Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is a very common biomechanical dysfunction of the semicircular canals of the inner ear which most commonly occurs insidiously but can be associated with head trauma, previous infections, prolonged bed rest, or sometimes results following dental work. Symptoms arise when calcium carbonate crystals (otoconia) located within the utricle dislodge into one or more of the canals, sending false and conflicting signals of movement to the brain. This results in transient episodes (less than 1 minute) of severe vertigo (the world spinning) when the head is turned or when there is a change in position or posture (eg. rolling in bed, getting out of bed in the morning or bending forwards). The severity of symptoms may subside over time but are likely to persist if untreated. A Vestibular physiotherapist can assess and identify where the crystals are located and subsequently treat the condition with a tailored Canal Re-positioning Techniques in order to effectively resolve your symptoms.
Vestibular Neuritis & Labyrinthitis
Vestibular neuritis and labyrinthitis are conditions arising due to inflammation of the vestibulocochlear nerve, which connects the inner ear to the brain. Inflammation most commonly arises from a viral infection (such as influenza or herpes) localised to one ear and affects the nerve’s ability to transmit both hearing and balance information from the vestibulocochlear apparatus. This often results in an abrupt onset of varied symptoms such as constant vertigo, nausea, vomiting, severe balance disturbance, difficulty with visual tracking and hearing changes or ringing. Symptoms often mimic more concerning causes such as stroke, and therefore many people tend to present to the Emergency Department when such symptoms arise. Diagnosis is often via a process of elimination of more sinister causes. Vestibular rehabilitation exercises can be an effective treatment and should be commenced as soon as possible. Often a short course of steroids can also be beneficial and may be administered by a medical practitioner.
Meniere's Disease is a chronic disorder characterized by unpredictable transient attacks of vertigo with associated tinnitus and hearing loss. It is thought that symptoms evolve from an abnormal accumulation of excessive fluid (endolymph) within the inner ear. It is currently unclear as to what exactly triggers acute attacks, but too much salt, excessive stress and fatigue may have an impact. The condition can develop at any stage of life, and both symptoms and attacks can vary in severity, duration and frequency throughout the course of the disease. Treatments currently are limited but recommendations consist of low sodium and water diets, medication targeting vertigo and nausea, and vestibular rehabilitation therapy to improve balance.