Dizziness is a very common problem, and it can mean many things to many people. The information here is only covering vertigo - the sensation that you or the room is spinning.
If you experience any CHEST PAINS, PALPITATIONS (feeling the heart beat quickly), SHORTNESS OF BREATH, COLLAPSE or LOSS OF CONSCIOUSNESS with your dizziness, seek medical attention immediately through contacting your GP or 111 / 999 as appropriate out of hours.
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is a common cause of dizziness. It occurs in people of all ages but is more common in middle-aged and elderly people. It causes short bursts of intense dizziness when the body or head is placed in certain positions such as lying on one side in bed or looking upwards. People can feel sick and are sometimes unsteady for a few hours after the dizziness has gone away.
- Benign – this means the cause of dizziness is not a threat to your health.
- Paroxysmal – the dizziness comes in short bursts.
- Positional – the dizziness is provoked by certain body or head positions.
- Vertigo – the medical name for the spinning sensation.
Causes:
There is a collection of tiny crystals inside your ear. They have a valuable role to play when sitting in the correct position. BPPV occurs when the crystals are dislodged from their correct position. They move into one or more of the semi-circular canals and either continue to float around or become attached to another part of the ear.
Treatment:
Like vestibular neuronitis, benign paroxysmal positional vertigo (BPPV) often clears up without treatment after several weeks or months. It's thought that the small fragments of debris in the ear canal that cause vertigo either dissolve or become lodged in a place where they no longer cause symptoms. BPPV can sometimes return.
Until the symptoms disappear or the condition is treated, you should:
- get out of bed slowly
- avoid activities that involve looking upwards, such as painting and decorating or looking for something on a high shelf
BPPV can be treated using a procedure called the Epley manoeuvre.
The Epley manoeuvre
The Epley manoeuvre involves performing four separate head movements to move the fragments that cause vertigo to a place where they no longer cause symptoms. Each head position is held for at least 30 seconds. You may experience some vertigo during the movements.
Your symptoms should improve shortly after the Epley manoeuvre is performed, although it may take up to two weeks for a complete recovery. Return to your GP if your symptoms haven't improved after four weeks. The Epley manoeuvre isn't usually a long-term cure and may need to be repeated.
Brandt-Daroff exercises
If the Epley manoeuvre doesn't work, or if it's not suitable – for example, because you have neck or back problems – you can also try Brandt-Daroff exercises. These are a series of movements you can do unsupervised at home.
To learn how to do these exercises click this link, or the attachment below. You repeat them three or four times a day for two days in a row. Your symptoms may improve for up to two weeks.
Brandt Daroff Exercises
Labyrinthitis / Vestibular Neuronitis
Labyrinthitis is an inner ear infection. It causes a delicate structure deep inside your ear called the labyrinth to become inflamed, affecting your hearing and balance.
The most common symptoms are dizziness, hearing loss (from mild to total loss of hearing) and vertigo – the sensation that you, or the environment around you, is moving.
These symptoms can range from mild to severe, with some people feeling that they are unable to remain upright.
Other symptoms include:
- a feeling of pressure inside your ear(s)
- ringing or humming in your ear(s) (tinnitus)
- fluid or pus leaking out of your ear(s)
- ear pain
- feeling sick (nausea) or being sick
- a high temperature (fever) of 38C (100.4F) or above
- changes in vision, such as blurred vision or double vision
- mild headaches
Certain things can make the dizziness worse, including:
- colds or illness
- the dark
- being in crowded areas or small rooms
- tiredness
- a women’s period
- walking
See your GP if you have these symptoms.
You should also avoid driving, using tools and machinery, or working at heights if you're feeling dizzy.
Treatment:
Self-help
Drink plenty of liquid, little and often, particularly water, to avoid becoming dehydrated.
In its early stages, you may feel constantly dizzy and it can give you severe vertigo. You should rest in bed to avoid falling and injuring yourself. After a few days, the worst of these symptoms should have passed and you should no longer feel dizzy all the time.
You can do several things to minimise any remaining feelings of dizziness and vertigo. For example:
- during an attack, lie still in a comfortable position (on your side is often best)
- avoid alcohol
- avoid bright lights
- try to cut out noise and anything that causes stress from your surroundings
You should also avoid driving, using tools and machinery or working at heights if you're feeling dizzy and unbalanced.
Medication
If your dizziness, vertigo and loss of balance are particularly severe, your GP may prescribe a short course of medication such as benzodiazepine or antiemetics (vestibular sedatives).
Recovery
The time taken to fully recover from labyrinthitis / vestibular neuronitis can vary. The older you are, the longer it can take to fully recover, varying from a few weeks to a few months.