Dietary Guidelines

General Guidelines
Dietary strategies for regulating fluid balances involve modifying the amount of certain substances consumed (and reducing fluctuations in those amounts), as well as reducing or eliminating other substances that can adversely affect the inner ear. Components of these dietary strategies include:
▪ Distributing food and fluid intake evenly throughout the day and from day to day.
▪ Avoiding foods and beverages that have a high sugar or salt content. Foods with complex sugars (e.g., those found in legumes and whole grains) are better choices than foods with a high concentration of simple sugars (e.g., table sugar and honey). Sodium intake also affects body-fluid levels and their regulation. Each individual's physician will be the best judge of appropriate levels of sodium intake.
▪ Drinking adequate amounts of fluid daily. If possible, fluid loss from exercise or heat should be anticipated, and extra fluids drunk before and during exercise and in hot weather.
▪ Avoiding foods and beverages with caffeine. Caffeine is a stimulant that can make tinnitus louder. Its diuretic properties also cause excessive urinary loss of body fluids.
▪ Limiting or eliminating alcohol consumption. Alcohol can directly and adversely affect the inner ear by changing the volume and composition of its fluid.
▪ Avoiding migraine triggers including foods that contain the amino acid tyramine. Examples of such foods include red wine, chicken liver, smoked meats, yogurt, chocolate, bananas, citrus fruits, figs, ripened cheeses (e.,g., cheddar and Brie), and nuts.

Benign positional vertigo

Benign positional vertigo (BPV) is the most common cause of dizziness due to an impairment of the balance center in the ear.

Description
BPV was first described by Adler in 1987. Dix and Hallpike named the disorder benign paroxysmal positional vertigo. The disorder can also be called canalithiasis or positional vertigo or "top shelf vertigo" (affected persons tip their heads back to look up when having an attack).
The internal ear consists of sacs, ducts, and bone. The internal portion of the ear can be divided into the bony labyrinth and membranous labyrinth. The bony labyrinth is a cave-like area composed of three parts: the cochlea, vestibule, and semicircular canals. The shell-shaped cochlea is the organ for hearing. The vestibule is a small oval chamber that contains two structures, the utricle and the saccule, responsible for balance. A membrane within the utricle and saccule normally contains particles called otoliths (calcium carbonate particles). The semicircular canals that occupy three planes in space contain the semicircular ducts for fluid (endolymph) flow.
The Canalolithiasis Theory, the most widely accepted explanation for the cause of BPV, explains the actual mechanism that causes BPV. The theory is that otoliths can become displaced from the utricle and enter a portion of the semicircular ducts. Changing head position can cause free otoliths to gravitate longitudinally through the canal. The endolymph fluid contained in the semicircular canal will flow abnormally, causing stimulation of special sensors (hair cells) of the affected posterior semicircular canal duct. This stimulation causes vertigo or dizziness.

Demographics
In the United States, the number of new cases (incidence) is 64 cases per 100,000 populations per year. The incidence is greater in patients older than 40 years, and women are affected twice more often than men. Several studies indicate that an average age of onset in the mid-50s. Approximately 20% of all falls by the elderly, resulting in hospitalization for serious injuries, are due to vertigo (dizziness). No information is available concerning predilection to race. Approximately 25–40% of patients with BPV express dizziness as their chief complaint. The incidence among the elderly is estimated to be about 8%.
Causes and symptoms

The most common cause of BPV is head trauma (21% of cases) with a secondary concussion. The force of head trauma is thought to displace otolith particles in the semicircular canal. Approximately 39% of cases do not have a cause (idiopathic), and 29% of patients with BPV usually present with an existing ear disease. Other common causes include alcoholism, central nervous system (CNS) disease (approximately 11%), major surgery, and chronic ear infections such as chronic otitis media (approximately 9% of cases).
The severity of cases varies. Some patients may experience nausea and vomiting even with the slightest head movement, whereas some patients may be minimally bothered by the dizziness. As the name implies, symptoms of BPV are typically dependent on head position. Head movement, rolling in bed, leaning forward or backward, or changing posture can cause an attack. The symptoms start abruptly and disappear with 20–30 seconds.

Diagnosis
In addition to a detailed history, the physical examination is important for detection of characteristic physical signs such as nystagmus (involuntary rhythmic oscillation of the eyes). The examination is also necessary to exclude other neurological diseases that may mimic benign positional vertigo. A physician familiar with the condition may perform the Hallpike test. Also, in patients with vertigo, hearing tests are generally necessary. Further testing may be necessary to evaluation other conditions that can cause vertigo or dizziness.

Source: healthline.com

I found this article very interesting and so I decided to post it up. I had never heard of this type of vertigo and I'm pretty sure that I am not the only one that can say that!

Vertigo Causes

Vertigo can be caused by problems in the brain or the inner ear.
Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements.
Vertigo may also be caused by inflammation within the inner ear. This is known as labyrinthitis. This condition is characterized by the sudden onset of vertigo and may be associated with hearing loss.

Meniere disease is composed of a triad of symptoms: episodes of vertigo, ringing in the ears, and hearing loss. People have the abrupt onset of severe vertigo, fluctuating hearing loss, as well as periods in which they are symptom-free.
Acoustic neuroma is a type of tumor causing vertigo. Symptoms include vertigo with one-sided ringing in the ear and hearing loss.

BPPV

Vertigo, or dizziness, usually results from a disorder in the peripheral vestibular system (i.e., structures of the inner ear). Dizziness also may occur as a result of a disorder in the central vestibular system (i.e., vestibular nerve, brainstem, and cerebellum). In some cases, the cause of vertigo is unknown.

Peripheral vestibular disorders include the following:
Benign paroxysmal positional vertigo (BPPV; most common peripheral disorder; may be accompanied by hearing loss, reduced cognitive function, and facial muscle weakness)

Cogan's syndrome (inflammation of connective tissue in the cornea; results in vertigo, ringing in the ears [tinnitus], and loss of hearing)
Meniere's disease (fluctuating pressure of inner ear fluid [endolymph]; results in severe vertigo, ringing in the ears [tinnitus], and progressive hearing loss)
Ototoxicity (i.e., ear poisoning)

Vestibular neuritis (inflammation of vestibular nerve cells; may be caused by viral infection)

Benign paroxysmal positional vertigo occurs when debris made up of calcium carbonate and protein (called otoliths or ear crystals) builds up in and damages the inner ear. Inner ear degeneration (usually occurs in elderly patients), head trauma, and inner ear infection (e.g., otitis media, labyrinthitis) can cause BPPV.

what is vertigo?

Vertigo, a symptom of a balance disorder, is the illusion of movement when no movement is present. This can be caused by a problem of the inner ear balance mechanisms, or by a problem in the brain. While usually harmless, vertigo can be a sign of a serious condition if accompanied by difficulty in speaking or walking, severe headaches, or double vision. Even when no other symptoms are present, it is always a good idea to consult a doctor. The same is true if the episodes worsen over time or if new symptoms appear.
Common causes of vertigo include the following:
Benign paroxysmal positional vertigo or BPPV, which is caused by an inner ear problem and is the most common cause of vertigo. BPPV is characterized by sudden and severe episodes that are nonetheless not serious.
Inflammation or infection of the inner ear, which can lead to hearing loss if not treated immediately.
Certain serious medical conditions, including multiple sclerosis and head or neck trauma.
Cerebellar hemorrhages, which cause vertigo because of decreased blood flow to the brain. In this case, vertigo is accompanied by more serious symptoms, such as difficulty walking and vision impairments.
Meniere disease, which often also causes ringing in the ear.
Severe migraines.

When does Vertigo occur?

Vertigo occurs when an imbalance or disturbance in vestibular function exists anywhere in the peripheral or central vestibular system (ie, labyrinth, vestibular nerve, brain stem, cerebellum, cortex). The etiology of vertigo includes familial, infectious, neoplastic, metabolic, toxic, vascular, autoimmune, and traumatic causes. Distinguishing the site and cause of the lesion resulting in vertigo is important because some causes of central vertigo can be life threatening and require immediate attention.

why do we feel dizzy when we spin?

I have always wondered, since I was a child, what causes us to become dizzy. Now is that I completely understand the answer.

If you have ever spun around like a top or rolled down a hill, then you have probably experienced dizziness or vertigo. Some people even get dizzy just getting up too fast from the sofa. When you become dizzy, a part of your body that senses motion has sent the wrong signal to your brain. An amazing system in your inner ear is the key to dizziness.
The body senses whether it is upright or lying down or whether it is moving or standing still through the vestibular system, which is in the upper portion of the inner ear. Here is how the system senses orientation with respect to gravity:
It has otolithic organs that contain crystals of calcium carbonate (chalk)
The crystals are attached to hair-like sensory nerve cells in different orientations.
When you bend your head in different directions (forward, backward, sideways), gravity pulls on the crystals that are oriented with it.
The crystals stimulate the hair cells to send nerve impulses to the brain.
The brain interprets these signals to know which way the head is oriented in space. Here is how the vestibular system senses motion:
There are three semicircular canals for sensing motion.
They are at right angles to one another.
They contain fluid called endolymph and hair-like sensory nerve cells.
As your head moves in a given direction, the endolymph lags behind because it resists a change in motion (the principle of inertia).
The lagging endolymph stimulates hair cells to send nerve signals to the brain.
The brain interprets them to know which way the head has moved. When you spin, the endolymph slowly moves in the direction you are spinning. The movement of the endolymph signals the brain that the head is spinning. The brain quickly adapts to the signal because the endolymph begins to move at the same rate that you are spinning and no longer stimulates the hair cells. However, when you stop spinning, the endolymph continues to move and stimulate hair cells in the opposite direction. These hair cells send signals to the brain. The brain determines that the head is still spinning, even though you have stopped. This is where the dizzy feeling comes from. Eventually, the endolymph stops moving, no signals are sent to the brain, your brain determines that your motion has stopped, and you no longer feel dizzy.

Post-Traumatic Vertigo

The American Hearing Research Foundation has some great info on their web site about post traumatic vertigo. I hadn't heard about that before and I learned a lot by reading that article, written by Timothy C. Hain, MD.

Here's an excerpt:

What is Post-Traumatic Vertigo?
Head injuries are sustained by 5% of the population annually. Post-traumatic vertigo refers to dizziness that follows a neck or head injury. While injuries to other parts of the body might, in theory, be associated with dizziness, in practice this is almost never the case. Because of the high incidence of litigation associated with post-traumatic vertigo, most clinicians are extremely cautious in making this diagnosis.

What Causes Post-Traumatic Vertigo?
There are many potential causes of post-traumatic vertigo:
After a head injury, otoconia may be displaced from the utricle and migrate into other parts of the ear, causing dizziness.

How is Post-Traumatic Vertigo Treated?
Treatment is individualized to the diagnosis. Treatment usually includes a combination of medication, changes in life style, and possibly physical therapy. Occasionally, surgery may be recommended.

what is vertigo?

Vertigo, or dizziness, is a symptom, not a disease. The term vertigo refers to the sensation of spinning or whirling that occurs as a result of a disturbance in balance (equilibrium). It also may be used to describe feelings of dizziness, lightheadedness, faintness, and unsteadiness. The sensation of movement is called subjective vertigo and the perception of movement in surrounding objects is called objective vertigo.
Vertigo usually occurs as a result of a disorder in the vestibular system (i.e., structures of the inner ear, the vestibular nerve, brainstem, and cerebellum). The vestibular system is responsible for integrating sensory stimuli and movement and for keeping objects in visual focus as the body moves.
When the head moves, signals are transmitted to the labyrinth, which is an apparatus in the inner ear that is made up of three semicircular canals surrounded by fluid. The labyrinth then transmits movement information to the vestibular nerve and the vestibular nerve carries the information to the brainstem and cerebellum (areas of the brain that control coordination, balance, movement, blood pressure, and consciousness). There are a number of different causes for dizzy spells.
Incidence and Prevalence Vertigo is one of the most common health problems in adults. According to the National Institutes of Health (NIH), about 40% of people in the United States experience feeling dizzy at least once during their lifetime. Prevalence is slightly higher in women and increases with age.

causes of vertigo

Vertigo, or dizziness, usually results from a disorder in the peripheral vestibular system (i.e., structures of the inner ear). Dizziness also may occur as a result of a disorder in the central vestibular system (i.e., vestibular nerve, brainstem, and cerebellum). In some cases, the cause of vertigo is unknown.
Peripheral vestibular disorders include the following:
Benign paroxysmal positional vertigo (BPPV; most common peripheral disorder; may be accompanied by hearing loss, reduced cognitive function, and facial muscle weakness)
Cogan's syndrome (inflammation of connective tissue in the cornea; results in vertigo, ringing in the ears [tinnitus], and loss of hearing)
Meniere's disease (fluctuating pressure of inner ear fluid [endolymph]; results in severe vertigo, ringing in the ears [tinnitus], and progressive hearing loss)
Ototoxicity (i.e., ear poisoning)
Vestibular neuritis (inflammation of vestibular nerve cells; may be caused by viral infection)

vertigo statistics

▪ The number of people who have Meniere's disease in one ear and who will ultimately develop the problem in both ears is not known. Estimates range from 17.7 percent to 75 percent. One study reported a 34 percent rate of bilateral disease over time.
▪ Most experts regard BPPV as the most commonly diagnosed vestibular disorder. It accounts for at least 20 percent of diagnoses made by doctors specializing in dizziness and vestibular disorders. It is the most frequent cause of vertigo in the elderly. The number of people affected by this disorder each year has been estimated between 10 per 100,000 and 64 per 100,000 people, and some experts feel even more may be affected.
▪ "In the general population (all ages), 347,000 hospital days [per year in the U.S.] are incurred because of 'vertiginous syndromes,' 202,000 because of 'labyrinthitis' and 184,000 because of 'labyrinthitis unspecified,' with several thousands more accounted for by other balance disorders, e.g., Meniere's disease."

Stats On Vertigo

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▪ U.S. doctors reported 5,417,000 patient visits in 1991 because of dizziness or vertigo.
▪ "While the majority [of outpatient visits for balance problems in 1976] involved mild to moderate symptoms, disability was severe in an estimated 10 percent of the patients."
▪ The exact number of people with Meniere's disease is difficult to measure accurately because no official reporting system exists. Numbers used by researchers differ from one report to the next and from one country to the next. The National Institutes of Health estimates that about 545,000 people in the U.S. have Meniere's disease and that 38,250 are diagnosed each year.
▪ A study looking at one geographic area in Japan over a number of years estimated that 17 of every 100,000 people in the population would be diagnosed with Meniere's disease each year.
▪ In Rochester, Minnesota from 1951 to 1980, out of every 100,000 people in the population 218.2 had Meniere's disease and 15.3 would be diagnosed with it each year.