This subject arises quite frequently (especially on weekends!), hence, I've included this brief discussion here for those who forget how to perform this maneuver.

Not all dizziness is the same and people often mean different things when they state that they are "dizzy."  For example, one person may use the term to describe sensations of feeling faint whereas another may use the same term to mean that their entire world is spinning around them to the point where they are unable to walk and are praying to the porcelain god (puking up their guts!). (This, by the way, is why good docs never try to put words in the mouths of our patients.  We want you to tell us exactly what you are feeling.)

 

True vertigo is not really usually caused by a virus (we docs had diagnosed this condition as viral labyrinthitis for years). Rather, the condition most often encountered is Benign Positional Vertigo (BPV). 

 

In our heads, one can find containers (utricle and saccule) on either side of our heads that hold very tiny "grains of sand." Because of gravity, the grains of sand are pulled towards the earth and stimulate tiny nerve endings (hair cells), that in turn send positional information to the brain.  The result is that our brain senses our upright posture.  If we were to stand on our heads or turn our heads suddenly, the grains would shift position, stimulate hair cells in other locations inside of the containers, and our brain would interpret this change in head position accordingly.

 

BPV arises when some of these "grains of sand" become 'misplaced,' i.e. the leave one of the containers and enter the other. The result is true vertigo i.e. sensation that the room/earth is spinning around you similar to being drunk.

 

Fortunately, this type of dizziness is easily fixed without the use of medications by performing the "Epley Maneuver." (Thanks to Martin Samuels, M.D., Neurologist -in-Chief at the Harvard Brigham & Women's Hospital, for sharing this trick at a Pri-Med conference a few years back!)

 

1.    Determine which side/direction induces the worst spinning i.e. left or right.

 

2.    Lie down flat on your back (supine) and wait for all spinning to cease.

 

3.    Turn your head in the direction that causes the dizziness.

 

4.    As soon as you perceive the sensation of movement beginning, immediately turn your head as far as you can go in the opposite direction and hold it in this position until the spinning stops.

 

5.    When the spinning has ceased, immediately sit up.

 

6.    The preceding steps may have to be repeated, but rarely does one have to perform this more than 4 times in a row.

 

This maneuver works quite nicely for most people,  If the symptoms persist, then one may want to try picking up some Antivert (an over-the-counter antihistamine commonly used for sea sickness; generic is meclizine).  If the symptoms continue to persist, a visit to the doctor is necessary.