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Stop the Room From Spinning: Causes and Treatments of Vertigo

Jul 14, 2015
Dizzy woman screaming

It's the thing that makes you go "ahh:" Vertigo.

"Vertigo is a specific sensation of spinning or turning that you get when your sense of place is not stable," says Tom Miller, MD, chief medical officer of University of Utah Hospitals and Clinics. "It's that feeling of 'my head is turning.'"

There are many causes of vertigo, including those that are rare, like vestibular neuritis, and Meniere's disease. Vertigo can also occur with migraine headache. It is also possible to induce vertigo by spinning quickly in circles, or through intoxication. A fairly common cause of vertigo is benign paroxysmal positional vertigo (BPPV). "Your lifetime risk of that is about two and a half percent," says Miller. "So, if you look at large numbers of patients it's pretty common."

BPPV is caused by tiny crystals in the inner ear. "Those crusty little crystals get into the semi circular canals and rattle around and send aberrant signals to the brain," says Miller. "If there's an imbalance in signal input you get that abnormal sensation of spinning."

The spinning effect from BPPV only comes with movement. "It's the snow globe effect," Miller says. "So when you move all those little crystals move around. If you're still the crystals don't do anything." Any motion, looking up, looking down or even rolling over in bed can set it off. "It lasts about 30 seconds, and then it goes away," Miller says.

In most cases diagnosing BPPV is usually done with a procedure known as the Dix-Hallpike maneuver. "It's usually in one ear or the other," Miller says. "You lean them back and, woah, the crystals move and they get dizzy. You watch their eyes. Their eyes move back and forth uncontrollably."

Treating BPPV is usually as simple as diagnosing the condition. "You don't need surgery or medicine; you need physical therapy for this," says Miller. "Once you figure out which side it's on you put them through a specific physical therapy called the Epley maneuver, and it's 85 percent effective at getting all of those crystals out."

Then you can breathe a sigh of relief.