Q: I used to have really bad vertigo. Every now and then it comes back. For the past few weeks I have been lightheaded and somewhat dizzy. If I put my head back or upside down, it gets worse. What can it be? Do I go see my regular doctor or a specialist?
Any ideas or suggestions?
A: A number of things can cause dizziness. However, the most common cause of dizziness / vertigo in adults is benign paroxysmal positional vertigo (BPPV). It’s generally thought to be due to debris that has collected within a part of the inner ear. This debris is crystals of calcium carbonate called “ear rocks”, or, formally, “otoconia”. The good news is, BPPV is benign. And even more good news is, with special head positioning exercises, the symptoms usually resolve completely. (Though it’s common for them to recur).
Doctors are more aware of it now than they were 10+ years ago and have learned more about treating it. (Years ago, doctors suggested that symptoms would go away on their own. Now they know that the Hallpike Maneuver as both part of diagnosis and treatment help to resolve the problem even in the physician’s office if the problem is BPPV.)
So your GP shouldn’t look at you strangely when you mention BPPV and she / he may be able to treat BPPV. Specialists that can treat BPPV are numerous, including neurologists, otolaryngologists (ENTs), PTs, OTs for starters. Here’s a link to the Vestibular Disorders Association for lists of clinicians in your area that are trained in the management of vestibular disorders.
Here’s a link to a PDF from the Cleveland Clinic on BPPV along with
other common causes of vertigo. Bring it with you to the doctor.
www.ccjm.org/PDFFILES/White9_04.pdf
I’d suggest heading to your GP to rule out other medical issues that could be causing dizziness / vertigo including orthostatic hypotension, Meniere disease, acute vestibular syndrome, and migraine-associated vertigo. Discuss the possibility of BPPV.
Here’s another helpful link regarding dizziness / vertigo and BPPV
http://www.dizziness-and-balance.com/disorders/bppv/bppv.html
as well as information from My Blank Hurts!
http://www.myblankhurts.com/ailment/BPPV/#
Good luck, and good health!
Meredith Soelberg, MPT, MBA
