A Spin on Vertigo

 - - - - -
Breathe deeply and brace hard. The chance of sudden heaving, volatile twisting, and terror is 100 percent. Hersheypark and its employees are not responsible for lost or stolen items, including items that fall out of pockets.

People drive great distances, stand on pavement for hours under the blistering sun, and pay large sums for this.

But the experience is not so great while rolling over in bed or putting on shoes. Positional Vertigo (PV) is all the terror of Hershey Park's best (or worst) brought to the comfort of your own home. It's a specific type of spinning, nauseous misery. The symptoms usually worsen with movement of the head but in severe cases may also occur while at rest.

Since treatment for feeling horribly sick and dizzy often involves specific methods that make you horribly sick and dizzy, it helps to have some understanding of what's going on.

Inside the temporal bones just behind each ear is a small organ called the vestibular labyrinth. This includes three fluid filled canals that are lined with very fine hair cells. Head rotation causes the fluid to create a waving motion of the hair cells, which in turn send signals to the brain. Specialized portions of the labyrinth contain small crystals that are sensitive to horizontal and vertical movement.

Yes, you do have rocks in your head.

To appreciate the almost unbelievable design of the vestibular system, simply roll your head in a moderate size arc of movement while reading this. For every degree of head movement, the eye muscles reflexively create a precise, equal and opposite amount of eye movement. Don't take it for granted that the letters remain in focus and your lunch in your stomach.

For a variety of reasons, the crystals can become dislodged and make the hair cells in the canals hyper sensitive. You and the house are not really moving, of course. The vestibular system sends signals to the brain that are in conflict with what the eyes are seeing. Suddenly the couch is a thrill ride, far worse than any amusement engineer could imagine.

It's difficult to say exactly why this happens. Problems often begin after a severe cold or prolonged period of bed rest. Other times the vertigo occurs with Meniere's disease, following trauma to the head, or as a general deterioration of the vestibular system in older populations.  

While positional vertigo literally stops people in their tracks, it's rarely serious except for increasing the chance of falls. The condition tends to disappear within six to twelve months, but the chance of reoccurrence is 30 percent. Medications that lessen nausea help buy some time but do not directly target dysfunction of the vestibular system.

Of course there is a "spin" to this! There's no need to grin and bear the debilitating discomfort for six or more months, hoping for the best. Trained physical therapists are able to help confirm whether or not the problem is truly a vestibular dysfunction as opposed to a wide range of other issues that cause people to "feel dizzy."

Interventions broadly fall into two categories. Moving the head through a specific sequence is thought to cause repositioning of the crystals in the vestibular canals. Side effects of this treatment for dizziness include dizziness. But only for a minute, or more precisely, 5 to 30 seconds. Accommodation exercises are thought to recalibrate the vestibular system and strengthen the mind's sense of equilibrium.

Treatments are often successful within two days to two weeks. Really - this is the closest thing to a quick fix that physical therapists offer. We may test your balance, your ability to turn quickly, look high and low, and send you back to normal life. Whether or not that includes bearing The Claw with a grin is up to you.


No comments:

Post a Comment