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Vertigo is a real malady of brain and balance but not like the movie version

Marion Thomason thought she was crazy. Several times a week, for seemingly no reason, she was overwhelmed by dizziness, a sensation of spinning that literally brought her to her knees.

"It feels like you're on the teacups ride at Disney World," the Riverview woman says.

But her "ride" would sometimes last up to an hour. The episodes were so frightening and unpredictable that Thomason, 52, stopped driving and going out in public. She needed medication for anxiety and panic attacks. After almost six years of not knowing what was wrong, she went to a new family physician who suggested Thomason see a hearing and balance specialist in Tampa.

Diagnosis: vertigo.

She has plenty of company. An estimated 69 million Americans over the age of 40 suffer from various types of vertigo at some point. Risk rises with age.

The current flu epidemic, due to the possible effect of the virus on the inner ear, may also prompt new cases of vertigo.

Sensations of spinning

Vertigo makes people feel like they, or the space around them, is moving even when everything is completely still.

Unlike dizziness, which is associated with feeling faint or light-headed, vertigo gives people the sensation of spinning, sometimes with nausea and vomiting. If you get dizzy when you look down from a great height (like James Stewart's character in the Hitchcock classic Vertigo), that's not really vertigo. It's visual-spacial disorientation, and to prevent it, you focus on a fixed point, keep your eyes there and don't look down.

Real vertigo has many causes:

Sudden head movement, such as bending down, reaching up or rolling over in bed.

Inflammation or an infection in the inner ear (such as that related to flu).

Meniere's disease, a combination of vertigo, ringing in the ears and hearing loss.

• A tumor or bleeding in the brain associated with stroke.

Multiple sclerosis.

• Head injury or trauma.

Migraine headaches.

Dr. Loren Bartels, director of the Tampa Bay Hearing and Balance Center, diagnosed Thomason's vertigo six years ago. He says the disorder is common in people who, like her, have migraines, but can occur with or without a headache.

"It happens spontaneously," he says, "It can happen even in the middle of the night. The vertigo may start abruptly with ringing or noise in the ears."

Thomason says she hears a whooshing sound, like rushing water, and knows to hang on, "because it's coming. I sit down, close my eyes, take deep breaths and pray. I don't move until it subsides."

Some vertigo starts in ear

The most common type of the disorder is called benign paroxysmal positional vertigo, associated with sudden head movements. In this type of vertigo, tiny particles that normally exist in one part of the inner ear manage to float into another part of the inner ear.

Over a period of years, these loose particles collect and form a sludge. With some movements, the sludge shifts, disturbing the flow of fluid in the ear canals. That sends signals to the brain that don't match up with other signals, such as those from the eyes, about your position in space.

The result is a spinning sensation. Up to 95 percent of people with this type of vertigo can be helped with a series of simple maneuvers, performed in a doctor's office or at home, that put those tiny particles back in their proper place.

The head is gently moved from side to side while the patient is reclined; then the patient repeatedly is brought up to sitting, and back to reclining. The same maneuvers can also be done mechanically by a new high-tech chair called the Omniax System. Patients are strapped in and can be turned in any position, regardless of their size or a clinician's physical strength. Go to www.vesticon.com and click on "The Epley Omniax'' to see how it works.

Malady comes and goes

After several years without an episode, Thomason says her vertigo returned about eight months ago, a common occurrence. Vertigo is known to come and go, and there can be long symptom-free stretches. Patients may be prescribed medication for nausea and in severe cases a daily medication to prevent attacks, but most vertigo eventually resolves on its own.

Bartels says he expects to see an increase in vertigo cases as the current flu season progresses. The influenza virus can become lodged in the inner ear or in the nerves of balance between the inner ear and brain stem, triggering vertigo.

Symptoms come on suddenly, usually in one to three weeks after the flu starts. Patients may go to a hospital emergency department, unable to walk without assistance and suffering from dizziness and severe nausea and vomiting.

"Most patients recover from this acute viral vertigo within two weeks, but it can take as long as six weeks in some people," Bartels says.

If treated within 24 hours of symptom onset, high doses of steroids can bring rapid relief. But antiviral medications, given to shorten the severity and duration of seasonal flu, don't have an effect on vertigo.

Irene Maher can be reached at imaher@sptimes.com or (813) 226-3416

To learn more about vertigo, go to:


Chicago Dizziness and Hearing: www.dizziness-and-balance.com

The Vestibular Disorders Association: www.vestibular.org

WebMD: www.webmd.com (search on "vertigo'')

Vertigo is a real malady of brain and balance but not like the movie version 11/04/09 [Last modified: Thursday, November 5, 2009 11:20am]

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