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  • Writer's pictureCornerstonePT

Feeling Dizzy?

See our article in Sandpoint Living Local on Dizziness and vestibular disorders.

Have you ever felt like the room is spinning or moving (vertigo)? Perhaps you rolled over in bed, looked up or bent over and felt sudden spinning. Some people feel their vision is unstable or bouncing (oscillopsia), or feel off balance when in grocery stores or busy environments.

Those are only some of the symptoms people with a vestibular disorder report. Depending on the cause, symptoms can last seconds or be constant. They can resolve in days or not at all.

To understand why some people get these complaints, let’s talk about what the vestibular system is. It is a sensory system essential to normal movement and equilibrium. We will focus on the semicircular canals, ampullae, and otolith organs.

There are three semicircular canals inside our inner ears. These bone encased canals house fluid and have dilated ends (ampulla) with hair cells. In a healthy system, when you move your head one direction, the hair cells deflect and excite a canal in one ear and simultaneously inhibit a canal in the opposite ear, this sends a message to the brain informing of angular accelerations of our head.

Between the semicircular canals and our cochlea are the otolith organs (utricle and saccule). They are responsible for sensing gravity and position in space. These organs contain calcium carbonate crystals called otoconia that sit on top of hair cells. Otoconia weigh more than the membrane surrounding them, thus they are gravity dependent. They send information to your brain such as where your head is in relation to gravity and detect linear accelerations of your head-such as when you jump, go down stairs or ride in a car.

As we age, otoconia tend to decay and become more porous. Additionally, healthy crystals are linked by filaments however age thins these filaments. All of these effects can lead to otoconia becoming dislodged.

The most common cause of a peripheral vestibular disorder is called BPPV (benign paroxysmal positional vertigo). Common triggers are transitional movements, tipping your head back, bending down, turning over in bed etc.

The most common explanation for BPPV is called canalithiasis. Here, crystals that were supposed to be in the utricle and saccule broke off and floated into the semicircular canals (which were supposed to be crystal free). When the person changes positions, these crystals move and send misinformation to the brain causing the spinning feeling and at times, jerking eye movements called nystagmus. This type of vertigo usually lasts for around 20 seconds after the provoking movement.

With the appropriate assessment by a healthcare provider you can learn if you do have BPPV or another cause of your dizziness/vestibular disorder. BPPV is by far the most common peripheral disorder (10% of the geriatric population will experience it). The good news is, BPPV can be treated often within 1-3 sessions with a 70-95% resolution rate.

If you find yourself experiencing vestibular symptoms it is encouraged you seek treatment from your healthcare provider who may refer you to physical therapy or physician specialist.

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