Why do I feel as if the world is moving around me for two weeks?

Question

Hi doctor,

Two weeks ago, I started swooning. The world seemed moving around me, and walking had to be supported. Immediately, I met a neurologist who said that it was likely to be vertigo. One week later, I met an ENT specialist. She confirmed the diagnosis, saying it was BPPV. She further said that the calcium crystals had been dislodged, but were dissolved by then. The treatment could only be carried out when it could be determined which ear has the problem. What is the cure for vertigo? On internet, the videos say that proper exercises can provide lasting benefits. Please guide me.

Answer 1

Hi,

Welcome to icliniq .com.

To start with, I would like to know how exactly was the onset of the symptoms. 1) Was it a spinning sensation? As in, the whole room was spinning when you open your eyes, or was it a wig feeling of unsteadiness, or was it more of the dimness of vision or a blackout feeling? If it were to be vertigo due to an inner ear problem, the sensation would be that of spinning. 2) The next thing that I would like to know is when was the actual time of onset? Did your symptoms start when you woke up from sleep or halfway through your sleep or was it at some other time of the day when you were working or sitting idly? 3) Are there any triggering factors, such as does vertigo or the spinning sensation comes on when you turn your head to a particular side or when you bend your head forward or upward? 4) Compared to the onset of symptoms two weeks back, how do you feel now? Is it slightly better or is it of the same intensity as when it started off? 5) How long does each episode last? Is it last only for a few seconds, or does it last for about half an hour or longer than that? 6) Do you experience any kind of ringing sound in any one ear, right or left side. Is there any kind of sensation of fullness in the ear? 7) How is your general sense of vision? Do you suffer from any kind of impaired vision due to cataracts? Do you use any glasses? 8) Do you suffer from any other comorbidities such as diabetes, hypertension, high cholesterol levels, and are you on any other long-term medications? The treatment of vertigo would depend upon its cause. If it were to be diagnosed as BPPV (benign paroxysmal positional vertigo), the treatment would be in the form of certain specific exercises. Without examining you, based on the above questions I may be able to get an idea about your possible diagnosis. However, considering the fact that a clinician has seen you and suggested the diagnosis as BPPV, the Brandt-Daroff exercise would be useful in bringing it back to the normal. However, you must realize that you would experience a spinning sensation when you do these exercises. So it would be highly recommended that you do these exercises when somebody is there with you. I would suggest, repeating these exercises at least five times in the morning and five times in the evening for three weeks. You must also avoid quick jerky head movements when somebody calls you from the back or side.

Answer 2

Hi,

Welcome back to icliniq.com.

Thank you for your feedback. Generally, BPPV (benign paroxysmal positional vertigo) would resolve on its own over two to three weeks. However, if there are minimal symptoms, we can still check the side of involvement, by doing the Dix-Hallpike test. As this is a teleconsultation, the best I can say is that you may proceed to test it on your own, but please make sure you have somebody next to you while checking it out. I must warn you that you would experience vertigo or spinning sensation on the involved side. However rest assured, it will not last more than one minute. So please do not panic, even if vertigo happens when you do the test, please continue in the position till vertigo subsides and then you can proceed further with the next position. Please do this test at home and revert.

Answer 3

Hi,

Welcome back to icliniq.com.

Sure, we can plan for Wednesday around 1.00 PM if that is okay for you. It would be good if you have one person with you to help you with the testing process. Best regards.

Answer 4

Hi,

Welcome back to icliniq.com.

No equipment is required. You only need to fix up an appointment for video consultation on that date and time and have someone with you so that I can instruct them to do the particular maneuvers for positional testing and so on. Best regards.