Don’t let vertigo spin out of control

Everyone experiences an occasional bout of feeling dizzy. But vertigo is a distinct type of dizziness, with an estimated 40% of adults suffering from it at least once in their lifetime — and the risk rises with age.

“Because vertigo often strikes out of the blue, an acute attack can be potentially dangerous by increasing your risk of a fall,” says Dr. Howard LeWine, chief medical editor of Harvard Health Publishing. “While there is no cure for most causes of vertigo, there are ways to reduce symptoms during an attack and avoid recurrent episodes.”

Vertigo and the brainCentral vertigo originates from a problem in the brain, like a stroke or tumor. Symptoms can be similar to peripheral vertigo (which originates in the inner ear), but often involves others, like a bad headache, double vision, slurred speech, or weakness or numbness on one side of the face or body. Signs of central vertigo require immediate medical care.

Spin zone

Vertigo is the sensation that the room or your body is spinning. Sometimes the primary symptom is a feeling similar to motion sickness along with imbalance. Depending on the cause, episodes may cause nausea and vomiting. In some cases, the person may develop longer term ringing in one or both ears (known as tinnitus) and low-frequency hearing loss.

Vertigo symptoms can be so severe that your only option is to lie in bed and move your head as little as possible. “Although it can be scary, the problem most frequently originates from the inner ear, not the brain, and should get better over time,” says Dr. LeWine.

Doctors refer to this as peripheral vertigo. (See “Vertigo and the brain” for the more worrisome central vertigo.) Peripheral vertigo happens when something goes awry in the delicate balance system within the inner ear. There are three main categories.

Benign paroxysmal positional vertigo (BPPV). BPPV is the most common form. Dizziness occurs after a sudden change in head position, like turning in bed or looking up. The symptoms resolve in a minute or less when your head returns to a neutral position. When you move your head again, the dizziness comes right back.

BPPV often happens when calcium crystals break free from the utricle (a fluid-filled sac in the inner ear) and move into the inner ear’s adjoining semicircular canals (see image). These canals are filled with a fluid called endolymph. When you move your head, the endolymph moves as well, sending signals to our brain that keep us connected to our surrounding environment. The crystals can set off erroneous nerve signals and trigger vertigo. The Epley maneuver helps to treat BPPV (see “The Epley maneuver”).

Vestibular neuritis and labyrinthitis. These similar conditions stem from inflammation of nerves that transmit impulses from the inner ear’s balance system. Vertigo comes on suddenly and can be associated with nausea, vomiting, and trouble walking. The symptoms can be severe during the first 24 hours and gradually improve over several days.

People with severe symptoms are sometimes treated with a corticosteroid like prednisone. More commonly doctors suggest either dimenhydrinate (Dramamine) or meclizine (Antivert, Bonin) to help ease the dizziness, and a prescription anti-nausea medicine.

Ménière’s disease. Here, a person experiences vertigo accompanied by low-frequency hearing loss, tinnitus, and a feeling of pressure in the affected ear. The cause is excessive fluid pressure within the semicircular canals, but it’s not clear why this happens. There is no standard treatment for Ménière’s disease. Some people can identify a trigger for attacks, such as an allergy or too much caffeine or alcohol. Doctors often suggest a low-salt diet, which theoretically lowers fluid pressure in the inner ear. Taking a diuretic (water pill) might reduce symptoms for the same reason.

The Epley maneuverThis is one of the most effective treatments for benign paroxysmal positional vertigo (BPPV). You lie on a table, and your doctor or a therapist gently moves your head through a sequence of positions. These movements help move loose crystals out of the semicircular canals in the inner ear. This is not a lasting treatment. Vertigo may return at any time, and some people have frequent attacks. After proper instruction, people may be able to perform the maneuver on their own.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

“If you, then, though you are evil, know how to give good gifts to your children, how much more will your Father in heaven give good gifts to those who ask him!” – Matthew 7:11

 “A cheerful heart is good medicine, but a crushed spirit dries up the bones.” – Proverbs 17:22

 “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God.” – Philippians 4:6

 “Above all else, guard your heart, for everything you do flows from it.” – Proverbs 4:23

 “For God has not given us a spirit of fear, but of power and of love and of a sound mind.” – 2 Timothy 1:7

 “Consider it pure joy, my brothers and sisters,[a] whenever you face trials of many kinds, because you know that the testing of your faith produces perseverance.” – James 1:2-3

 “In all your ways acknowledge him, and he will make straight your paths.” – Proverbs 3:6

 “Commit your actions to the LORD, and your plans will succeed.”- Proverbs 16:3

 “Consider the ravens: They do not sow or reap, they have no storeroom or barn; yet God feeds them. And how much more valuable you are than birds!” Luke 12:24 – Luke 12:24

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