Causes
Vertigo is a type of dizziness. It is described as a ‘spinning’ sensation in the head and is usually brought on by sudden changes in position.
The most common cause of vertigo is called benign positional paroxysmal vertigo or BPPV. BPPV happens when tiny particles in the balance centre of the inner ear are disturbed, usually by sudden movement. This causes the spinning sensation.
There are other causes of vertigo, including head injuries, stroke, circulation problems, infections, inner ear disorders, and the degeneration of inner ear structures. For some people the cause may not be found.
When to seek help immediately
If you have more serious symptoms – speech difficulty, double vision, unsteady walking, difficulty swallowing, altered strength or feeling in your legs or arms, ringing in your ears or deafness – you should seek medical help.
Treatment
Vertigo often gets better by itself. Many people improve without treatment. If BPPV is an ongoing problem then your doctor may offer options.
• Medication – motion sickness medication can sometimes help with nausea. It will not prevent vertigo attacks.
• Special exercises – you may be advised to perform Brandt-Daroff exercises (see below). You may be referred to a specialist doctor for further treatment or to rule out other rare causes for your dizziness.
Home care
Here are some things you can do at home.
• Avoid head positions that provoke an attack.
• Do the Brandt-Daroff exercises, as instructed.
• Avoid sleeping on the affected or ‘bad’ side.
• Elevate (raise) your head on two pillows when resting.
• In the morning get up slowly and sit on the edge of the bed for a minute.
• Take prescribed medications as directed.
• Do not drive until your symptoms have completely resolved.
Brandt-Daroff exercises
The Brandt-Daroff exercises are thought to disperse any tiny particles away from the balance centre in your ear, therefore getting rid of the cause of your dizziness. You may be anxious that the exercises will bring back your symptoms. This is normal. However, the exercises will only work if you feel dizzy as you do them. The dizziness will get less with time.
1. Sit on the edge of the bed. Turn your head 45 degrees (look to the left). Lie down quickly on the right side. Ensure the back of the head rests on the bed. Wait 20–30 seconds or until the dizziness stops.
2. Sit upright. Wait 20–30 seconds for any dizziness to settle.
3. Repeat on the other side. Turn the head slightly to the right before lying down quickly on the left side.
4. Do five times on each side (takes about 10 minutes). Repeat three times a day.
