Are you Learning to Live with Vertigo?
Many people who have unresolved BPPV for many years, sometimes 20, 30, or 40 years, tend not to complain of dizziness or vertigo when I interview them. This is because these individuals have learned how to change their movement pattern to avoid the position(s) that make them uncomfortable, essentially they are learning to live with vertigo.
When I meet someone who is falling repeatedly and I ask them, “How do you sleep?”
They often say:
“Well I never lie flat.”
Then I ask them, “Do you ever get dizzy?”
They reply to me:
“No, I never get dizzy.”
If I inquire in more detail, “Why is it that you never lie flat?”
They usually say something like:
“I never lie flat. I prop my head up on at least two pillows so I won’t spin or get dizzy.”
Therefore, they do not complain of vertigo or dizziness because they avoid the provoking positions.
People are really smart and our bodies are inherently intelligent. If we are uncomfortable, we will change a movement pattern to prevent from experiencing that discomfort. This change may be conscious or unconscious.
Even though these individuals have learned how to avoid the position that provokes “positional vertigo,” they still have underlying problems with walking or balancing from chronic, unresolved BPPV.
I often find vestibular issues, like positional vertigo caused by BPPV, when I evaluate older people who are repeatedly falling without a clear explanation, which is a problem I call “unexplained, repeated falls.”
Learning to Live with Vertigo can Cause Mis-Diagnosis of Cognitive Problems
MCI a newer diagnosis for early dementia. This diagnosis represents more cognitive changes than are typically associated with normal aging, but the mental changes are not as severe as a diagnosis of dementia.
MCI is typically characterized by difficulty with concentration, reduced short term memory, difficulty with executive level brain function for decision making, and reduced “cognitive stamina.” Reduced cognitive stamina means that they can’t concentrate for long periods of time, such as reading, because they have to take mental breaks.
Untreated positional vertigo (BPPV) can also cause many of the symptoms that are considered MCI, so it can masquerade as “mild dementia.”
There is one major difference:
When the BPPV is treated successfully by a Vestibular specialist, the cognitive impairment from BPPV instantly goes away!
That resolution of cognitive issues caused by BPPV makes it much more easy to function than simply learning to live with vertigo.
Balance Improves when Vertigo is Resolved
The underlying issues with walking and balancing, if they are related to the BPPV, can also be resolved! Some people have an immediate improvement in walking stability. Other people need 4-8 weeks of Vestibular Rehab physical therapy for a full recovery.
The individual may also be able to go back to the sleeping positions that they have avoided for so long, while trying to avoid triggering the positional vertigo symptoms that they were previously experiencing.
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This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.