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Everything You Need to Know About Vertigo

By Vivian Manning-Schaffel ; Updated August 14, 2017

I was freaking out: Was I having a stroke? Did I have a brain tumor?

I had just woken up out of a dead sleep with a terrible case of the spins. My eyes were literally going back and forth in my head as if I were possessed. I scrambled to regain composure but passed out again, only to wake a few hours later with the same problem. Did I need to go to the emergency room?

It turns out that what I had was a classic case of vertigo, which is often a temporary yet debilitating disturbance of the inner ear. Unfortunately, because a number of different things can cause it, establishing an official diagnosis of vertigo isn’t always so easy to come by.

We spoke with expert Dr. Jack Wazen, Chairman, Division of Otolaryngology Head and Neck Surgery at Sarasota Memorial Hospital, and author of “Dizzy: What You Need to Know About Managing and Treating Balance Disorders,” to learn more about what causes vertigo and how to deal with it.

1. Vertigo can come out of nowhere.

As what happened with me, vertigo doesn’t announce itself or even hint that it’s coming before it strikes. Dizziness, nausea and extreme lightheadedness can be followed by nystagmus— rapid, uncontrollable eye movements. When that happens, it’s almost impossible to focus, walk or stand upright because the room is spinning so quickly. Next stop? Vertigo central.

2. It’s most often caused by moving your head a certain way.

Benign positional vertigo, the most common type of vertigo, can occur by moving your head in a way that shifts the crystals in your inner ear to a different part of the ear canal. These crystals help the brain to navigate gravity, so when they shift, your brain gets messages that you’re moving even when you’re not, which is what makes you so dizzy and nauseous.

3. It’s more common in older adults.

Dr. Wazen says vertigo is more common among older people due to degenerative changes in the cellular structures of the inner ear. A study published in Clinical Medicine confirmed that, of a select group of people over 65, 39 percent had benign positional vertigo, and 32 percent had an additional peripheral vestibular (balance) impairment.

4. A simple maneuver can help.

Recently, the New York Times published an article about how the Epley maneuver — a series of movements designed to shift the crystals back into the correct part of the ear canal — can help many people with benign positional vertigo feel a lot better very quickly.

“The Epley maneuver is very successful (85 percent with just one maneuver) in eliminating a specific type of vertigo,” affirms Dr. Wazen. Once the crystals shift back into place, it generally takes about 24 to 48 hours to feel like you’re back on solid ground, but, he warns, “The Epley maneuver doesn’t relieve all types of vertigo.”

5. There are less common types of vertigo.

Another type of vertigo, called cervical vertigo, can happen with people who’ve had whiplash or head and neck injuries. According to the American Hearing Research Foundation (http://american-hearing.org/disorders/cervical-vertigo/), there are two probable causes. One happens when arteries in the neck become compressed by vertebrae, which can be due to arthritis, swelling from surgery or chiropractic manipulation. Another possible cause of cervical vertigo is the sensory input your brain is getting from nerves that sense movement and vibration are off-kilter.

6. Salt reduction can help with one type of vertigo.

One possible cause of recurrent vertigo is Ménière’s disease — a disorder of the inner ear that causes a feeling of ear congestion, ringing in the ears and even possible hearing loss. Old inner-ear infections, trauma to the ear, autoimmune disorders, allergies, degenerative changes and genetics are among the many possible causes for Ménière’s, says Dr. Wazen. While there is no specific cure, there are certain medications and a special no-salt diet that can really help.

7. Meds can help ease symptoms

When you’re suffering from vertigo, Dr. Wazen says medications like meclizine (an antihistamine for motion sickness), over-the-counter Dramamine and prescription antianxiety meds like diazepam and lorazepam can help reduce the intensity of an attack. If you’re suffering through an attack, consult your doctor about which one may be best for you. Dr. Wazen stresses that meds should not be continued after the attack is over.

8. Vertigo can be a symptom of something serious.

Though the dizziness feels absolutely terrible while an attack is happening, vertigo is usually a temporary condition and, quite often, eases in a relatively short period of time. But vertigo can be caused by stroke or a tumor in the brain or ear. To rule those things out it’s best to seek medical attention when you have an attack of vertigo — that way you can at least leave anxiety off of your list of symptoms.

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