Dizzy feeling may be vertigo

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EDITOR'S NOTE: This weekly column by reporter Bill Kettler answers readers' questions about topics of general medical interest with information provided by doctors from PrimeCare, Jackson County's independent practice association.

My daughter recently had an attack of dizziness so severe that we had to take her to the hospital emergency room, where a doctor quickly and efficiently identified her problem as vertigo, which I had never heard of. Can someone tell me more about vertigo?

— Chris A., Medford

"Vertigo" is the term physicians use to describe the feeling of motion or spinning that can be caused by a number of conditions, says Dr. David Chambers, a Medford ear, nose and throat specialist.

People who experience vertigo describe feelings of uncontrollable spinning or rocking in a boat. Some may have nausea as well, or sweat heavily.

Chambers says one of the most common causes of vertigo is a viral inflammation of the parts of the inner ear that regulate our sense of balance. This "labyrinthitis" often develops a day or two after a head cold.

Vertigo can also occur when microscopic crystals break free from balance organs in the inner ear. Three small semi-circular canals and two other structures, the utricle and the ventricle, are fluid-filled organs that allow us to perceive motion in three dimensions.

"That's why you know you're going up in an elevator even when you can't see outside," Chambers says. "Your ears tell you."

If the crystals strike any of the tiny hairlike projections (cilia) that line the semicircular canals, they send an incorrect message to the brain that the head is moving. This condition is called benign positional vertigo. Physicians don't know why these microscopic particles break free. A head injury may jar them loose, or they may be loosened by a nerve inflammation. Generally, physicians see more of this kind of vertigo among older people, Chambers says.

Autoimmune diseases such as lupus may also be associated with vertigo, and people who have multiple sclerosis may also experience the spinning sensation. Certain kinds of tumors may cause vertigo, and it sometimes precedes migraine headaches.

With so many different causes to investigate, Chambers says physicians have a difficult time trying to pin down why an episode of vertigo occurs.

"About 50 percent of the time we never figure out what's causing it," he says.

People who have a recurring problem with benign positional vertigo can often find relief through what's known as the "Epley maneuver." The physician directs the patient to move his or her head in a way that moves the loose particles out of the semicircular canals and allows them to settle out.

To make sure the procedure works, the patient has to sit still with a level head for as long as two or three days, which requires them to sleep in a sitting position.

Fortunately, for many people vertigo often goes away as quickly as it appeared. The brain can also be trained to suppress the bogus information that it's receiving during an episode of vertigo.

Motion sickness drugs such as meclizine (generic name) which are often prescribed for sea sickness can provide relief for vertigo, too.

Chambers says vertigo is usually more of a frustration than a serious medical problem, but the feeling can be incapacitating and debilitating.

Call Bill Kettler with your medical questions at 776-4492, or e-mail them to: bkettler@mailtribune.com or send them to: Mail Tribune, Ask Your Doctors, P.O. Box 1108, Medford OR 97501.

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