Vertigo: It May Be Menieres Disease or BPPV
Imagine waking up in the morning, opening your eyes, moving your head, and seeing your room spin around you. As you get out of bed, you have to hold on to the furniture and walls just so you can take a few steps.
Assuming you did not have too much to drink the night before, one of the most plausible explanations for this moving experience is that you are suffering from a bout of vertigo.
As frightening and uncomfortable as the sensation is especially accompanied by nausea and a headache most cases of benign positional vertigo are just that benign.
And, interestingly enough, it may all be in your ears.
A Balancing Act
Most episodes of vertigo are brief, and though they may be intense, they are usually harmless. That is why they are commonly referred to as Benign Paroxysmal Positional Vertigo (BPPV), which can occur when you get out of bed in the morning, or when you turn your head too quickly. The cause of BPPV is not known, although it may be related to head injury or simply aging.
Diagnosis and Treatment
Since accurate assessment of hearing loss is essential in diagnosing Meniere's disease, several tests are usually performed. According to NIDCD, these procedures include hearing and balance tests, as well as magnetic resonance imaging (MRI), which is useful in determining (or excluding) that a tumor might be causing the hearing loss and balance disorder.
Doctors use several types of hearing tests to pinpoint whether hearing loss is sensory, that is, arising from the inner ear, or neural, deriving from the hearing nerve. Physicians make this determination by recording the auditory brain stem response (which measures electrical activity in the hearing nerve and brain stem). A test called electrocochleography, which records the electrical activity of the inner ear in response to sound, is also used in confirming the presence of Meniere's.
One option includes balance retraining exercises, which include movements of the head and body specifically developed for each individual patient. These programs are administered by professionals with proper training and knowledge of the vestibular system, as well as its interactions with other systems in the body.
No one treatment works for everyone, yet every treatment seems to work for someone. We each seem to respond differently to various treatments. Some patients are nearly symptom-free just by observing a low-sodium diet. Other patients may need more complex and/or more invasive treatment. Other patients seem unresponsive to any treatment -- even invasive surgery. The bottom line: each patient tries to find the treatment (or treatments) that works best for each one of us.
The NIDCD, which is part of the National Institutes of Health, says scientists are looking into environmental and biological factors that may cause Meniere's disease and are also studying how fluid composition and movement in the labyrinth affect hearing and balance. Obviously, new insights gleaned into the mechanisms of Meniere's and other balance disorders will enable scientists to develop preventive measures and more effective treatment.
And, good news may be coming from out of space. The NIDCD has joined NASA for Neurolab, a research project focused on the most complex part of the human body -- the nervous system, which also encompasses the balance system.
Since the exposure to the weightlessness in space temporarily disrupts balance on astronauts return to earth and gravity, researchers believe that data collected during space missions may shed light on the mechanisms of recovery from balance disorders.