Do you get dizzy from heights?

Dizziness sometimes crops up in people with perfectly normal balance systems.  Motion sickness is an example of this, but there are other forms, too.  Your inner ears constantly detect whether or not your head is moving, but your eyes also do this.  As you turn your head, your eyes move to counter-balance the head movement, and then jump forward to focus on the world again.  This is a form of normal, physiologic nystagmus.  Your arms and legs also detect movement and feed back to your brain to help you maintain balance by controlling sway.  A problem occurs if the head motion detected by the inner ears does not match what is coming in from vision or the body.  Height vertigo is a very common manifestation of this problem.

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Treating the canalith jam form of BPPV

Blockages in the canal that keep particles from exiting with maneuvers are very rare, fewer than 1 in 100 cases of BPPV.  We don’t yet know exactly how rare it is.  However, these rare cases can still be  treated with maneuvers.  Some modifications are needed to get the particles past the blockage.

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Canalith jam: a rare cause of BPPV

Rarely, maneuvers don’t seem to work, even though the vertigo seems to be BPPV.  The affected person is able to make spells happen by making head movements like lying down, rolling over or tipping the head up, but the particles seem to be stuck, unable to exit the ear.   Each time a maneuver is done, the vertigo remains the same, rather than improving.

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