The People's Perspective on Medicine

Dealing with Dizziness Is Difficult

Determining the cause of dizziness is the first step to finding a way to relieve it.
Senior woman with a headache rubbing her temple

Doing cartwheels, riding rollercoasters or spinning until they’re dizzy makes children scream with delight. For older people, though, dizziness is a disaster.

When adults feel dizzy, they frequently become nauseated. Nausea may be harder to handle than pain. It can be difficult to function when vomiting seems imminent.

Vertigo, a sensation of the world spinning around, can be very disorienting. Lightheadedness can make a person unsteady on her feet and could lead to a fall.

Dizziness Due to Drugs:

Sometimes dizziness is a consequence of drug treatment. Many useful medications, such as those to lower blood pressure, can cause dizziness as a side effect. Patients and physicians must weigh the benefits of the drug against the unpleasant reaction, and see whether another treatment might work just as well.

When a drug has little evidence of benefit, however, any dizziness that results is simply a tragedy. We spoke recently with a delightful older woman who described a medical misadventure that began with tinnitus. The ringing in her ears was incessant, and her primary care physician referred her to an ENT specialist. That doctor prescribed an antipsychotic medicine called risperidone (Risperdal), although we can find no evidence that risperidone alleviates tinnitus. The Risperdal made her so unsteady that she fell and broke her ankle, putting her in a cast for months.

Dizziness from Inner Ear Changes:

In other cases, dizziness results from changes in the inner ear.

Benign paroxysmal positional vertigo (BPPV) occurs when small calcium crystals (“rocks”) in the inner ear drift out of position. As a result, rolling over in bed, standing up or turning the head can make a person feel violently dizzy for up to several minutes.

Sometimes people with BPPV are given inappropriate treatments. One reader shared this experience:

“I first had vertigo about 20 years ago. I woke up in the middle of night spinning and vomiting, thinking I was dying. I went to the doctor and was put on vertigo medications. The doctor said it would go away in a few weeks, and I just had to deal with it.

“Eventually the vertigo improved but it came back a few years later. This time the ENT moved my head back and forth and had me sit up and lie down. It made everything spin and I threw up, but was told to sleep in a recliner for three days. By the fourth morning, the spinning was gone!

“When it recurred, I had that same Epley maneuver done again, and it worked like a charm. I’ll go for the same thing if I get BPPV again.”

The Epley Maneuver

To understand the Epley maneuver and BPPV better, readers can listen to our one-hour interview with dizziness expert David Kaylie, MD. Radio show 816 can be streamed for free at Dr. Kaylie also discusses Meniere’s disease, vestibular neuronitis and other balance disorders and offers valuable practical information about these conditions. If you would like to purchase a CD or an mp3 version of the show to share with a friend or loved one suffering from dizziness, here is a link to the program.

Treating dizziness with the antinausea medicine meclizine doesn’t always help. According to Dr. Kaylie, if the problem is vestibular neuronitis, drug treatment with meclizine can actually aggravate the condition and slow recovery.

Diagnosing dizziness can be difficult. It often requires special expertise. Describing the nature and duration of the sensation can help the doctor determine the cause and the best treatment.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I was diagnosed with Meniere’s almost 14 months ago. I have the 4 major symptoms – vertigo, tinnitus, hearing loss and fullness (right ear), but I don’t have episodes / attacks – I have the symptoms every day, from the moment I get out of bed in the morning until I return at night. I’ve had the usual tests, including a head MRI (negative results), and drug regimens (currently taking none) – nothing helped.
I recently retired (Meniere’s pushed me over the edge) and am taking long, brisk-paced walks nearly every day in the hopes that regular exercise will help. I am also looking into Vestibular Rehabilitation Therapy (mostly balance related exercises), but I’m beginning to wonder about and investigate surgical possibilities (non-destructive; perhaps Endolymphatic Mastoid Shunt).
This really wears me out. Driving is not a problem, except multi-hour trips; I now take several breaks. Heavy traffic, even short trips, is also fatiguing.
Any advice is welcome.

I have/had Menieres 30 years. It started with one ear feeling ‘stopped up and then moved to full blown attacks. For 10 years I was tested and retested, took antivert after trying a diuretic and changed my diet a bit. Nothing helped. There were times I was free of attacks…. a week here, a month there. Once I went 9 months. When the attacks started again they were relentless, some lasting hours with spinning and vomiting. I can remember one time lying on the floor for 10 hours not being able to move at all. Every time an attack was over I was spent and would sleep.
After 10 years of this I found a clinic (Shea) in Memphis, TN that specialized in ear problems and did a lot of work with Menieres patients. Bottom line I went to Memphis and had a shunt put in the affected ear. There was an adjustment time (maybe 6 weeks) but after that I had no attacks for 7 years.
Then the attacks started again. I did more research and ended up doing acupuncture. I talked to one of the patients that had tried it and he was pleased with the results. I started acupuncture and never looked back. I don’t remember how long ‘it’ took to ‘kick in’ but not long. I’ve been free of attacks (knock on wood) for years. I am sorry for anyone having to put up with this debilitating syndrome…. it can rule your life. Not everyone will respond to the same treatment… each of us is different. I was so miserable I would have tried anything.
I wish all of you the best in your quest for answers to Menieres.

A couple decades ago I was diagnosed with Meinere’s Syndrome and have taken amiloride/hctz ever since. When I started taking that and cut way back on my salt the attacks lessened but did not entirely go away. Some years ago I heard Aspartame could have such effects and quit Diet Coke cold along with reading labels and avoiding anything with Aspartame, including most kinds of chewing gum. Since then I’ve not had an attack.
I urge anyone with this problem, particularly if Epley doesn’t work, to try getting entirely off Aspartame. In fact I urge anyone with any mystery ailment to give that a good try. I liked my Diet Coke but I love being free of nausea and vertigo a whole lot more.

I have had Meinere’s for 30 years. That will give you vertigo and vomiting. My doctor dealt with it by having me take a water pill three times a day and take a Valium pill only if the vertigo came back. It hardly ever occurs anymore, thank goodness. I believe I have had BPPV for the last 6 years until I fell and banged my head on the floor. Haven’t had a dizzy day since. The fall did not injure me, just a knot on my forehead. I am so happy to not be dealing with dizziness for the first time in years.

A Colorado doctor who suffers from vertigo has developed a modification of the Epley maneuver that’s easier for people to perform at home.

I loved spinning as a child, and then got out of the habit until I took up hoop dancing as a mid-life (48 yo) adult. All the turning made me dizzy. My teacher made a comment about how some people liked the feeling, and that made me remember my childhood experience.
Since then, I’ve learned to process a fair amount of dizzy when I’m turning and my eyes move in one plane. I can move my eyes in two planes (turn, and at the same time move from looking up to looking horizontal (90-degrees) but if I go farther than 90 degrees, I fall over like a rock. Many of the younger hoop dancers can manage a 180-degree shift. That could be what distinguishes the professionals; that is, an innate ability to process more dizziness than the rest of us.
In other words, to some extent, some amount of the ability to process “dizzy,” albeit not all, and certainly not the serious medical conditions, can be a learned ability.
Someone who taught children with autism told me that one way to stop their spinning-induced dizziness was to jump with both feet off the ground and land with a bump. It works for me, but I’m careful not to jump very enthusiastically. I don’t recommend this to hoop students who strike me as not very agile, though.

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