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Positional Vertigo-Balance problem-by Harold Gunatillake

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One morning when you get up suddenly, your feel that you or your surroundings are spinning. That would be positional vertigo. You feel your room is moving or turning while your head is still. This may be associated with or without nausea, visual disturbances, and fatigue.

We call it Benign paroxysmal positional vertigo, also called BPPV. We also called Vestibular Dysfunction.

Benign paroxysmal positional vertigo (BPPV) is triggered by specific changes in head position, such as tipping the head up or down. It’s rarely severe unless it increases the risk of falling. It is most common when you get up from bed, especially from a side position. The Head needs to be moved to sit up and stand out of bed.

Sometimes it’s caused by stroke, migraines, or medication side effects.

If you rest on a reclining chair, you will not get vertigo as there is no movement of your head. So, what it means is that you can avoid dizziness by sleeping on your reclining chair or ‘Hansi Putuwe.’

People can experience dizziness, a spinning sensation (vertigo), lightheadedness, unsteadiness, loss of balance and nausea.

Common among housewives working in the kitchen where you need to move your head, pick up things from the shelves, and constantly look down whilst chopping.

In America presently, 69 million people over 40 experience vestibular dysfunction vertigo, according to the Vestibular Disorder Association. So, it is a common condition afflicts ageing people and is not common among the young.

The incidence of vestibular dysfunction is high among the Sri Lankans.

The vestibule is a central cavity of the ear’s bony labyrinth. The vestibular system includes parts of the inner ear and brain that are fundamental for controlling our balance and eye movements. Any dysfunction in these processing areas can result in dizziness or balance disorders.

It sends signals to your brain about where your body is in space. Your eyes also help you keep your balance, as do your muscles and joints.

The ear is divided into three compartments- the outer ear -you see and touch; the middle ear, which is hidden by the eardrums and the inner ear containing a few anatomical structures like the semicircular canals containing fluid. When you move, walk, and change positions, this fluid tends to move in these semicircular tubules. These canals are very sensitive to any movement of the liquid. This movement of fluid sensation signals your brain and your body’s position. This helps you to keep your balance.

There are two pouches attached to the canals on both inner ears. These sacs or pouches are filled with minute crystals like salt. They contain bone-like material. With age, they tend to move into the canals from the sacs and float within them. Such release of crystals confuses the brain as far as balance is concerned.

Young people hardly get this situation. Most people over 40 tend to suffer from vertigo (BPPV). The first attack is disastrous, and you end up in the hospital thinking it is a stroke. The spinning lasts for a few minutes or a few days. When you are briefed on the nature of the condition, your panic lessens, and you learn to cope with the disorder.

Be conscious of the condition when moving your head. When you get up in the morning, close your eyes and get up slowly, turning onto your good side. In the sitting position at the edge of your bed, rest for a few seconds and then keep your feet on the ground and walk.

Sleeping on the reclining chair is the best solution to avoid episodes. You adjust your backrest to a comfortable angle and sleep comfortably. You can turn from side to side with a bit of manoeuvring. Remember, there is a good side and a wrong side. Sleep on your good side or facing upwards. When you get up from a reclining chair, you invariably keep your head straight without turning your head. You feel so good to get up and walk out from a reclining chair. Try one, and you’ll believe me. Think you are travelling business class on a plane. Say goodbye to vertigo.

Moving your head in a certain way can send the crystals back to the right place, i.e. those two tiny sacs or saccules.

You can do these manoeuvres by yourself or by a physiotherapist. This condition can be treated with a simple head exercise.

Tai chi seems to help. These slow, focused movements strengthen muscles, train your brain, and help you learn to walk more quickly and smoothly.

Despite being cautious and careful, your doctor will prescribe stemetil tablets to take when you get an episode. Some doctors may prescribe betaserc pills to take daily to prevent attacks. A popular manouever that is recommended is the Epley manoeuvre done by specialists. Good results are about 30%., In this manoeuvre, the crystals may go back into the sacs to prevent further attacks.

There are complications with these manoeuvers- the crystals may move into another canal, or severe vomiting could occur during the manoeuver and worsen the condition. The exercise should be performed in the doctor’s office than at home. Sometimes, with this manoeuver, neurological symptoms are provoked due to compression of the vertebral arteries.

A high sodium diet can offset fluid balance and regulation in your body. Stick to a deficient salt diet.

Avoid sugary foods. Taking foods containing lots of sugar, such as ice cream, fruit salads, cakes, and beverages high in added sugars, should be avoided as they can trigger a minor attack.

Avoid foods containing tyramine like meats, cheeses, nuts and seeds. They are high in tyramine. Avoid red wine and other alcoholic beverages.

Add plenty of ginger to your food and recommended herbs to prevent vertigo. Avoid sports where you need to turn your head frequently

Be careful when you recline on a dentist’s chair or have hair washed at your saloon. Move very slowly, keeping your eyes closed.

Do some balancing exercises daily at home.

Brandt-Daroff exercises can be done at home to help your brain get used to the abnormal balance signals triggered by the particles in the inner ear.

Stand on one leg, count to 10 and then try with the other—one of the best balancing exercises.

Consult an ENT surgeon if you still feel not suitable to get specific investigations done to rule out more challenging situations.

In conclusion, I would like to say, sleeping on a reclining chair is the best long-lasting remedy.

I hope this video talk was helpful, especially for those who suffer from this condition. Stay safe, and goodbye for now.



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