vertigo and dizziness relief Deerfield Beach

Vertigo & Dizziness

Balance is defined as a state of equilibrium. It takes significant amount of work for this to occur in the body. The brain uses input from many sources to understand where the body is located in relationship to the world and to allow it to function. Sensory information from the eyes, ears, and position receptors in the rest of the body help keep the body upright and allow it to move in a coordinated fashion.

Vertigo, a feeling of spinning movement and sometimes accompanied by nausea and vomiting, occurs when any part of the system breaks down. However, people tend not to use that word to describe their symptoms but instead use the word dizziness or lightheadedness. It is up to the health care practitioner to understand the person’s symptoms and define vertigo as the cause of their situation.

Dizziness is a difficult word to understand and needs to be divided into two categories, either lightheadedness or vertigo. Lightheadedness is the feeling that a person might faint while vertigo is most often described as a spinning sensation with loss of balance. The direction of care is markedly different since lightheadedness may suggest to the health care practitioner to investigate decreased oxygen or nutrient supply to the brain due to a variety of causes including heart rhythm disturbances or dehydration, while vertigo sends the health care practitioner looking for a neurologic or inner ear cause.

The most important initial step in helping a person with vertigo is to take a history and understand that the person is complaining of spinning symptoms that may be associated with nausea and vomiting and loss of balance among other symptoms. Once the diagnosis has been made, the patient can be treated effectively. Aetna, Humana Insurance, Florida Blue, United Health Care, Blue Cross Blue Shield, United Health Care, as well as Medicare and Medicare Advantage Plans, and Cigna Insurance all cover the treatment of balance and vertigo/dizziness.

Causes and Risk Factors for Vertigo

There are a variety of causes for this condition. The cause may be central or peripheral. Central causes occur in the spinal cord or brain, while peripheral causes are due to a problem with the inner ear. An upper respiratory illness (e.g. a cold or sinus condition) can result in fluid passing through the Eustacian tube from the sinus into the middle ear causing inflammation or infection of the semicircular canals (labyrinthitis) or vestibular nerve (neuronitis). This in turn can result in lightheadedness or dizziness.

If small crystals in the utricle of the inner ear  become displaced and through certain head positions become lodged within the semicircular canals, the person can experience severe vertigo where it feels as if everything is spinning. This is a peripheral cause and known as benign paroxysmal positional vertigo (BPPV).

With Meniere’s disease, there can be a fluid buildup in the inner ear that can cause vertigo. Headaches, head injuries, strokes, tumors, and multiple sclerosis can also cause vertigo.

Head injuries definitely increase the risk factor for vertigo. In addition, antidepressants, aspirin, blood pressure medications and anti-seizure meds can also cause vertigo. For some, alcohol can cause vertigo.

Diagnosis is usually made after the health care practitioner takes a detailed history and then performs a physical examination. This includes positional testing using specialized goggles to determine directional eye movements or nystagmus. As the inner ear, brain and eyes are continually in communication with each other, the direction of the eye movements can assist in the diagnosis.

Facts About Vertigo

  • Vertigo describes the sensation of the patient or the room spinning. It may be associated with intense nausea and vomiting.
  • Benign paroxysmal positional vertigo is the most common reason to develop vertigo, but it is uncertain what might cause BPPV. Females are 3 times more likely to get BPPV than males, and scientists think that hormones may be the culprit. Dehydration may also result in the crystals dislodging within the utricle. The crystals can move into the canals (then called canalathiasis) or they can get stuck on the cupula (then called a cupulothiasis).
  • Depending on the location of the crystals, BPPV is treated with various canalith repositioning maneuvers (e.g. Sermont or Epley maneuver) to clear debris that causes inflammation within the semicircular canals of the inner ear.
  • Labyrinthitis, vestibular neuronitis, or a vestibular weakness are treated differently than BPPV. These specific vestibular exercises involve  head movements at various frequencies, and simultaneously balancing the body at various levels of difficulty. These exercises recalibrate the brain and need to be performed regularly and progressed correctly within certain parameters, with the guidance of skilled therapists. Patients’ recovery time to recalibrate the 2 inner ears from a labyrinthitis can vary from a couple of weeks to a few months.

Diagnosis and Treatment

To diagnose vertigo, a medical professional will take a full history of your symptoms and events. This includes previous medical issues, recent illnesses, and medications. Then, a physical exam is performed. It includes a comprehensive neurological exam to check brain function. This allows for the determination of whether it’s peripheral or central. Signs of abnormal eye movement may pinpoint the problem. The Dix-Hallpike test or the roll test may be done. The Dix-Hallpike test repositions the head and monitors symptoms. With the roll test, the head is rapidly moved from side to side. A CT scan or MRI may be done to exclude structural problems. Sometimes, electronystagmography may be performed.

The most effective treatments if the vertigo is peripheral include partial repositioning movements. It’s known as the canalith repositioning procedure or the Epley maneuver. Specific head movements are performed to move the crystals in the inner ear. Cawthorne head exercises may also be performed. It’s a series of head and eye movements. This leads to decreased sensitivity of the nerves and improves vertigo. However, this needs to be done on a regular basis for optimal results. A trained physical therapist can perform these types of treatment. Keep in mind that medications may provide some relief but are not a cure. Meclizine is the most popular medication prescribed.

The Prognosis

Most patients with peripheral vertigo can find substantial relief with treatment; it has been suggested that the Epley maneuver in cases of BPPV can benefit as many as 90% of affected patients. Although recurrence of BPPV may be more than 15% in the first year after an episode, it is unlikely that vertigo will persist beyond a few days. When vertigo persists, evaluation for any underlying structural problems of the brain, spinal canal, or inner ear may be necessary.

Are you feeling dizzy with a sense of movement? You just might be experiencing vertigo. Make your world stop spinning with the help of our experienced and certified Deerfield Beach physical therapists. They are trained in the Cawthorne head exercises and Epley maneuver for vertigo. They can even give you instruction on how to do these exercises at home. Be sure to request a consultation and full evaluation of your symptoms. We’ve helped many others and can help you too. For more information, contact us at Deerfield Beach, FL center.