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Hearing Blog

Dizzy or off balance

July 12, 2021

Are you dizzy… do you sit up and just say “wait a minute” … while you “kind of get settled?”  Do you have to “line yourself up” … before you get moving?  Perhaps you hare having a little problem with the crystals and the fluid that provides your balance in inner ear.  The best news… it may be an easy fix.             

According to Mayo Clinic over 200,000 people annually are affected by balance problems.  Inside your inner there are three loop shaped structures called your semi-circular canals.  They contain fluid and hair-like sensors that are responsible for monitoring the rotation of your head.  They control your horizontal, vertical, perpendicular motion.  Positional Vertigo or Benign Paroxysmal Positional Vertigo (BVVP) is the most common vestibular disorder and it is also the most easily treated.  BVVP occurs when micro sized calcium crystals that are normally in the utricle of the inner ear move and enter the semi-circular canals.  If enough of the crystals move and become clumped together then as a group, they are heavy and when they shift, because unwanted flow of fluid in the semi-circular canals.  The fluid may continue to shift even after your head has stopped.   This gives a false sensation of movement.

Often people first experience BVVP when they are rolling over in bed or perhaps tipping their head back in the shower.   Sometimes when people are getting out of bed after hours of laying in the same position they may be unbalanced.   Often people will feel the need to steady themselves when they get up in the morning.   BVVP may come on abruptly.  It can be frightening.   The room may spin and turn black and may be accompanied by nausea.   People may think they are having a stroke.        

BVVP can be linked to mild, moderate, or severe head trauma.  The trauma can dislodge the crystals.  Sleeping in the same position, like always on your right side can predispose you to a possible issue.  A long bike ride on rough trails... continual jolting of the head.  High intensity aerobics.  Ménière's disease, and Vestibular migraines are also known contributors to BVVP.  As we age however, there is often no known "event" that causes the vertigo.  It is believed that the crystals just separate and move more easily. 

If you experience balance issues you should contact your hearing health care professional.  The issue should be addressed as soon as possible to avoid falling and injury.  The Ear, Nose, & Throat Doctor (ENT) will diagnose BVVP by observing eye movement.  Your eyes should move smoothly when moving your head.  If your eyes jerk or jump while trying to follow an object like perhaps a light in front of your eyes, it is a sign of severe vertigo.     

Treatment for BVVP involves maneuvers in which the head is tilted and kept in the direction that provokes the dizziness, after 30 seconds the head is then tilted 90 degrees in the opposite direction.  The head movement and the body are then rotated in several different positions, depending upon the position that causes the vertigo.  The moves are repeated 5 or 6 times over several minutes.  The goal of these exercises is to get the crystals to move out of the semi-circular canals.       

According to John Hopkins Medicine approximately 80% of patients have an immediate cure.  The symptoms may return in 20% of the patients within the first week and should immediately be treated again.  If you are experiencing dizziness or balance issues the earlier, you seek treatment the more successful the treatment will be.  To Hear Better Is To Live Better!


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