A friend’s father, who was sleeping on his bed, got up to use the rest room. As soon as he stood up, his head started spinning. He sat on the edge of the bed and could not stand up again as he was losing balance. His felt like the objects in the room were spinning around him and his vision became hazy. They thought it to be the result of hypertension and diabetes. However, after many tests done, it turned out to be Paroxysmal Positional Vertigo- a disease condition of the ear.
About Paroxysmal Positional Vertigo
A human ear has three parts- the external ear, the middle ear, and the inner ear. The external part of the ear is called as auricle or pinna. The middle part of the ear is separated from the external ear by the eardrum, and consists of an air filled cavity and three ear bones known as ossicles. The inner part of the ear consists of structures known as the cochlea (organ of hearing), vestibule (balance portion of inner ear) and three semicircular canals. When there is a problem with the structure of the inner ear, and nerves associated with it, dizziness may occur. This condition is termed as benign paroxysmal positional vertigo. This condition is rarely serious, but can be irritating.
Symptoms
A person experiencing benign paroxysmal positional vertigo feels like objects in the room are moving around him or her; vision becomes blurred; person can lose balance while trying to stand or change position; nausea and vomiting can also occur. The episodes can occur for less than a minute and they vary from person to person. Nystagamus (abnormal eye movements) can occur with this condition.
Causes
The inner ear has three semicircular canals that contain tiny calcium particles that are evenly distributed in them. These particles stimulate nerve cells in the canals when you move your head, and then the nerve cells transmit the messages to the brain regarding the direction in which the head has moved. If these calcium particles happen to join together in these canals, then the signal sent to the brain will be incorrect regarding the head movement. This is when benign paroxysmal positional vertigo occurs. The other causes of this vertigo can be viral infection of the inner ear, trauma to the head, and aging.
Diagnosis
The doctor may conduct a physical exam in which he or she looks for symptoms of vertigo, and observes the eye and head movements of the patient. The doctor checks if the patient has the ability to control eye movements. If the involuntary eye movements (nystagamus) cannot be diagnosed by simple examination, then the doctor conducts electronystagmography (ENG) or Videonystagmography (VNG). In the process of ENG, electrodes are used to determine the cause of vertigo while in VNG, cameras are used. In these procedures, the balance organs are stimulated artificially by air and water or the patient is kept in different head positions. This helps the doctor to measure the involuntary eye movements and determine the cause of dizziness. An MRI scan (magnetic resonance imaging) can also be done in which magnetic and radio waves are used to get cross sectional images of brain which are then studies by the doctor to look for any abnormalities or conditions that may be causing vertigo.
Treatment
To treat benign paroxysmal positional vertigo, the doctor conducts a procedure known as canolith repositioning procedure. The doctor makes you move your head in such a way that the calcium particles are moved out of the inner ear semi circular canals to areas where they do not cause any vertigo. This procedure greatly helps to check symptoms like dizziness, and stops it from recurring. After the procedure you are asked to avoid sleeping flat. The treated ear should not be placed below the level of your shoulder for the entire day. A day after the procedure, you need not follow restrictions. The doctor will teach you how to do the procedure, so that you can do it yourself whenever you need to.
If the canolith repositioning procedure does not prove effective in treating your vertigo, the doctor will recommend a surgical procedure in which a plug made of bone is used to block the area of the inner area that is causing the dizziness. This surgical procedure has a success rate of more than 90%.
Coping with your vertigo
If you are suffering from benign paroxysmal positional vertigo, you must make sure that your room is well lit during the night as you may need to get up for urination. It is advised that you use a cane for support and stability while walking. If you feel dizzy at any point, you must sit down immediately. Discuss your problem with your doctor and he or she may recommend a support group that you can join where you will meet people suffering from the same condition, who can teach you new coping skills.
