Vertigo

One morning last October David Magnant had a problem getting out of bed and walking.

“I stumbled along. I balanced myself against a piece of furniture,” says Mr. Magnant, 58, about his symptoms of vertigo and imbalance, which lasted for a couple of minutes, then disappeared.

The symptoms continued each morning and when he laid down at night or moved his head in certain positions. His primary care physician sent him to Dr. Howard Hessan, an otolaryngologist and chief of otolaryngology at Howard County General Hospital in Columbia, Md. Otolaryngologists, commonly known as ear, nose and throat doctors or ENTs, treat diseases and disorders of the ear, nose and throat, including problems with the sinuses and inner ear.

Dr. Hessan diagnosed Mr. Magnant, a Howard County, Md., resident, with benign paroxysmal positional vertigo, or BPPV, which causes vertigo with movement or changes of position of the head. Mr. Magnant was treated with a 45-minute, in-office procedure that was able to restore his balance.

“I was absolutely amazed,” Mr. Magnant says. “It’s like I never experienced the problem.”

The classic definition of vertigo is a spinning or rotating sensation inside a patient’s body or a sensation that causes the environment around the patient to seem to move when it isn’t, says Dr. Jeffrey Kim, an otolaryngologist specializing in neurotology at the Georgetown University Medical Center in Northwest. Neurotology is a subspecialty of otolaryngology dedicated to inner ear disorders.

Dizziness, a broad term that includes vertigo, refers to anything from lightheadedness to a feeling of faintness.

“The common complaint that is often cited is called dizziness. That is a very vague, not well-understood term that is not terrific for diagnosis,” says Christopher Platt, program director of the balance and vestibular program at the National Institute on Deafness and Other Communication Disorders (NIDCD) in Bethesda. NIDCD supports clinical research, vertigo-inducing experiments and other research and studies on vertigo.

“Vertigo is a more specific diagnosis,” says Mr. Platt, who holds a doctorate in marine biology.

Vertigo can be a symptom of a migraine headache, a brain tumor, or a heart, circulation or neurological problem, along with a side effect of some medications. It can be associated with various inner ear problems, as can hearing loss, a feeling of fullness or clogging in the ear, and tinnitus, or ringing or buzzing in the ear.

“A function of the inner ear is to tell us where we are relative to the environment. When you move your head, you stimulate your inner ear to tell you where you are,” Dr. Kim says. “If that function is not normal, it causes dizziness.”

The inner ear houses the hearing and balance apparatuses, but when infected or damaged by disease, the inner ear can send false signals to the brain about movement or balance, says Lisa Haven, executive director of the Vestibular Disorders Association (VEDA), an organization based in Portland, Ore., that provides access to information, offers a support network and increases awareness of vestibular, or balance, disorders.

“This is an invisible illness to other people,” Ms. Haven says about vestibular disorders.

Eighty percent of vertigo comes from inner ear disorders, the most common of which is BPPV, also a vestibular disorder, according to metro-area otolaryngologists.

Three semicircular canals in the ear, which are oriented at 90 degrees to one another, have fluid in them and nerve hairs that send messages of movement, Ms. Haven says. Disease or head injury can cause the microscopic calcium carbonate crystals on the hairs called otoliths to break off and bounce around, giving the brain a false sense of movement, she says.

Story Continues →