Vertigo: Stop The World, I Want to Get Off

 

Every ten years, the British Film Institute asks a panel of experts to choose the greatest film ever made. Citizen Kane held the title for a half-century, but was replaced in 2012 by a hypnotically weird offering: Alfred Hitchcock’s “Vertigo.”

Like Citizen Kane, Vertigo was a total commercial and critical flop when it was released.  Over the decades, it has morphed into a classic. It also provides the viewer with a disturbing taste of how it feels to live with vertigo.

Vertigo is not a disease; it is a symptom – typically of an infection, injury or reaction to medication or physical condition that impacts their vestibular system, which is responsible for helping the body to sense spatial orientation and movement. People with vertigo feel that they, or their surroundings, are continually spinning in a dizzy circle. Not surprisingly, nausea and/or vomiting are also commonly experienced by people with vertigo. So is ringing in the ears, and difficultly maintaining one’s balance.

A recent study estimates that as many as 35% of adults aged 40 years or older in the United States—approximately 69 million Americans—have experienced some form of vestibular dysfunction. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), a further 4% (8 million) of American adults report a chronic problem with balance, while an additional 1.1% (2.4 million) say that they have a chronic problem with dizziness alone.

According to statistics from the Vestibular Disorders Association, Vvertigo from a vestibular problem accounts for a third of all dizziness and vertigo symptoms reported to health care professionals.

What Causes Vertigo?

Hitchcock represented the disorientation of vertigo using a camera trick that he developed that involves a  simultaneous zoom-in and pull-back of the camera that has become known as a “trombone shot” or “dolly zoom.”

In real life, vertigo is a symptom of an injury to the brain, spinal cord or inner ear. Among the most common cause is fluid buildup in the inner ear — called Meniere’s disease — and benign paroxysmal positional vertigo, or BPPV, in which calcium carbonate crystals are displaced from their place in the inner ear and migrate into the ear’s canals.

Less frequently, vertigo can be caused by a stroke, multiple sclerosis, or a particular type of migraine (basilar artery migraine). Some types of medication, such as antidepressants, antiseizure medications, and even aspirin, can cause vertigo too. Colds, flu, high fevers, dehydration and other physical ailments can also result in vertigo.

How to Treat Vertigo

Vertigo caused by relatively simple ailments will often clear up on its own within hours or a few days. Symptoms that continue past that point, that reoccur regularly, or accompanied by symptoms indicating the presence of untreated physical issues such as a stoke should be evaluated by a healthcare professional.

One of the most common causes of vertigo is fluid buildup in the inner ear — called Meniere’s disease – and benign paroxysmal positional vertigo, or BPPV, in which calcium carbonate crystals become dislodged from their place in the inner ear and migrate into the canals.

Meniere’s is considered a chronic condition, but there are medications and therapies that can make it easier for patients to cope with the symptoms. BPPV is primarily treated with the “Epley maneuver,” during which their heads are slowly moved through several different positions to encourage the crystals to move back into place. It’s important to understand that performing these “particle repositioning movements” can initially lead to the vertigo worsening, so don’t try this at home. Get the help of a medical professional.

Your healthcare provider may also show you how to perform “Cawthorne head exercises,” a series of eye and head movements which can desensitize the nerves within the inner ear and reduce the sensation of vertigo. You need to perform these movements regularly for best results.

Prescription medications can help people to gain some relief from vertigo, but most are not recommended for long-term use. Vertigo is one of those conditions that don’t respond well to home remedies, apart from the Cawthorne exercises and (modified) Epley maneuvers that a professional may suggest that people perform on a regular basis. These movements have been shown to result in marked improvements in vertigo for many people.

 

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