Sudden onset of dizziness which leave your nauseated and unsteady on your feet may be caused by benign positional vertigo, also known as benign paroxysmal positional vertigo -- BPPV. This disorder of the inner ear can be debilitating but isn't life-threatening, and usually doesn't get worse with time. Exercise and other treatments may correct BPPV and restore stability and balance. If exercise does not solve the problem after repeated attempts, you may need surgery.
Some people experience benign positional vertigo following a head cold. A clogged head and ears may lead to an imbalance in the inner ear that causes the characteristic dizziness of BPPV. Other people experience symptoms after a head injury. The condition is characterized by sudden onset and severe dizziness that occurs when you move your head even slightly. Symptoms may pass quickly, only to reoccur. Your hearing won't be affected, though you may experience nausea or vomiting.
Inner Ear Function
Your inner ear controls your balance. The semi-circular canals in the inner ear contain fluid -- think of the bubble on a level. The fluid acts much the same way, sending signals to the brain that help you maintain your balance. With BPPV, tiny calcium crystals lodge in the semicircular canal and interfere with this communication. These crystals, called otoconia, bounce around, striking against nerve endings and sending confusing signals to the brain, leading to dizziness as your brain can't tell if you're balanced or not.
BPPV usually resolves on its own in a few weeks as the crystals dissolve or move out of the semi-circular canals in your ear. To cope in the meantime, some people resort to anti-nausea medications such as Antivert, Dramamine or Phenergen. But these can leave you feeling groggy and unable to drive or perform other vital functions. Antihistamines may relieve a clogged feeling in the ears but do little to move the crystals. However, many people get help from physical therapy, which teaches them to perform exercises to reposition the crystals in the semi-circular canals.
Otolith Repositioning Maneuvers
The exercises to correct benign positional vertigo go by various names, including canalith repositioning, otolith repositioning, Sebold maneuvers and Epley maneuvers. All involve positioning the head in various ways to shift the crystals in the semi-circular canals to the vestibule, where they don't cause problems and where your body eventually re-absorbs them. A physical therapist can best take you through these movements, but if you want to try them on your own, start by sitting up straight on the edge of a bed with your feet on the floor. Look straight ahead, then slowly turn your head about 45 degrees to one side. Hold for 30 seconds. With your feet still on the floor, lie down on your side and turn your head to look up at the ceiling. Hold this position for 30 seconds, then sit up straight again. Lie down on your other side, with your head turned to look down at the mattress. Hold for 30 seconds. Sit up straight and turn your head 45 degrees in the opposite direction than you looked before.
Up to 80 percent of people who suffer from benign positional vertigo are cured after only one session of repositioning exercises. Most others respond after repeated sessions. After you complete a session, you shouldn't lie down flat for 48 hours, so you'll need to sleep propped in a recliner or on pillows. Don't lean down to pick up anything off the floor, to tie your shoes or even over a sink while brushing your teeth, as this could cause the crystals to slip back into the semi-circular canal. Avoid sleeping on the side that was affected for one week after treatment.
- Journal of Clinical Neurology: Benign Paroxysmal Positional Vertigo
- International Journal of Otolaryngology: Inner Ear Disease and Benign Paroxysmal Positional Vertigo -- A Critical Review of Incidence, Clinical Characteristics, and Management
- International Journal of Otolaryngology: Benign Paroxysmal Positional Vertigo (BPPV) -- History, Pathophysiology, Office Treatment and Future Directions