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  • Dizziness and giddiness. By Mariel C. Kraus

Medical Diagnosis

Medical Diagnosis

When we were children, we enjoyed spinning until we dropped. We giggled, held our head in our hands and fell on the lawn as we looked up to watch the clouds, treetops and the faces of our playmates above us churning like the spin cycle of a clothes dryer. Unfortunately, to many people, this sensation can feel sickening and can surprise us when it happens out of the blue or after an unfriendly event such as a head injury, whiplash or a medical condition.

Eleven years ago, I was very congested and blew my nose a bit too hard, and the next thing I felt was that same kind of spinning after being on the teacup ride at the fair. I became nauseous and fell to my knees. I became clammy, and cold sweats took over my body as I crawled to the edge of my bed to hold on to something I knew wasn’t moving. I prayed for God to stop the spinning.

As soon as I could get an appointment, I saw an ear and balance specialist who made the diagnosis of Perilymph Fistula. I have had a few mild occurrences since then but have learned to manage the condition well. However, this event changed how I respond to roller coasters and swings (which I used to love). It even made me more sensitive to the acceleration and cabin pressure in airplanes—mostly in smaller commercial aircraft.

The inner ear structures involved in balance and vertigo symptoms belong to the vestibular system, which is located below the eyes. There are more than 25 adult vestibular disorders, but children can also suffer from vestibular dysfunction, and the leading type is due to concussions. In this short article, we will only briefly discuss the most common type of adult vestibular disorder, Benign Paroxysmal Positional Vertigo (BPPV). BPPV occurs when tiny calcium carbonate crystals are jarred out of their permanent place in the vestibular system.

BPPV is defined and described as follows:

Benign: not life-threatening

Paroxysmal: comes on suddenly

Positional: certain positions or movements will trigger symptoms

Vertigo: the sensation of spinning—not the fun type!

BPPV treatment involves proper assessment to determine where those dislodged ear crystals traveled to within the tiny labyrinth and surrounding spaces, then reposition them with quick head movements (called maneuvers) to lead them back to home base. Clinicians who perform these maneuvers have taken extra courses to learn how to assess and administer them appropriately.

Occupational therapists (OTs) are experts in returning patients back to their pre-injury roles utilizing therapeutic solutions for the skills of living. They will add functional tasks to treatments after the repositioning maneuvers; teach patients symptom management; and teach adaptive body mechanics to keep them independent with their self-care tasks because bending down during self-care tasks can provoke debilitating symptoms.

If you or someone you know have experienced dizziness without the “giddiness” and would like to read the full version of this article, please visit

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