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Medical Breakthroughs: Virtual vertigo


Last Update: 11/18/2009 7:45 pm
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It doesn't take much to throw their worlds off-balance.  Judith Uhl, vertigo patient.  "At times, standing in front of the shelf and looking from top to bottom would set me off."  Betty Austin, vertigo patient.  "The room just spins and spins and spins. Even when your eyes are closed, you can feel the room spinning."

For people with vertigo, going to the grocery store can be a dizzying experience.   Researchers are treating the balance disorder by forcing people to face their fears in a virtual world.  Susan Whitney, PhD, physical therapist,  UPMC Ear, Nose & Throat Specialists, Pittsburgh, Pa.  "It's similar to what some psychotherapists do for anxiety or panic disorder, that you expose somebody to more and more difficult situations."

Six weeks of wheeling through the virtual store eased dizziness in the real world for 75-percent of patients.  Susan Dearden,
vertigo patient.  "It's wonderful. It's like I got my life back."   This "dizzy chair" made of recycled aircraft parts is helping Betty Austin with her vertigo.  While Betty tips and turns, special glasses record her eye movements.  Those movements help doctors locate loose crystals in the inner ear, a major cause of vertigo.

Ian Purcell, MD, PhD, neurologist, Senta Medical Clinic, San Diego, Ca.  "There is a certain maneuver or path that I can vector the patient along to reposition those crystals."

When the crystals are moved back in place, the vertigo stops. Betty says it's working.  "The treatment is incredible and how well it works and how good you afterwards."

Two unique ways that stop the spinning and help patients land securely on their feet.

Doctors say while other conditions and medications can cause dizziness, true vertigo happens when patients become dizzy while lying down.

BACKGROUND: Vertigo is a vestibular disorder commonly associated with a dizzying sensation within stable surroundings. This illusion of motion becomes more common and more of a complaint as patients age. Though vertigo is most common in the elderly, it can still affect both sexes at any age, and it can be a temporary or permanent condition. Some of the corresponding symptoms include nausea, emesis and diaphoresis. Dizziness is one of the most common symptoms, affecting about 30 percent of people over the age of 65. From 2001-2004, 35.4 percent of adults 40 years and older had been diagnosed with vestibular dysfunction, and broad-based demographic studies consistently show that vestibular disorders are under diagnosed and undertreated.

CAUSES: Vertigo is caused when the organ of balance, the vestibular system in the ear, has problems calculating information to the brain. Balance problems can range from ringing in the ears to loss of hearing. Vertigo can also be caused by any changes in the parts of the brain that control balance. Vertigo can occur in any instance when tiny crystals in the inner ear become loose, giving the body a false sense of movement. Some other causes include head trauma, labyrinthitis, neuronitis and Meniere's disease. If taken in high doses over time Aspirin, caffeine, alcohol, nicotine, sedatives and tranquilizers can cause temporary dizziness.

TREATMENT: For acute vertigo that usually only lasts a few hours the most useful treatment is medication. Some of the most popular medications include: Meclizine (Antivert), Dimenhydrinate (Dramamine), Diazepam (Valium) and Lorazepam (Ativan). Vestibular rehabilitation exercises are another step towards beating vertigo. These exercises train the brain to use other visual and other sensory cues to maintain balance. During the exercises, it is very important for the patient to re-experience vertigo so the brain can adapt to a new baseline vestibular function. After stabilization, medications should be minimized.
Another option for treatment is visiting the "Dizzy Chair," which is used to target the loose crystals in the ear and reposition them away from nerve endings to stop the vertigo. Doctors use a set of infrared goggles to find crystals and record inaudible movement to make a diagnosis. Researchers are in the process of manufacturing a take home set of infrared goggles paired with a computer read system so a diagnosis can be safely and accurately done at home, then o reported to a doctor.

FOR MORE INFORMATION, PLEASE CONTACT:
Pat Sparto, PhD
Susan Whitney, PhD
Otolaryngology at the University of Pittsburgh Medical Center
(412) 647-8069

Michael O'Leary, MD
Senta Clinic
San Diego, CA
(619) 229-4903



 
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