#constantvertigo

Through this experience I’ve learned that many people experience vertigo in their lifetime. Typically it is short-lived or episodic.

As far as I can tell it is categorized into two primary origins:

Peripheral (vestibular or ear related) or 

Central (Central Nervous System = brain, spine or even brain-to-ear). Occasionally vertigo can be involved in heart-related issues.

Peripheral causes

Peripheral vertigo is the most common origin, responsible for the vast majority of Vertigo cases. This includes BPPV or calcium crystals that break off in one of the fluid-filed canals in the ear causing episodic spinning or nausea for a few minutes at a time which is provoked by head movement. This type is often cured in 1 treatment (80% of cases) using body positioning maneuvers to relocate the crystal. A physiotherapist or physician with relevant training can usually do it. General Physicians see a lot of BPPV and other peripheral issues such as labyrinthitis, vestibular neuritis and Meniere's disease.

Central causes

Central causes involving the CNS or central nervous system are rarer, unfamiliar/unrecognized and sometimes harder to spot. Signs can be mixed, subtle, untested, overlooked by physicians because the majority of cases are of peripheral origin. Mine was missed by many different physicians. 

Additional reading on Etiologies and Evaluation:

www.ncbi.nlm.nih.gov/pmc/articles/PMC3096243/

http://www.aafp.org/afp/2006/0115/p244.html

http://www.nhs.uk/Conditions/Vertigo/Pages/Causes.aspx

Visited the new ENT Otology/Neurology Doc yesterday to see if the problem really is related to my ears (the most common assumption). He appeared fastidious, thorough, and brilliant. He also did a barrage of tests: hearing, neurological, coordination/gait, balance, positional, eye-tracking (while flicking my head quickly to each side watching my eye movement for nystagmus).

Note: None of the Walk-in clinic or ER Docs were able to trigger this; however, he got it going quite profoundly! I could actually feel my eyes jumping and jerking. This also happens at home when I lie on either side.  This was so strong the first time it occurred I thought my whole head was twitching in time to my heart beat. (Not my eyes in this clip, couldn’t get the video of it).

See my previous post Etiologies of Vertigo.

With positional vertigo (BPPV or a crystal in the ear) nystagmus is episodic. Further, the Dix-Hallpike test should show strongly towards the positive ear. The problem this time is, my eyes jump intermittently (lying on either side when supine). The specialist stated they also don’t stop bouncing after 30-60 seconds as they should if it were BPPV. I’m told currently that my eye movement slows considerably, to almost imperceptible, but keeps bouncing. Apparently the direction and beat of nystagmus often provides a clue as to its origin. Basically my eyes jump continuously when I’ve got the full-on spins.