Positional vertigo:

If you’ve ever had a bout of vertigo (aka dizziness) you’ll remember it was a scary feeling. There are many serious causes of vertigo such as stroke, brain tumors, bacterial/viral infection in the inner ear etc. These things need to be ruled out by a primary care physician. Often a good indicator that you have a serious or potentially life threatening cause of vertigo is vertigo that persists for longer than a 60sec. Immediately consult your doctor or attend the local hospital emergency department if you have any concerns of this nature.

By far the most common cause of vertigo and dizziness is called BPPV; Benign (it won’t kill you), Paroxysmal (occurs from time to time), Positional (caused by a changed in head position), Vertigo (dizziness or disequilibrium such that you feel like you are being pushed to the floor or around in circles by your head). Many people who have had serious pathology ruled out by their medical doctor or who have undiagnosed short term vertigo (as in the vertigo only lasts for 30sec but could occur intermittently over a course of days, weeks, months or years) have BPPV. Most people experience this dizziness about 3 seconds after they lay down, roll over, look up or bend forward and episodes last for around 30 seconds. BPPV does not cause any auditory symptoms. The problem is caused by small calcium particles which become dislodged from one part of your inner ear which is responsible for sensing head movements and gravity which then move into the semicircular canals of the inner ear and alter the function of these canals. I often describe it like the snow in the toy crystal ball, when you turn the ball over and stop, the snow flakes start moving and push the fluid around – it’s the movement of fluid that your inner ear senses .

What can be done?

There are head movement tests which can be used to assess if you have positional vertigo. If the signs are present you will likely be taken through a series of gentle head movements to help relocate the crystals into the correct area of the inner ear such that they do not cause vertigo. A clear explanation of the problem, treatment approach, variables and treatment plan will be discussed before the procedure. These manoeuvres are around 80% successful within 1-2 sessions.

For those people who have had this condition for a long time, further vestibular rehabilitation will be needed since their brain has had to adapt to a poor functioning balance system over a long period of time.