For some people, their first experience with vertigo is a simple roll in bed.
It can set off a high speed spin or just a weird swirl. Sometimes getting up to a sitting position will also trigger the same thing. Try to walk and you start to lurch to one side or stumble. So you sit down and wait. You might start to feel better, but when you reach to the floor to pick something up, the dizziness returns!
Help! I rolled in bed and now I feel dizzy!
WHAT’S GOING ON !!!!?????
Understanding Position Related Vertigo
Welcome to position related vertigo. That sensation of spinning is called rotary vertigo. But some people just have a weird disoriented feeling or an unsteadiness instead of spinning.
It starts in the inner ear.
Each inner ear has 3 loops that are motion sensors. They’re built 90 degrees to each other – like at a corner of a room with the floor and the two walls representing each of the 3 loops.
Each loop is filled with fluid.
Normally, the fluid moves as your head moves. There’s a sensor switch at one end of each loop that gets deflected by the moving fluid. This gives you information about head motion. Like a 3 dimensional motion sensor in your phone.
But the other end of the loop connects to a chamber.
And in that chamber exist tiny little salt crystals that are stuck to a gel like pad.
Those salt crystals can sometimes fall off.
But no big deal, they just get recycled.
…UNLESS…
If some have fallen off and your head just happens to be in the wrong position at the wrong moment for the wrong amount of time…
…some of the salt crystals can fall into one of the 3 loops of one inner ear.
No big deal right?
WRONG!!
As those tiny little salt crystals fall through a loop, it pushes the fluid, which deflects the sensor, which sends signals to your brain indicating you’re moving. Spinning and spinning and spinning until the salt crystals finally settle at the lowest part of a loop.
Ahhh. The dizziness has stopped.
…Until you move your head again…
...this changes the position of your head in the world. But because the loops are in your head, they change position in the world too.
So the process begins again with the salt crystals falling through the loop toward where gravity pulls them – toward the new lowest point in the loop.
But now the salt crystals are trapped!
They’re stuck rolling and falling -- being pulled around by gravity – and disturbing your sense of place in the world and creating difficulties with balance.
You may even see the world jumping around with your vision which can be even more disturbing.
That happens because each of the 6 loops send signals to your eye muscles to correct for the perceived head motion. They’re supposed to work like a steady cam system. But now your eyes jump around uncontrollably during the periods you feel dizzy because abnormal information about motion is being sent to the eye muscles.
So what should you do?
You could wait and see if the junk just randomly finds its way out of a loop by regular head motions through the day and night.
But you could be waiting for days, weeks, months (and yes, even years).
Medical research suggests that spontaneous recovery without treatment occurs in 20% of people by one month, and 50% of people by 3 months.
-- Well that seems disappointing!
It’s not like catching a cold where you can be very certain to recover after several days.
Vertigo can be very discouraging – not knowing when you’ll feel better.
There’s not a predictive rule either to say how many days or weeks it will last.
But there’s hope.
Hope in the form of science. Hurray for science!
Treatment of Position Related Vertigo
This requires a proper assessment.
The best testing involves use of an infrared camera to watch your eye in the dark while testing a number of different head positions and monitoring how you feel and the specific eye movement triggered by the head position. Each loop creates a different eye motion (remember each of the loops is linked to eye muscles that move your eye as a reflex).
Once the specific loop is identified as being the problem, a series of head positions can then be used to move the salt crystals (using gravity) along the loop and drop them out into the chamber where they belong. There they can begin to get recycled.
YAY!
Vertigo gone!
How effective is this?
In over 90% of people, the condition is resolved within 3 sessions!
Most people say “Sign me up! Please! I’m so tired of this stupid sensation interfering with my life every single day.”
Occasionally people have more than one loop affected. This could be in the same ear, or one in each ear. This complicates treatment a little. But it’s still treatable.
Does this type of vertigo come back?
About 50% of people will have a recurrence over the next 10 years after the initial episode.
So it’s a bit of a heads or tails game. But if it comes back, treatment is available.
You might one day hear someone say, "I rolled in bed and now I feel dizzy!"
If you know someone that might be experiencing this type of problem, forward this article and help them learn more.
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