If you have ever had an attack of dizziness, you know how frightening it can be. Almost everybody has felt faint, but many people experience a spinning or falling sensation—vertigo—and attacks may recur. Vertigo is often caused by problems with the body’s sense of balance.
Your body uses three kinds of information to determine balance: visual, tactile, and internal signals from the vestibular structure in the inner ear, which acts as the body’s “level.” Fluid moves through the vestibular structure, bending tiny hairs that send signals to the brain. Several conditions can throw the vestibular structure off balance, such as migraines or inner ear infections. Dizziness or vertigo can also be the first symptom of a stroke or other disorders, or it may be a side effect of some medications, particularly high blood pressure drugs such as angiotensin-converting enzyme (ACE) inhibitors. (You will need medical advice to rule these out.)
Often, however, vertigo is caused by some malfunction of the vestibular structure, including a condition known as benign paroxysmal positional vertigo (BPPV). This occurs when calcium carbonate crystals inside the vestibular structure break down and collect inside the semicircular canals. BPPV is the most common type of vertigo, with over 50% of people in their 70s experiencing at least one episode of vertigo.
Many people put off going to a doctor after suffering an attack of vertigo. But according to Lloyd Minor, M.D., Director of the Laboratory of Vestibular Neurophysiology at Johns Hopkins, “It’s not normal to have spontaneous episodes of vertigo, so it’s reasonable to get an evaluation after one occurs.” Your doctor may refer you to an otolaryngologist (ear and throat specialist). Once you discover the exact cause of your vertigo, you can start on a course of treatment, which usually consists of vestibular rehabilitation exercises supervised by a physical therapist.
