A 48-year-old man arrived at the clinic, complaining of dizziness and vertigo. The patient said that he would see the room spin and feel faint several times a day. These problems arose especially with certain head movements. The spinning, he said, could last from a few seconds to several minutes. In between these spells of vertigo, he felt fine. But he was worried that it might be a symptom of an oncoming stroke or a brain tumour.
The man was concerned enough that he had already been to see another medical practitioner for an MRI(Magnetic Resonance Imaging) scan of his brain to rule out the possibility of a tumour. The MRI was normal, reassuring the patient that a malignancy in the brain was not the root of his symptoms. The scan, however, did not reveal the cause of the problem. The patient still needed to find out what the ailment was and seek proper treatment for it. Even if it wasn’t a serious medical problem, he said, it was still very anxiety-provoking.
He had no other medical problems. He tried to exercise daily and lead a healthy lifestyle. His physical examination was normal.
Dizziness is a common complaint, especially during the summer when people may be dehydrated due to excessive sweating and inadequate fluid replenishment. Drinking enough liquids often cures this common cause of dizziness. In the summer, people are also more prone to diarrheal diseases. Diarrhea can compound the problem of dizziness.
Feeling faint is a very common sensation for those suffering excessive diarrhea because of the decreased blood flow to the brain, due to fluid loss, especially when someone with severe diarrhea attempts to suddenly stand up after sitting or lying down.
As a precaution, those who feel dizzy while standing up from a lying down position need to stand up gradually with support. This will allow time for an adequate amount of blood to reach the brain and can prevent a fall. Injuries after a fall will only further the problem. This is especially true for the elderly, who may fall down due to dizziness triggered by dehydration and sustain a fracture.
Dizziness, a sensation of lightheadedness, is different from vertigo. Vertigo, as in our patient’s case, is often described as a sensation that the room is spinning. Fluid intake will not relieve the problem. People sometimes use these terms, dizziness and vertigo, interchangeably which can be misleading.
Our patient was suffering a common but alarming problem called benign positional vertigo (BPV). The name indicates that it is benign, not serious, which can be reassuring to the patient. It is a positional vertigo because turning the head to the right or left, tilting the head to look upward, or lying down can often bring on the sensation of the room spinning. The pathology lies in the labyrinth, the passage, inside the ears. The labyrinth of the ear is responsible for processing information with regards to position and movement. The displacement of calcium carbonate crystals inside the ear causes BPV. The ‘Epley maneuver’ can reposition the crystals to their normal position and help the patient. After the diagnosis of BPV, health care professionals can carry out this simple procedure in the examining room and provide great relief to the patient.