hours, the membrane will heal and the symptoms will go away for another month or two until the unbalanced fluid pressure builds up again.

Viral vestibulopathy is also a sudden episode of vertigo, ringing noise, change in hearing, nausea and vomiting. This is caused by a common virus penetrating the inner ear and damaging the specialized nerves. This is a disorder that will not typically recur.

Migraine vestibulopathy is also a common cause of episodic vertigo. It is much less predictable and the symptoms can vary greatly. That is because the problem is with the function of the specialized nerves themselves.

These problems may require some medication when they are sudden and difficult to tolerate, but the most important step is to call for an appointment to discuss your symptoms. Your story is often a key ingredient in the recognition of what is the cause. A hearing test (audiogram) and specific tests of the balance system (videonystagmogram – VNG) are important.

“My dizziness has been a problem for years and it can be so bad that I used to have to stop when driving. I have a problem called migraine vestibulopathy. I have never had a headache. The HeadacheFree pills work pretty well. Only occasionally do I feel off-balance. I like getting the extra vitamins, too.” - Claudio Zuena

Can I do anything about my motion sickness?

Yes. This is a hypersensitivity of the balance system. There are some possible treatments of this chronic ailment. It may be worth a visit to learn more about this chronic condition.

We also provide information for people suffering from the persistent sensation of movement after getting off a boat. (mal de debarquement disorder). links: www.vestibular.org, www.etete.com/mdd/, www.dizziness-and-balance.com/, www.mddsfoundation.org