Balance Disorders
Information courtesy of: www.webmd.com

Benign Paroxysmal Positional Vertigo (BPPV)

What is benign paroxysmal positional vertigo (BPPV)?
Vertigo is the feeling that you are spinning or the world is spinning around you. Benign paroxysmal positional vertigo is caused by a problem in the inner ear. It usually causes brief vertigo spells that come and go.

For some people, BPPV goes away by itself in a few weeks. But it can come back again. BPPV is not a sign of a serious health problem.

What causes BPPV?
Normally, there are little calcium “stones” in the inner ear canals that are moved around by gravity. BPPV can be caused by things like infection or inflammation that stop the stones from moving around like normal. This sends a false message to the brain that affects your balance.

What are the symptoms?
The main symptom of benign paroxysmal positional vertigo (BPPV) is the feeling that you or your surroundings are spinning, whirling, or tilting. This sensation is called vertigo.

It is important to understand the difference between vertigo and dizziness. People often use those two terms as if they meant the same thing, but they are different symptoms and they may indicate different problems. Vertigo is the feeling that you are spinning or the world is spinning around you. It happens when your body's balance sensory systems disagree about what kind of movement they sense. You may find it hard to walk or stand. You may even lose your balance and fall. If your vertigo is bad enough, you may also have nausea and vomiting.
Dizziness is not a feeling that you are spinning. It is a woozy or unsteady feeling.

To determine whether your vertigo is caused by BPPV, your health professional will want to find out what causes it, how bad it is, and how long it lasts. With BPPV: Tilting the head, looking up or down, rolling over in bed, or getting in and out of bed causes vertigo. It begins a few seconds after you move your head. It usually lasts less than a minute. The spinning sensation may be mild, or it may be bad enough to cause nausea and vomiting. Vertigo becomes less noticeable each time you repeat the same movement. After 3 to 4 repeats, the movement may no longer cause vertigo. Several hours may pass before the same movement again causes

How is BPPV diagnosed?
You and your doctor will talk about your symptoms. Your doctor will do a full physical exam and will test your nervous system to see if there’s a problem with how your nerves send messages to your brain. Your doctor may be able to tell that you have BPPV by watching how your eyes move as you turn your head and lie back. This is called the Dix-Hallpike test. There are other things that can cause vertigo, so you may have other tests too.

How is it treated?
BPPV usually goes away by itself within a few weeks. Over time, your brain will likely get used to the confusing signals it gets from your inner ear. But you can do some simple exercises that might make the vertigo go away faster.

One kind of exercise for BPPV can move the calcium stones in a way that they don’t trigger vertigo. Another kind of exercise can try to train your brain to get used to the confusing vertigo signals.
Medicine can help with severe vertigo that makes you sick to your stomach. But using this kind of medicine can also make BPPV take longer to go away. Only you know whether you feel sick enough that it is worth it to take medicine (and possibly have vertigo longer).

Be extra careful so that you don’t hurt yourself or someone else if you have a sudden attack of vertigo. Do not drive or cycle if there is any chance that vertigo could strike and make you lose control. (This depends on what kind of movement triggers vertigo for you.) At home, keep floors and walkways free of clutter so you don’t trip. Avoid heights. Don’t use tools or machines that could be dangerous if you suddenly lose your balance.

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Ménière's Disease

What is Ménière's disease?
Ménière's (say "men-YAIRZ") disease is a disorder of the inner ear that affects hearing and balance. It causes sudden attacks of vertigo (a spinning sensation), tinnitus (a loud ringing in the ears), and a loss of hearing that may become permanent.

Ménière's disease usually develops between the ages of 40 and 60 and affects both men and women.1 Children can also have Ménière's disease.

What causes Ménière's disease?
The cause of Ménière's disease is unknown, but it may be related to a fluid imbalance in the inner ear.

What are the symptoms?
During an attack, Ménière's disease causes symptoms that include:
A low-pitched roaring, ringing, or hissing in the ear (tinnitus).
Hearing loss, which may be temporary or permanent.
Vertigo, which is the feeling that you or your surroundings are spinning or whirling.
A feeling of pressure or fullness in the ear

How is Ménière's disease diagnosed?
Ménière's disease can usually be diagnosed based on your medical history and a physical exam. If your health professional is uncertain, hearing tests or imaging tests, such as magnetic resonance imaging (MRI) may be done to rule out other conditions.

How is it treated?
Treatment focuses on reducing the severity of the vertigo until the attack ends. For some people, it may be possible to reduce the frequency of attacks by eating a diet low in salt and using a medication (diuretic) to rid the body of excess fluids and doing exercises to improve balance. Medications that affect the inner ear, called vestibular suppressants, may be used to reduce the whirling or spinning sensations of vertigo. Medications that reduce nausea and vomiting (antiemetics) can also be effective in relieving those symptoms.

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