anyone know about vertigo?

[Guest guest]

Evening all,

I know I should probably be more in touch with my FNP but....does anyone know

much about vertigo? I was diagnosed last monday. I am on meklazine. Had that

wrong and was telling people I was taking meskaline! Had no idea that was a

illegal drug!! LOL!!!

Anyway, I haven't heard back from my FNP about my blood work. My thyroid is

swollen, can feel it even when I don't swollow. I already have hypothyroism. My

vertigo symptoms aren't getting much better despite meklazine and decongestant,

which is supposed to be a no-no for thyroid disease, but my thyroid was swollen

before I started taking it. I was to understand that I should be taking

anti-biotics for the vertigo, but haven't been called to do so yet.

The only good thing about this, if there is one, is that perhaps by sheer

coincidense, my pancreas isn't as bad as it has been and I have only taken 1

pain pill in 5 days! I am really scared to take them as I always feel like I

have vertigo anyone while on them so I don't want to make tjhat worse.

Anyway, long question long!!! Does anyone or one of the nurses on the board

know if for a fact I should be on a anti-biotic for sure with vertigo? I don't

wanna call the FNP and rock the boat so to speak after my problems getting

medication refills a few weeks ago. If anyone knows the answer to my question,

I would appriciate it. And if anyone has had vertigo and had a pain less period

with their pancreas while having it, I would like to hear about that too.

Thanks,

Sandy in Ca

[Guest guest]

What is benign paroxysmal positional vertigo (BPPV)?

Benign paroxysmal positional vertigo is an inner ear problem that causes a

spinning or whirling sensation when you move your head. That sensation is called

vertigo. This vertigo usually lasts for less than a minute. It may be mild, or

it may be bad enough to cause nausea.

What causes BPPV?

Experts do not know for sure, but suspect that particles of calcium normally

found in your ear break off and float into the ear's semicircular canal. Once

there, they interfere with your balance and cause vertigo. Medicines, disease,

aging, or a head injury are some of the things that may cause the particles to

break off.1

Anyone can develop BPPV.

Cause

Experts believe benign paroxysmal positional vertigo (BPPV) is probably the

result of a buildup of particles in the inner ear. This is probably what

happens:

a.. Tiny calcium particles, called canaliths, break off from their normal

position in the inner ear and enter the semicircular canal.

b.. The particles build up in the canal.

c.. When you move your head a certain way, such as tipping it back to look up,

the particles float around in the canal, brushing against tiny hairs that detect

movement. The hairs mistakenly tell your brain that you are moving.

d.. Because your other balance systems do not detect the same movement, they

send conflicting signals to your brain, and vertigo is the result.

Symptoms

The main symptom of benign paroxysmal positional vertigo (BPPV) is the feeling

that you or your surroundings are spinning, whirling, or tilting. This sensation

is called vertigo.

It is important to understand the difference between vertigo and dizziness.

People often use the terms interchangeably, but they are different symptoms and

may indicate different problems. Vertigo happens when your body's balance

sensory systems disagree about what kind of movement they sense. You may find it

hard to walk or stand. You may even lose your balance and fall. If your vertigo

is bad enough, you may also have nausea and vomiting.

To determine whether your vertigo is caused by BPPV, your health professional

will want to find out what causes it, how bad it is and how long it lasts. With

BPPV:

a.. Tilting the head, looking up or down, rolling over in bed, or getting in

and out of bed causes vertigo.

b.. It begins a few seconds after you move your head.

c.. It usually lasts less than a minute. The spinning sensation may be mild,

or it may be bad enough to cause nausea and vomiting.

d.. Vertigo becomes less noticeable each time you repeat the same movement.

After 3 to 4 repeats, the movement may no longer cause vertigo. Several hours

may pass before the same movement again causes in vertigo.

What Happens

Benign paroxysmal positional vertigo (BPPV) causes a whirling, spinning

sensation even though you are not moving. If the vertigo is bad, it may also

cause nausea or vomiting. The vertigo attacks happen when you move your head in

a certain way, such as tilting it back or up or down, or by rolling over in bed.

It usually lasts less than a minute. Moving your head to the same position again

may trigger another episode of vertigo.

BPPV often goes away without treatment. Until it does, or is successfully

treated, it can repeatedly cause vertigo with a particular head movement.

Sometimes it will stop for a period of months or years and then suddenly come

back.

What Increases Your Risk

Scientists think you're more likely to develop benign paroxysmal positional

vertigo (BPPV) if you have one of these conditions:

a.. You are an older adult.

b.. You have a head injury.

c.. You have an inflammation of the nerve that connects the inner ear to the

brain, a condition called vestibular neuronitis.

d.. You have ear surgery.

If you've had one episode of vertigo caused by BPPV, you are likely to have

more.

When To Call a Doctor

Call your health professional immediately if you have the spinning, whirling

sensation of vertigo together with any of the following:

a.. A head injury

b.. Complete, sudden hearing loss

c.. Weakness in an arm or leg

d.. Blurred or double vision

e.. Difficulty speaking

f.. Persistent numbness or tingling anywhere on your body.

Call your health professional to schedule an appointment if:

a.. This is the first time you have had an attack of vertigo.

b.. You have a low-pitched roaring, ringing, or hissing sound in your ear,

especially if you have not had this before. This is called tinnitus.

c.. You have frequent or severe episodes of vertigo that interfere with your

activities.

d.. You have an attack of vertigo that is different from what you were told to

expect.

e.. You need medicine to control nausea and vomiting.

Benign Paroxysmal Positional Vertigo (BPPV)

Exams and Tests

Benign paroxysmal positional vertigo (BPPV) is diagnosed with a physical exam

and from your medical history. However, diagnosing the cause of the spinning,

whirling sensation of vertigo can be difficult. Several diseases, the side

effects of medicines, and head injuries can also cause vertigo.

A Dix-Hallpike test may be done to help your health professional determine the

cause of your vertigo. During this test, he or she will carefully observe any

involuntary eye movements. This will help determine whether the cause of your

vertigo is inside your brain, inner ear, or the nerve connected to your inner

ear. The Dix-Hallpike test also can help determine which ear is affected.

Other tests may be done to help diagnose your condition:

a.. Electronystagmography, which attaches small wires to your face that

measure eye movements. It looks for the special eye movements that happen when

the inner ear is stimulated. The pattern of eye movements can point to the

location of the cause of the vertigo, such as the inner ear or the central

nervous system.

b.. Imaging tests, such as magnetic resonance image of the head (MRI) or

computed tomography of the head (CT scan). These tests may be done if symptoms

could be caused by a brain problem.

c.. Hearing testing to detect hearing loss. A special hearing test can

determine whether the nerve from the inner ear to the brain is working

correctly. Hearing loss with vertigo usually indicates a problem other than

BPPV, such as Ménière's disease or labyrinthitis.

Benign Paroxysmal Positional Vertigo (BPPV)

Treatment Overview

Benign paroxysmal positional vertigo (BPPV) may go away in a few weeks by

itself. If treatment is needed, it usually consists of head exercises called

liberatory maneuvers. These exercises will move the particles out of the

semicircular canals of your inner ear to a place where they will not affect your

balance.

Over time, your brain may react less and less to the confusing signals triggered

by the particles in the inner ear. This is called compensation. Compensation

occurs most quickly if you continue normal head movements, even though doing so

causes the whirling sensation of vertigo. A Brandt-Daroff exercise may also be

done to speed the compensation process. This exercise takes you from sitting to

lying on the side that causes the worst vertigo. You'll remain in this position

until either the vertigo goes away or until 30 seconds have passed. This

movement is then repeated on the other side. These exercises are done twice a

day for several weeks to months, or until the vertigo goes away.

Medicines called vestibular suppressants (such as antihistamines, sedatives, or

scopolamine) reduce vertigo and may be tried if your symptoms are severe.

However, using medications to control vertigo often extends the time needed for

compensation to occur.

Antiemetic medications may also be used to reduce nausea and vomiting that can

occur with vertigo.

In rare cases, surgery may be used to treat BPPV.

Benign Paroxysmal Positional Vertigo (BPPV)

Prevention

In most cases, benign paroxysmal positional vertigo (BPPV) cannot be prevented.

It may simply be a consequence of getting older. However, some cases may result

from head injuries. Wearing a helmet when bicycling, motorcycling, playing

baseball, or doing other sports activities can protect you from a head injury

and BPPV.

Home Treatment

You can reduce the whirling or spinning sensation of vertigo when you have

benign paroxysmal positional vertigo (BPPV) by taking these steps:

a.. Use two or more pillows at night.

b.. Avoid sleeping on your side with the ear causing the problem facing down.

c.. Get up slowly in the morning and sit on the edge of the bed for a moment

before standing.

d.. Avoid leaning over to pick things up or tipping your head far back to look

up.

e.. Be careful about reclining, such as when you are in the dentist's chair or

having your hair washed at a hair salon.

f.. Be careful about participating in sports that require you to turn your

head, lean over, or lie flat on your back.

You can also help yourself by doing balance exercises and taking safety

precautions.

Taking safety precautions for vertigo, such as adding grab bars near the

bathtub and toilet and keeping walking paths clear, may prevent accidents and

injuries.

Balance exercises for vertigo, such as standing with your feet together, arms

down, and slowly moving your head from side to side, may help you maintain your

balance and improve symptoms of vertigo.

If your health professional treated you with a liberatory (Semont or Epley)

maneuver, you may be instructed to restrict your head movement for about a day.

Do this by sleeping with your head propped up, not sleeping on the affected

side, and not tipping your head too far up or down.

If your health professional has you try the Brandt-Daroff exercise to help your

brain adjust, you will need to do the exercises at home several times a day,

possibly for weeks. The exercises will allow your brain to get used to the

abnormal balance signals triggered by the particles in the inner ear.

Staying as active as possible usually helps the brain adjust more quickly. But

that can be hard to do when moving is what causes your vertigo. Bed rest may

help, but it usually increases the time it takes for the brain to adjust.

Medications

Medications do not cure benign paroxysmal positional vertigo (BPPV). However,

they may be used to control severe symptoms, such as the whirling, spinning

sensation of vertigo and the nausea and vomiting that may result.

Medication Choices

Medications to reduce the whirling sensation of vertigo are called vestibular

suppressants. They include:

Antihistamines (such as Dramamine, Antivert, Benadryl).

Scopolamine (such as Transderm-Scop).

Sedatives (such as Valium, Klonopin).

Antiemetic medications may be used if you have nausea or vomiting along with the

vertigo.

What To Think About

Medications that calm the inner ear (vestibular suppressants) may also slow down

the brain's ability to adjust to the abnormal balance signals triggered by the

particles in the inner ear. They should be taken only for 1 to 2 weeks to

control severe symptoms.

Surgery

Ear surgery is an option for treating benign paroxysmal positional vertigo

(BPPV) only in severe cases when other treatments have not worked.

Other Treatment

Exercises are used to treat benign paroxysmal positional vertigo (BPPV) These

exercises move particles floating in the semicircular canals of your inner ear

so that they don't affect your balance. Although the exercises usually stop the

vertigo for months or years, the particles may return and cause your symptoms to

come back.

Other Treatment Choices

Exercises that may be used to treat BPPV include:

a.. Liberatory maneuvers, such as the Semont or modified Epley maneuver. These

exercises often cure BPPV by moving the particles in your inner ear so that they

do not affect your balance. During these exercises, your health professional

will help you hold your head in a series of positions. Often, one treatment is

enough. You may be taught to do these exercises on your own at home.

b.. Brandt-Daroff exercise may be tried if liberatory maneuvers do not work.

During this exercise, you will repeatedly go from a sitting position to a lying

position until the vertigo stops. This exercise may help speed your brain's

ability to adjust to the conflicting balance signals it is getting. You need to

do these exercises several times a day for weeks for them to work.

What To Think About

These exercises can eliminate symptoms of BPPV and have about the same success

rates. Liberatory maneuvers usually are more comfortable, and they work

faster-in 1 or 2 treatments rather than being repeated several times a day for

weeks. Therefore, liberatory maneuvers have become the first line of treatment.2

Other Places To Get Help

Organizations

American Tinnitus Association

P.O. Box 5

Portland, OR 97207-0005

Phone:

1-

Fax:

E-mail: tinnitus@...

Web Address: http://www.ata.org/

This organization provides education and a network of services through

clinics and self-help groups for patients with tinnitus. It also publishes a

quarterly newsletter.

Vestibular Disorders Association (VEDA)

P.O. Box 13305

Portland, OR 97213-0305

Phone:

1-

Fax:

E-mail: veda@...

Web Address: http://www.vestibular.org

This organization provides information and support for people with

dizziness, balance disorders, and related hearing problems. A quarterly

newsletter, fact sheets, booklets, videotapes, a list of other members in your

area, and information about centers and doctors specializing in balance

disorders are available to members.

Related Information

a.. Labyrinthitis

b.. Ménière's Disease

c.. Vestibular Neuronitis

References

Citations

1.. Victor M, Ropper AH (2001). Benign positional vertigo (of Bárány)

section of Deafness, dizziness, and disorders of equilibrium. In M Victor, ed.,

and Victor's Principles of Neurology, 7th ed., pp. 321-322. New York:

McGraw-Hill.

2.. Koelliker P, et al. (2001). Benign paroxysmal positional vertigo:

Diagnosis and treatment in the emergency department-A review of the literature

and discussion of canalith-repositioning maneuvers. ls of Emergency

Medicine, 37(4): 392-398.

Other Works Consulted

a.. Frohman EM (2002). Evaluation of the dizzy patient. In DC Dale, DD

Federman, eds., Scientific American Medicine, vol. 3, part 11, chap. 1. New

York: Scientific American.

b.. Hilton M, Pinder D (2004). The Epley (canalith repositioning) manoeuvre

for benign paroxysmal positional vertigo. Cochrane Database of Systematic

Reviews (2). Oxford: Update Software.

c.. Von Brevern M, et al. (2004). Migrainous vertigo presenting as episodic

positional vertigo. Neurology, 62(3): 469-472.

Credits

Author Tank

Editor Renée Spengler, RN, BSN

Associate Editor Lila Havens

Associate Editor Shaw

Primary Medical Reviewer Adam Husney, MD

- Family Medicine

Specialist Medical Reviewer Colin Chalk, MD, CM, FRCPC

- Neurology

Last Updated February 24, 2005

[Guest guest]

Hi Sandy. I'm sorry that you feeling so badly with the vertigo. I

have never felt it beofre but have heard that it is quite

uncomfortable. Lucky thing about the panc behaving.

As Mark pointed out so well, there are many things that can cause

vertigo. Infection may or may not be the cause of yours. Anti-biotics

would be used to treat a bacterial infection and if you did not have

one all the med would do is probably give you diahrrea. Are you

running a temp greater then 101.5? I think if you were to call the FNP

to check the status of your labs and to let her know of your continued

symptoms would be perfectly fine.

I hope you feel beter soon and keep up with those decongestants. It

does take time but they will help.

Warmly,

OHHH and PS. That bit with the mescaline, thats funny...*S*