Prevention & Recovery

All about vertigo: symptoms and treatment

By: Amberly McAteer

Author: Canadian Living

Prevention & Recovery

All about vertigo: symptoms and treatment

By: Amberly McAteer
This story was originally titled "Vertigo (BPPV)" in the May 2008 issue. Subscribe to Canadian Living today and never miss an issue!

Contrary to popular belief, vertigo is not a fear of heights. It's the sensation that your surroundings are rapidly spinning while you remain still. The condition is not uncommon but is rarely serious. Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by sudden episodes of dizziness brought on by movement.

Here's what you need to know about BPPV.

1. BPPV is caused by a confusion of signals to the brain.
The vestibular apparatus, a series of canals located inside the ear, includes a structure that contains tiny crystals of calcium carbonate. These crystals help the body detect gravity, tilting and speed changes in linear motions like stopping and starting at a traffic light. BPPV occurs when some of the crystals escape from their normal chamber and get into one or more of the canals. "When you move your head, the fluid in the canals moves as usual, but when you stop, if the escaped crystals are still moving in one ear, they will continue to stimulate the canal, creating a clash of signals to the brain," explains Kathleen Shortt, a physiotherapist who specializes in vertigo at LifeMark Physiotherapy in Toronto.

2. BPPV often develops very suddenly.
BPPV typically occurs without provocation, seemingly out of nowhere. According to one report in the Canadian Medical Association Journal, 50 to 70 per cent of BPPV cases are idiopathic, meaning without substantiated cause. This sudden onset is the way people usually discover that they have vertigo. Their first experience of the condition is often when they roll over in bed, says Shortt.

3. BPPV can be mistaken for a stroke.
Some common symptoms of BPPV – nausea, dizziness, light-headedness and loss of balance – are also signs of stroke. However, "there is no physiological connection between the two," says Shortt. "BPPV tends to come and go, and symptoms last only about 30 seconds, whereas stroke symptoms are continuous."

Page 1 of 24. BPPV can be diagnosed and successfully treated.
To determine which side of the brain is responsible, a physiotherapist has the person wear special goggles that simulate darkness and track eye movement. The direction in which his or her eyes move indicates which ear canal is involved.

Once the affected side has been identified, a physiotherapist who specializes in BPPV can successfully treat the condition. The most common treatment, called the Epley Manoeuvre, involves rotating the patient's head and body through four specific movements at differing speeds, each held for about 30 seconds. The patient's head and body are manipulated so that the dislodged crystals are moved along the canal and drop back into the correct chamber of the inner ear. Near the end of the Epley Manoeuvre, some patients feel a falling sensation. The vertigo symptoms can resolve quite quickly after this, but the feeling of being a bit "off" may persist for a while after, says Shortt. The treatment is 98.4 per cent effective after three treatments, if required, says Shortt.

5. People with severe BPPV are at risk of injury.
To minimize the risk of falling, Shortt suggests the following measures.
• Get rid of area rugs.
• Clear stairs and pathways of anything that may cause you to slip.
• Install grab bars and shower seats in the bathroom area.

Coping with Vertigo
Here are some ways to cope with BPPV-induced dizziness.
Sleep with extra pillows. This will help prevent your head from resting on an angle that further aggravates your condition.
Get in and out of bed very slowly.
Walk as if you have a book on your head. This minimizes head movement and helps avoid moving the crystals.
Avoid rapid movements such as tilting your head forward, upward or sideways.
• Your doctor can prescribe Serc, which is a betahistine and an anti-vertigo medication that works to reduce the pressure of the fluid in the inner ear. It may help to minimize the initial symptoms of BPPV, although it will not correct the condition.

The Vestibular Disorders Association has an informative website that offers support groups, a vestibular physiotherapist directory and information about BPPV.

Read more: Natural headache remedies.

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Prevention & Recovery

All about vertigo: symptoms and treatment