Dizziness and phrases of anticipation: What might they mean?

"What do you mean by dizzy?"  To answer this question, I have often heard clients use phrases and words like the following: 

"I'm about to become dizzy"

"Am I going to get it?"

"I could become dizzy"

"It’s going to come on" (but doesn’t)

"Like, ok, maybe"

"I might get dizzy"

"I may become dizzy"

Clients who make these statements have a sense that something is about to happen in relation to their dizziness, but then they do not actually experience their familiar sense of dizziness.  Why do clients have these feelings of anticipation?  I hypothesize that it could be any of the following reasons:

       ·       Problem is in remission, but brain doesn’t know it (need compensation)

·       Problem present, but:

o   You are in the early stages of the problem returning

o   You are in the late stages of the problem going away

o   You are having the same problem as before, but not as severe

·       Avoidance; not moving enough to stimulate the problem

Bilateral BPPV

Is traditionally considered uncommon.  Unless a person had a head injury, I would typically consider bilateral BPPV highly unlikely.  I have noticed that sometimes left sided posterior canal canalithiasis can mimic a less intense form of right sided posterior canal canalithiasis by causing right torsional upbeating nystagmus in the right Dix-Hallpike position.  Lately, however, I have had a few clients (within one week) who had intense torsional, upbeating nystagmus in the same direction of the Dix-Hallpike maneuver on both sides.  This nystagmus was typical BPPV type nystagmus (crescendo/fatigue/symptomatic).  These findings made me think of the following question: Is bilateral BPPV really uncommon?

If there is a vascular or hormonal cause of BPPV, one could hypothesize that if the inner ear is not getting the nutrients it needs to be healthy on one side, why couldn't it experience a similar state on the opposite side.

Can BPPV Be Prevented?

The answer to this question depends upon the cause.  If BPPV has a vascular cause, then improving circulation to the vestibular system may prevent future spells.  If the cause of BPPV is from Migraines or Thyroid issues, then preventing Migraines and regulating Thyroid levels may prevent BPPV.  BPPV caused by head injuries would have been prevented had the head injury not occurred.  Of course, I am sure the individual who hit their head did not have a choice about the matter.

What if one is not able to improve the underlying cause of BPPV?  Is there a chance that completing repositioning maneuvers on a regular basis may help prevent the problem from becoming symptomatic?  One study completed suggests no.  However,  I would like to suggest that the following types of recurring BPPV may be prevented...

Imagination, Memory and Dizziness

Have you ever heard someone say, "That makes me dizzy just looking at it" (In reference to a picture of individuals on the edge of a cliff) or "That makes me dizzy just thinking about it" (In reference to a discussion about climbing up a ladder or riding an elevator to the top of a skyscraper)?

How is it that someone can become dizzy just looking or thinking about a height related topic?  Click here to learn more...

Motion Sickness From a Sick Ear

If our inner ear is not working properly, it will make our brains believe we are spinning.  It has the power to cause the eyes to spin very fast if it is not in balance with the other ear.  This is called nystagmus.  Because our eyes spin, we feel spinning.  Click here to read more...

People over 85

seem to perceive dizziness differently than people under 85.  Now, I don't mean to generalize.   All individuals are unique.  However, I do believe that our senses change the older we get.  Therefore, when the same individual is 65, they may perceive nystagmus as "spinning".  However, when they grow to be 85, they may perceive nystagmus as "floaty" or "off balance."

Reflux and BPPV

I was recently reminded of the impact of BPPV on reflux.  When BPPV occurs in people with a predisposition toward motion sickness, they may vomit with spells.  If this type of individual also has GERD, the vomitting from the vestibular problem will trigger the GERD to be inflamed.

Once the BPPV is fixed, the client may continue to be nauseated when lying down...but, not because of the BPPV, because of the GERD.