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Why am I falling?

Monday, Nov. 25, 2019
 

Statistics Canada indicates that falls are the number one cause of injury among older Canadians. In any given year, approximately 1 in 3 Canadians over 65 are likely to fall at least once. Falls are the leading cause of injury-related hospitalizations amongst older Canadians and over 1/3 of seniors who are hospitalized as a result of falls are placed in long-term care.

Any condition that affects mobility, such as arthritis or deconditioning, as well as any neurological or cardiac condition, can increase the risk of falling. What people may not know is that our vestibular system plays an important role in posture and balance and any disorder of the vestibular system can also increase the risk of falling.

What is the vestibular system?

Our vestibular apparatus is a sensory organ located just inside of each ear. It detects all head movement as well as whether or not our head is upright. We use this for balance, equilibrium and to focus clearly when the head is in motion. Disorders of the vestibular system cause symptoms such as vertigo (the sensation of movement or spinning), loss of balance (particularly when the head is in motion, the ground is unstable or it’s hard to see) and sensitivity to motion – either our own motion or that occurring around us.

What vestibular problems commonly occur?

  • Benign Paroxysmal Positional Vertigo (BPPV): This is the most common cause of vertigo. It occurs when crystals dislodge from the otolith organs into the semi-circular canals. This can occur secondary to a head injury, but often occurs spontaneously for no apparent reason. It is more common in the elderly. BPPV is characterized by the sudden onset of vertigo triggered by a change in the position of the head, like rolling over in bed or bending over, for example. Bouts of vertigo from BPPV typically last less than a minute. Each bout resolves by “waiting it out” but may re-occur with further movement of the head. BPPV may resolve over time, but can be quickly corrected with appropriate treatment called repositioning maneuvers in the vast majority of cases.
     
  • Vestibular Neuritis/Labyrinthitis: This occurs as a result of a viral infection of the nerve carrying the information from the vestibular apparatus to the brain, or of the apparatus itself. It is characterized by the sudden onset of vertigo that is constant for hours or even a day or two. Standing balance is often quite dramatically affected. Nausea and vomiting are common and sometimes hearing changes can occur too. Acute symptoms subside in the first 48 hrs, but loss of balance and sensitivity to motion or busy environments can persist for weeks or even years afterward. A type of treatment called Vestibular Rehabilitation has been proven to help the recovery process. It is recommended that you see your doctor as soon as possible, particularly if you are experiencing hearing loss during the event. 
     
  • Vestibular Migraine: This is the most common cause of episodic dizziness. Bouts of dizziness last from 5 minutes to 72 hours, and at least 50% of the time are accompanied by migrainous symptoms such as headaches, sensitivity to light or sound, or nausea and vomiting. Vestibular Migraine can be associated with stress, poor sleep and dietary factors. Sufferers typically have a history (or family history) of migraine headaches, and diagnosis is based on the exclusion of other vestibular disorders.
     
  • Meniere’s Disease: This is less common than Vestibular Migraine, but presents similarly. It is characterized by bouts of vertigo which can last from 20 minutes to 12 hours. Suffers usually have hearing changes during the attacks and over time tend to develop hearing loss that persists between attacks. The cause of Meniere’s disease is not well understood, but it may relate to an increase of fluid pressure in the vestibular organ.

These are a few of the more common vestibular conditions, but many other vestibular disorders exist such as Persistent Postural Perceptual Dizziness, Vestibular Paroxysmia and Mal de Debarquement syndrome. Even if the vestibular organs are fine, disorders affecting the pathways and processing of vestibular information in the brain can also produce the types of symptoms described above.

What should you do?

If you suspect that you may have a vestibular problem, it is recommended that you seek medical attention.  Lifemark Vestibular therapists are trained to thoroughly investigate your dizziness and balance concerns. If findings are consistent with a vestibular disorder that is appropriate for repositioning maneuvers or vestibular rehabilitation, they may be able to resolve the problem immediately (as is often the case with BPPV) or progress you through techniques that offer a longer-term benefit.

Don’t put yourself at increased fall risk and reduce your quality of life by trying to just put up with dizziness and balance issues! To schedule an appointment with a Lifemark vestibular therapist, check out our Locations page to find a clinic near you or book online. For more information about our vestibular rehabilitation program, you can also consult our website.

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