Dizziness Misdiagnosis

May 5, 2012 | Dizziness, General, Meniere's, vertigo

Yesterday I was exhibiting at the Mind Body Spirit Festival in Sydney, where people walk by the stall, unaware that they may be about to discover the key to solving a condition that has plagued them for decades. It is exciting to invite them in, get out the ear model and be able to explain what is really going on for them. Yesterday, as often happens, I met a woman whose dizziness had been misdiagnosed.
She told me she suffered from vertigo, and when I asked if she knew the cause she said it was Benign Paroxysmal Positional Vertigo (BPPV). She had been taught the Epley Manouver, where you lie down and do a series of exercises where you tilt the head in particular directions. The aim of this is to roll the little crystals in the semi circular canals back into the correct chamber within the vestibular labyrinth.
On questioning her further, I learned about her symptoms, which were sudden, unprovoked, severe dizzy attacks involving falling down and nausea that could last a week, and she had had this since childhood. (She was now 47.) These are the classic symptoms of Meniere’s Syndrome, which has been known about since it was first described by Dr Meniere in 1861. BPPV was only identified and described by Dr Epley in 1980!
The symptom of BPPV is mild dizziness, specifically caused by a particular tilt of he head such as when tying the shoelaces, looking up, or rolling over in bed. The resulting vertigo usually only lasts a few seconds or minutes.
This is a completely different condition to Meniere’s Syndrome which is caused by excess pressure in the labyrinth, comes on suddenly and unprovoked (except perhaps by stress) causes compete disorientation, a feeling as if the world is falling way beneath you, nausea, vomiting and in severe cased being confined to bed for a week.
I am shocked at how often people come to me having been misdiagnosed by their doctor. With the spread of education on BPPV, and short courses on how to teach the Epley manoeuvre, it seems many doctors are now assuming that if its vertigo it must be BPPV.
The other sad fact is that medical science has remained blind to the actual cause of Meniere’s, which was identified by Dr Tomatis in the 1960s. His theory explains why Meniere’s attacks are always sudden. The general belief that there is an unexplained, constant elevation of labyrinthine fluid pressure does not explain the suddenness of the attacks, nor indeed why such pressure would cause dizziness at all. Dr Tomatis linked the attacks to a sudden twitch or spasm of the stirrup muscle, which suddenly increases the labyrinthine fluid pressure, causing the effect of a storm passing through the labyrinth.
If we accept this theory it then becomes evident why Sound Therapy is such an effective treatment for Meniere’s. The music provides gentle rehabilitation to the stirrup muscle by activating the brain centres in charge of middle ear muscle tone. Over the course of treatment, this reduces the likelihood of muscle spasms and hence of the vertigo attacks.

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