Instructions for Patients Suffering from Vertigo
(Dizziness, Spinning Sensation, Severe Imbalance)

J. David Cunningham, MD; Timothy Heffron, MD; Frances E. Marchant, MD; Ernest L. McKenna, Jr., MD

What's Wrong?
Within your ear is a balance center called the labyrinth. It is composed of two partner chambers that work together to maintain your balance.

Diagram A
If the balance center becomes diseased, one partner won't carry his share of the work.

Diagram B
When one partner is slacking off, you may have trouble in the form of dizziness. It is called vertigo if you experienced a sensation that makes you feel as if the room around you is spinning or that you are spinning in place.

Diagram C
The longer the partners refuse to cooperate with each other, the more difficult it will be to coordinate them again.

Diagram D
The closer and more often the partners confront each other, the more quickly the problem, which is disequilibrium, will be solved. When the partners reach a mutual agreement, your balance mechanism will be restored.

Diagram E
About Your Problem
Although disequilibrium, or vertigo, is an extremely annoying and sometimes disabling symptom, it will not permanently affect the rest of your health. However, if it remains untreated, it may become worse. Although vertigo is a frightening symptom, it is actually a good sign. It is a signal that the two partners in your balance system are trying to work together. You can learn through exercise how to make the partners “confront each other.” This will force the balance chambers to work together to restore your balance. By doing “labyrinthine exercises,” you will intentionally cause vertigo. Doing this as often as you can tolerate will enable you to begin to control your symptoms. Medications will help you to tolerate the exercises.

Each dizzy spell that you induce will bring you closer to resolving your balance and getting well.

Labyrinthine Exercises

If your vertigo is related to changing positions of your head:
Place your head in the position that most frequently causes you to become dizzy for as long as you can tolerate it. Then gradually return the head to a midline position and rest. Attempt to repeat this four or five times at a sitting, four or five times per day.

If your vertigo is related to motion:
Choose a sport or activity that has become difficult for you because of your vertigo. Very gradually, begin to perform motions included in that activity each day. Do this for as long as you can tolerate, two or three times a day. You may induce significant dizziness during these exercises. If you challenge yourself by doing the most difficult activities or trying the most bothersome head positions, you will restore your balance more quickly.

Remember:
You can help yourself get better! As bothersome as these exercises are, it is only by doing them that you will recover.

Medication cannot solve your problem. It will help you tolerate the vertigo but, if the vertigo is unresolved, your balance will continue to deteriorate. Your doctor will ask to see you in the office about once a month.