Dizziness After a Car Accident Is a Very Common Complaint.
There are many causes of dizziness or vertigo after an auto accident injury:
- Disc herniation
- Neck sprain
- Inner ear problem called BPPV
This article discusses BPPV or Benign Paroxysmal Positional Vertigo. This can be a mild dizziness on moving your head to a debilitating problem preventing most activities. Whether the symptoms are mild or severe, the good news is there are fairly simple treatments that can fix the problem.
It Starts in Your Ear…
In your inner ear there is an organ system that senses where you are in space and tells the brain. When you move your head a gelatin-like substance that has tiny crystals embedded on top moves hair cells that detect movement. If the system is working ok, normal head movements can be made without causing dizziness. A common problem can occur though, that causes a malfunction in the system. If your head is shaken very hard, some of the crystals may dislodge and find themselves where they don’t belong. If enough of them are loose they can clump together into a stone. This can cause changes in fluid flow so that when your head moves the fluid continues to flow abnormally and your brain detects motion even though you are no longer moving your head. Your brain becomes confused and you interpret this as dizziness or vertigo. Along with the vertigo you will often also have a rapid twitching or cycling of the eyes from side to side called nystagmus. This results in blurred or double vision.
What’s it Feel Like to Have BPPV?
Dizzy. Nauseous. If you are suffering from BPPV the main symptom is dizziness or feeling like the room is spinning whenever you move your head or change positions from down to up or side to side. You may have double vision, many people become nauseated and some actually vomit because the symptoms of BPPV are so severe. A common complaint is “I get dizzy when I turn in bed and can only lie on one side or I have to sleep with my head propped up.” Others will say, “I get dizzy and feel like I’m going to fall whenever I try to get up out of a chair.”
These symptoms are also associated with low blood pressure, iron deficiency anemia and certain medications, especially drugs acting on the heart. It’s important to distinguish between these other causes of dizziness because they can be very serious. If your doctor has already told you, you have vertigo and given you a prescription for anti-vert and not done the treatment suggested in this article, you may want to give this a try to see if your BPPV goes away and you will not need the drugs any longer.
What Causes BPPV?
This vertigo problem can seemingly come out of nowhere with no known precipitating event. Elderly patients are more likely to suffer BPPV with no identified cause. The older we get the easier it is for this to occur. In younger people it is very often the result of your head being shaken or jolted quickly such as after a slip and fall, a sports injury, car accident, having your head tilted back too long at the dentists or hair salon, bumpy mountain bike rides, body surfing, bouncing as in aerobics or Zumba, etc. The sudden movement of the head causes embedded crystals to break off and wander into the canals. If enough of them do this and they coalesce into a sizeable little rock (otolith) they can wreak havoc with the fluid movement in your ear and create dizziness.
How Do You Diagnose Benign Vertigo?
The description you give to the doctor is a strong indicator; sudden onset dizziness on turning your head with recent accident or bumpy activity, no changes in medications recently, etc
Once BPPV is suspected, it is definitively diagnosed with a simple maneuver called the Hallpike Test or Dix-Hallpike Test. This is a provocative test, meaning it is designed to specifically re-create your dizziness in order to determine if it is BPPV and which ear is involved. It can be both ears! Your dizziness and nausea will be aggravated by this test, but it is crucial to properly diagnosing your condition and the good news is, the test is halfway to the treatment and resolution of your vertigo because the treatment will immediately follow the test and only take a short time.
The Hallpike test involves turning your head 45 degrees and lying on your back with your head still in 45 degrees rotation while your head is dangled over the edge of the table or bed. Your head is held in this position for up to 30 seconds to see if your vertigo worsens and most importantly, your doctor is looking for “nystagmus” or a rhythmic jumping of the eyes. If this occurs it indicates that is the problem side. The test is repeated to the opposite side just in case you have it on both sides.
What is the Treatment for BPPV?
Once the side is figured out, your doctor will then perform what is called “Epley’s Maneuver” or “canalith or otolith repositioning maneuver.” This procedure is similar to the Hallpike test in that you are quickly brought back with your head lying over the edge of the exam table with your head turned to the bad side. You are held in this position for up to 2 minutes or when dizziness and nystagmus stops. Your head is then turned to 45 degree angle the opposite angle with head hanging and held another 2 minutes. You may feel dizziness moving. You are then directed to roll onto the side you are turned to with your head facing down towards the table and hold for 2 minutes. Lastly, you are brought upwards to a sitting position holding your head turned. You then straighten out your head and look forward and sit for about 10 minutes. It is important not to tilt your head up or down while waiting for the 10 minutes. Afterward, if your symptoms recur, your doctor will repeat the procedure on subsequent visits until no symptoms return.
Tips for After the Treatment
- Avoid tilting head back or forward for the rest of the day.
- Avoid sudden head movements for a day or two
- Avoid activities that cause a lot of bumping or vibration for a day or two
- Avoid sleeping on the affected side for about a week
If the symptoms return, go back to your doctor right away and have the procedure done again. In some cases you may need to have this done 3-5 times. The majority however clear up after only 1 session.
Benign Paroxysmal Positional Vertigo can be a very scary and disabling condition. Luckily it is fairly easy to diagnose and treat without drugs or surgery. If you’ve suffered from vertigo you might want to consider getting checked for BPPV.