Dr. Michael Lee graduated from Stanford University with honors and received his medical degree from the University of Chicago in 1996. Dr. Lee completed his internal medicine residency at Mount Auburn Hospital, a Harvard Medical School teaching hospital.

Vertigo

In the past few weeks, there have been an unusually large number of patients coming to me with a complaint of vertigo (a sensation of spinning) when rolling over in bed or looking up.

As you watch the animationepley.jpg, keep your eye on the black ball rolling in one of the semicircular canals. It represents a stone that has gotten trapped. When you turn your head or look up, the stone moves causing vertigo. You can see after the patient has been rolled around, the stone drops out of the canal where it no longer causes a problem (like rolling a bead out of a hole in a hoola-hoop).

For some reason, I haven’t found many doctors who are aware of this condition (Benign Positional Vertigo) or how to treat it. Most patients I see have already been treated with antibiotics. Many have had MRIs and hearing tests.

In my experience, at least half of patients I see improve with the Epley manuever.

3 Comments »

  1. raquel mello Said,

    November 5, 2011 @ 5:46 pm

    Hi Dr. Lee
    I am trying to find a copy of your wonderful article “Falling sensation may be vertigo” on the Health & Fitness journal/paper from July 5 2011.
    Can you send me a link as i want to forward to a friend?
    Thanks,
    Another Seattlelite,
    Raquel Mello

  2. drmikelee Said,

    November 5, 2011 @ 9:40 pm

    Here is that article. Thanks for your interest!

    Good News! Sometimes there is a cure for Vertigo

    I wasn’t long into my career as a primary care physician when I began to notice that many of my patients were coming to me after experiencing vertigo when rolling over in bed, looking up at a shelf, or leaning back in a hairdresser’s chair.

    Unlike lightheadedness which feels as if you will pass out, vertigo is the sensation of spinning, twirling or falling. It can cause nausea and vomiting and may make it difficult to walk or stand. In many cases, the vertigo can last a few days but often improves on its own.

    Vertigo is a symptom of a number of different problems, but the most common is a condition called Benign Paroxysmal Positional Vertigo (BPPV). Let’s break that down. Benign (not harmful), Paroxysmal (sudden), Positional (with changes in position), Vertigo. So, it is a condition that is not harm and causes sudden episodes of vertigo with changes in head position.

    The problem originates in the semi-circular canals of the inner ear. Normally, these canals are lined with fine hairs and filled with fluids. When you turn your head, the fluid activates the hairs, letting the brain know which direction your eyes should move when your head changes position. In patients with BPPV, small calcium crystals, which normally sit outside the canals in a chamber called utricle, get thrown in the canals. These tiny “ear rocks” then move into the inner ear canals, like a bead in a hula-hoop, causing the sensation of vertigo.

    The good news is that once diagnosed, BPPV can be cured in about half of patients using a simple office maneuver called the Epley procedure. This procedure is a series of positions which moves the “ear rocks” out of the canal back into the utricle where it doesn’t cause a problem. After the procedure, one of my patients said she was able to look up into the sky for the first time in two years.

    Medication is available to patients for whom this procedure is unsuccessful. These medications can reduce vertigo, but only last a few hours and are often accompanied by side effects such as drowsiness. If vertigo persists, talk to your doctor about a prescription seasickness patch.

    Vertigo is also a symptom of a other illnesses including Meniere’s disease or an inflammation of a nerve within the inner ear by a viral infection—both of which can involve loss of hearing. Vertigo can also occurs in more serious conditions such as a stroke or transient ischemic attack (TIA). If you experience a sudden onset of vertigo paired with loss of function such as in your speech or ability to move, seek immediate medical attention.

    Vertigo is very unpleasant and debilitating. Most people who experience vertigo that gets worse with changes in head position have BPPV. Fortunately, this condition isn’t life threatening and doesn’t require imaging of your brain with an MRI or CAT scan. And more than half of people can be cured with the Epley procedure. The biggest problem can be finding a doctor who has been trained in the procedure.

    Dr. Michael Lee earned his medical degree from the University of Chicago Pritzker School of Medicine. He completed his residency in internal medicine at Mount Auburn Hospital, a Harvard Medical school teaching hospital. He specializes in providing comprehensive care for adolescents, adults and the elderly and has a special interest in vertigo. He is currently accepting new patients. For more information, visit http://www.drmikelee.com/vertigo or call (206) 368-1311 to schedule an appointment.

    There is a simple in office procedure that can cure the problem in more than half of the patients. One of my patients said she was able to look up into the sky for the first time in two years.

  3. Aqua Bubble Said,

    January 30, 2012 @ 8:46 am

    Vertigo is an impressive share. Thanks for this article.

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