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Vertigo is common, and can be easily treated

By Michael J. Solender
Correspondent
  • http://media.charlotteobserver.com/smedia/2013/12/09/17/00/3BZFg.Em.138.jpg|316
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    - Courtesy of Dr. Michael Ferguson
    Dr. Michael Ferguson.

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  • What you can do

    While doctors and other experts point to success with vestibular physical therapy such as the Epley maneuver, not all patients respond initially. Here are some tips to help manage your symptoms.

    • Stay hydrated. This is important for all parts of the body and helps with circulation and blood flow to the affected area.

    • Avoid head positions that trigger dizziness. This may seem obvious, yet many patients repeatedly put themselves in a physical position that will exacerbate their condition.

    • While not everyone benefits from vestibular physical therapy and some who gain initial relief may experience symptoms later, treatment approaches such as the Epley maneuver may yield improved results after trying several times.

    • Medication. Some doctors don’t advocate medication for vertigo but recognize other forms of vertigo where medication may be appropriate. Prescription-strength antihistamines or those available over the counter may be appropriate when there is inner ear inflammation. Both prescription and over-the-counter medicines are available for nausea; you should consult your physician.

    •  For many people, the vertigo simply fades away with no need for treatment.



It happens to millions of people every year. And if it’s their first time, it’s often scary, conjuring fears they have a horrible disease.

Take the case of a 63-year-old south Charlotte man, who was awakened by a ringing telephone. “I stood up and the room immediately started spinning. I felt dizzy and started to become nauseous,” said the health care administrator. “I fell back into the bed and didn’t move my head. It subsided after about a minute of lying still, but if I moved my head, it all began to spin again.”

He was initially reluctant to seek medical attention, thinking the situation would “go away or just take care of itself.” But when the episodes persisted, he made an appointment to see his doctor, fearing the worst. “I really thought it was something serious and imagined terrible things like a brain tumor,” he said.

He was diagnosed with benign paroxysmal vertigo (BPV), also known as benign positional vertigo or simply vertigo. He was surprised to learn that it’s quite common. Some 69 million Americans have experienced some form of vertigo – nearly 35 percent of adults over age 40. Common symptoms include mild to intense dizziness, often accompanied by nausea.

The diagnosis covers “almost 60 percent of the patients I see that claim dizziness as their primary symptom,” said Dr. Michael Ferguson, director of WakeMed Ear, Nose and Throat/Head and Neck Surgery in Raleigh. “It is quite common and something I see many times every week.”

It occurs when tiny calcium crystals that have formed inside the inner ear dislodge and become “free-floating debris,” Ferguson said.

These crystals interfere with the delicate mechanism of the inner ear, which contains three bony loops, tiny hair cells and fluids that help the body regulate balance. The dislodged crystals send false signals to the brain that the head has shifted position and cause the sensation of spinning.

“The good news is that this condition is able to be treated reliably and on the spot, helping a large percentage of the patients,” Ferguson said. Nearly 80 percent of the patients who are diagnosed with vertigo respond to a procedure of head position manipulation known as the Epley maneuver, he added. It’s a form of “vestibular physical therapy.”

Patients lie with their head extended beyond the end of an exam table, which allows for it to be tilted side to side. It helps the crystals settle in a larger reservoir within the ear and be reabsorbed into the body.

But for many people, the condition simply goes away without any treatment.

Check with your doctor

Not all vertigo symptoms should be treated equally, especially if they are coupled with other symptoms or with patients who have certain risk factors, doctors say.

Individuals who experience headache, ringing in the ears or temporary hearing loss; or who experience vertigo as a result of head trauma; or people with a history of heart disease, stroke, elevated blood pressure, Meniere’s disease and/or atherosclerosis should seek immediate medical attention, said Dr. Charles Bregier, medical director of Novant Health Urgent Care in Charlotte.

“Some instances of vertigo are related to viral infections causing inflammation of the inner ear,” Bregier said, and may indicate more serious problems. Some instances of vertigo don’t have an identifiable cause. “It is important for people to see their physicians to be checked out if symptoms persist or there are other risk factors involved,” he said.

While vertigo is seen in most age groups, Ferguson said it’s more common in middle age and beyond.

“While the research doesn’t say exactly why this is the case,” said Ferguson, “The body simply seems more susceptible to the stresses of aging and BPV…”

The south Charlotte man said he was treated with vestibular physical therapy, and while he still has occasional bouts of vertigo symptoms, they are milder and less severe than in the past.

“My body seems to instinctively know how to react and even how to prevent it from occurring,” he said. “I don’t jump up out of bed anymore; I take things slowly.”

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