YOU MAKE ME DIZZY, MISS LIZZY

All of a sudden, I feel knocked off balance, and my head seems to spin. If I fall, gravity is going to win. What is happening, is it Love or is it just Vertigo 

Poem by Anne Johnson 

As anyone knows, when a person experiences dizziness or vertigo, it simply means that he momentarily loses the ground under his feet. Nothing to write home about, right? With some people, unfortunately, this feeling is so regular and so strong that they are even scared to leave their homes. Let’s discuss this problem at some length.  

Dizziness and muscle spasms  

Vertigo has too many causes and comes in too many types to be covered in a single chapter. I’ll be talking just about the most common and relatively benign cases. In fact, dizziness is quite often due to muscle spasms at the border between the neck and the skull. These muscles act as additional receptors for the vestibular system. We orient ourselves in space on the basis of the signals coming to the brain from our eyes, our muscles, and the vestibular system located in our ears. Any phase differential between these signals stupefies the brain cortex and makes us feel spinning or swaying. Wrong information sent to the brain by pinched or inflamed muscles at the back of the head and lower jaw may have a similar effect.  

Signals coming to the brain from the eyes, muscles and the vestibular system located in the ears make us aware of our position in space.  

Otoliths are crystals that belong to the vestibular system in humans and animals.  

Here is an example. An elderly lady feels so dizzy that she cannot drive a car and has to be brought to our clinic by her daughter. She even had to quit her job as a seamstress after many years of bending over the sewing machine. Because of a strong muscle spasm, she looks “hunch-chested.” She can only stand when leaning against a wall, and it was not easy to have her lie down on the examination table. But after the very first session, when I managed to relax her thorax somewhat (which meant her neck muscles also got a chance to relax), she stood up - and could not believe she was not losing ground under her feet anymore!  

This astounding change can sometimes be achieved by manipulating the lower jaw joint to improve the blood supply and relieve muscle spasms, which, in turn, would relieve dizziness and nausea. Incidentally, some cruise ships offer their passengers special patches to be placed between the ear and the lower jaw joint. A minor irritation caused by these patches reduces muscle spasms and therefore alleviates seasickness.   

Blood pressure fluctuations  

Dizziness caused by hypotension may be alleviated by quickly taking a couple of glasses of water to rehydrate your body. 

Vertigo and a feeling of imbalance may also arise from arterial blood pressure disorders.  Hypotension sufferers may experience them when abruptly standing up from a chair or raising the head from a bent position. This happens because the blood supply to your brain is interrupted for a moment. Your vision goes dark, you lose your balance, and you may even faint. Don’t panic: promptly take a pint or so of water to rehydrate your body, ask your doctor to check your blood pressure, and have a blood test to rule out anemia. Similar brief interruptions of blood supply to the brain may be caused by osteochondrosis of the neck that narrows and displaces the spinal arteries. In this case, vertigo may come after nodding or turning your head fast.  

Dizziness has often been the subject of art. Alfred Hitchcock’s “Vertigo”, based on a story of a policeman with this disorder, is widely regarded as one of the best American movies ever.  

Positional vertigo 

The third common type of this condition that afflicts mostly old people is called benign positional vertigo. As a person simply tries to change his or her position in bed, everything around starts spinning at a crazy speed for a few seconds. They call this type of vertigo “benign” because it is short-lived and has no consequences. It is caused by a disorder of the vestibular system. Our ears contain tiny crystals (0.5 – 30 mcm in diameter) of calcium carbonate, the so-called otoliths (ancient Greek for “ear stones”). Head injuries, inflammation or old age may cause these crystals to stick together. So, instead of producing a uniform pressure on the numerous receptors in the inner ear (like falling fine sand), they focus on a limited number of receptors, overexcite them, and trigger a bout of strong vertigo.  

So, dizziness or vertigo may be a sign of a variety of disorders, each calling for a different treatment. Make sure you choose the right one – and your vertigo may soon be gone.