For many Canadians, dizziness or vertigo interferes with their daily life. Having a better understanding of symptoms and their triggers can be empowering. It can lead to helpful conversations with healthcare providers and support an accurate diagnosis and appropriate treatment.
Lifemark vestibular physiotherapists hosted a free webinar session where they spoke about four common underlying causes of dizziness and vertigo relating to the inner ear/vestibular system. Below are some key takeaways from the discussion. Play the video above to watch the full webinar.
Benign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) is an inner ear condition where crystals move into the wrong part of the ear, creating brief spinning sensations where individuals feel like they are in motion even when they are not. During these sudden periods of vertigo, nystagmus is present, which is rapid, repetitive, uncontrolled movement of the eyes. The various directions of this eye movement help vestibular therapists know if it is truly BPPV, and if so, which ear and canal are being affected, and this guides treatment. With BPPV symptoms commonly occur with quick head movement, bending over, looking upward, getting in/out of bed, and rolling over in bed.
Vestibular Neuritis or Labyrinthitis
Vestibular Neuritis, often known as an inner ear infection, is another common cause of dizziness and vertigo related to the inner ear. It is caused by inflammation of the vestibular nerve or the vestibular labyrinth. The inflammation is typically from a viral infection but can also be caused by a bacterial infection or autoimmune conditions. Symptoms include sudden, severe vertigo, unsteadiness and nausea/vomiting that lasts at least 24 hours. It is continuous, even at rest, and worsens with head or body movement. While vertigo may ease in 1-2 days, symptoms may be on-going for 1-2 weeks while the infection runs its course. If the infection leaves behind damage, people will have ongoing symptoms, such as nausea, dizziness with head movement, unsteadiness, and trouble seeing clearly when the head is in motion.
Vestibular Migraine
Vestibular migraines are the most common neurological cause of vertigo amongst adults. It is commonly referred to as dizzy migraines because it is like a typical migraine but with vestibular symptoms added on. However, for vestibular migraines, the headache aspect of the migraine is not always present.
About 30% of people who experience typical migraines also experience vestibular migraines where they experience dizziness, vertigo or imbalance during their attacks. Common triggers include dehydration, stress, irregular sleep, changes in hormones, as well as certain foods, including chocolate, caffeine and alcohol. While the cause is still not well understood, it predominantly affects women in their 40’s, those with a previous history of migraine headaches or motion sickness, and those with a family history of migraines.
Persistent Postural Perceptual Dizziness (PPPD)
Persistent Postural Perceptual Dizziness is a sensation of dizziness, unsteadiness and non-spinning vertigo that has persisted for more than 3 months and is present more than 50% of the time. It commonly occurs after a vestibular issue like those described above, or any other medical or psychological event that initially triggered dizziness, The triggering event is no longer driving the symptoms, but the brain stays on ‘high alert’, so a heightened sensitivity to self or visual motion persists. It affects females more than males, with a ratio of 4 to 1.
How vestibular rehabilitation can help
Our vestibular therapists are trained to support individuals who are affected by vestibular issues. For those with BPPV, 90% experience their symptoms resolving within 1 to 3 treatments.
Vestibular rehabilitation can help the brain restore balance and respond appropriately to signals from the visual and vestibular systems. It can also provide desensitization to triggering visual and motion stimuli. Treatment may include exercises to help coordinate the visual and vestibular systems, reset the nervous system and build up tolerance to certain movements.
When vestibular issues arise, the research shows that vestibular rehabilitation should be part of your care.
To schedule an appointment, contact a pt Health clinic near you or book an appointment online.
This blog originally appeared on Lifemark.ca and was written by Sheelah Woodhouse, Vestibular Physiotherapist