Benign Paroxysmal Positional Vertigo (BPPV) Many dizziness problems turn out to be BPPV, the most common of the vestibular disorders. BPPV is an inner-ear balance disorder characterized by sudden brief bouts of vertigo and nystagmus induced by specific head movements. The two main theories about BPPV suggest that debris floating in a semicircular canal or stuck to the cupula of a canal can cause the attacks.
A change of some sort must occur to or in an individual to set BPPV into motion initially. In about half the people with BPPV, this change is never identified. In the other half, one of several things is thought to be the cause. The most common cause of this debris in people under age 50 is thought to be head injury, which may have been either a direct blow to the head or a whiplash injury. The second-leading cause is thought to be change associated with aging. BPPV is much more common in the elderly than in the rest of the population. BPPV is also seen frequently in people with other inner ear conditions such as vestibular neuronitis, Meniere's disease, endolymphatic hydrops, and ototoxicity.
The vertigo of BPPV occurs with head movement and may be accompanied by nausea. The kind of movement that brings on the symptoms is different for each individual, depending on which part of tech vestibular system has been affected. Forward-backward movement most commonly causes symptoms. However, moving the head to look upward may cause dizziness for some people, while sudden movements to the left or right may bring on symptoms for others.
(Watson, Sinclair, & Haybach, 2001, p.29)
Labyrinthitis and Neuronitis
Infections of the inner ear that cause inflammation of the labyrinth (labyrinthitis) or the vestibulo-cochlear nerve (neuronitis) occur infrequently. Viral labyrinthitis, viral neuronitis, and bacterial labyrinthitis can all occur.
Viral labyrinthitis usually causes a sudden, violent onset of vertigo, nausea, vomiting, and sudden hearing loss. Viral neuronitis also causes sudden, violent vertigo, nausea, and vomiting but no hearing loss. Because antibiotics are not effective against viruses, treatment is symptomatic and may include anti-vertiginous medications, antihistimines, and bed rest. Some doctors treat these problems with antiviral drugs. Within a week the person is usually able to sit up and after two weeks will begin to compensate for tech dizziness and vertigo. Although permanent vestibular damage may remain in some cases, most people recover fully from viral labyrinthitis.
Bacterial labyrinthitis can occur from the spread of a middle ear infection or brain infection to the inner ear, and on rare occasions it can occur as an adverse effect of middle or inner ear surgery. This kind of infection needs to be treated immediately with antibiotics.
(Watson et al., 2001, p.30)
Meniere's Disease
In 1861 a French physician, Prosper Meniere, described a condition which now bears his name. He was also the first to correctly attribute the cause to the inner ear. Meniere's disease is a disorder of the inner ear that causes these four classic symptoms: vertigo, tinnitus, a feeling of fullness or pressure in the ear, and fluctuation hearing loss.
Meniere's attacks many begin with little warning, or tinnitus or a feeling of ear fullness may precede them. An attack usually lasts for a short time (minutes to hours). An acute attack of Meniere's disease is thought to result from fluctuating pressure of the endolymph or inner ear fluid.
The cause of Meniere's disease is unknown.
The number of people who have Meniere's disease in one ear (unilateral) and who will ultimately develop the problem in both ears (bilateral) is unknown. Estimates range from 17.7 percent to 75 percent. A study conducted in Rochester, MN, from 1951 to 1980 reported a 34 percent rate of bilateral disease over time.
Hearing fluctuates, and a gradual loss of hearing occurs, depending on the number of episodes. As the disease progresses, the loss of hearing first becomes worse for lower tones, then affects both high and low tones.
Meniere's disease affects about 46 out of 100,000 people. The majority of people affected are more than 40 years old, and recent evidence indicates that Meniere's is slightly more common in women than in men.
(Watson et al., 2001, p.31)
Migraine
Migraine is a disorder usually associated with headache. However, symptoms may also include vertigo and imbalance. Studies indicate that about 30-35 percent of migraine sufferers experience dizziness during the attacks.
Watson, M.A., Sinclair, H., Hayback, P.J., (2001). Balancing Act For People with DIzziness and Balance Disorders (2nd ed.). Portland: Vestibular Disorders Association.
