It can happen to anyone, of any age, at any time – tiny crystals within the canals of the inner ear can dislodge, leaving the person feeling nauseated, dizzy, and with serious balance difficulties that can make daily life almost unbearable.
“Our body’s balance system relies on the brain, eyes, inner ears, and body working together to keep us upright and stable. When the inner ear part of this system is affected, it can lead to what is known as peripheral vertigo,” says Ruhee Hoosain, an audiologist practising at Netcare Garden City Hospital.
“You can roll over in bed one day, and suddenly the tiny crystals in the inner ear that help us keep our balance can come loose and move around where they shouldn’t be. This sends the wrong signals to the brain and causes sudden spinning, dizziness and nausea,” explains Hoosain, who is certified in vestibular and balance rehabilitation through the American Academy of Balance.
| Pic: Ruhee Hoosain, Audiologist |
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It is estimated that approximately four percent1 of emergency department visits globally are due to vertigo.
Hoosain treats peripheral vertigo both in-hospital and on an outpatient basis at Netcare Garden City Hospital. She has personal experience of the nightmare of living with benign paroxysmal positional vertigo, having developed peripheral vertigo herself in Grade 11, making school and daily life a constant battle with motion.
“It feels like the room is spinning, there’s visual disturbance and it’s easy to lose your balance every time you move your head in a certain way. During daily prayers, when I was prostrating, that is bowing down in prayer with my forehead to the ground, the movement would trigger my vertigo, leading to serious nausea,” she says.
“Unfortunately, the treatment I specialise in was not available to me then, and although my condition has improved, I was left with ongoing balance sensitivity because the underlying physical problem in my inner ear was not corrected early, so I am especially passionate about helping others with this common cause of vertigo,” Hoosain says.
There is a higher risk of developing vertigo among individuals with traumatic head injuries, and the general risk increases with age. Women are also more prone to the condition.
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“Medication is often prescribed as the frontline treatment for people suffering from vertigo, but this usually only treats the symptoms, not the cause. In conditions like benign positional vertigo, medication does not fix the crystal problem, and can sometimes delay proper recovery by suppressing symptoms rather than correcting the mechanical issue in the inner ear. Once the medication is stopped, there is a risk that the symptoms will return.
“There is a simple physical treatment that can quickly fix the problem by putting the crystals back where they belong, but many people aren’t referred for it early enough,” she says.
“People come into my practice with terrible, debilitating vertigo symptoms, and through a physical examination of the movements of the person’s eyes in response to movement – known as the Dix-Hallpike test – we establish which of their inner ear canals is affected.”
With a set of repositioning manoeuvres, Hoosain tilts the person’s head through a series of movements according to which canal the tiny wayward crystals are in. Through this simple, non-invasive treatment, the crystals can be restored to their original position, resolving the underlying cause of imbalance and dizziness.
“It is always important to investigate symptoms of vertigo lasting more than a week. Other underlying causes of vertigo can be related to infections, inflammation of the inner ear, injuries to the central nervous system, referred to as central vertigo, as well as stroke or brain tumours, although these are less common and treatment differs.
“If we can diagnose and treat peripheral vertigo early in this way, there is often no need for medication, and by the following day, the person usually feels they are back to normal. It can have a profound effect on a person’s functioning and quality of life,” Hoosain concludes.
Ends.
Notes to editors
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References and further reading: https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.043406
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