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Loose Ear Crystals: How they make you dizzy and how to fix them

Loose Ear Crystals: How they make you dizzy and how to fix them

     You’re rolling over to your right in bed, when suddenly the room starts rolling over, too. For a couple of days the world spins each time you turn to the right—until the sensation fades on its own.

     The condition, called benign paroxysmal positional vertigo (BPPV), is downright scary because it takes you by surprise. And the dizziness, light-headedness and nausea lefty in its wake will keep you from working and doing normal activities.

     Episodes of BPPV can last for a few seconds, a few days, a few weeks or a few months and because it is so fleeting, it’s hard to get good data on how common an ailment this is.

What are ear crystals, anyway?

At the root of the problem are tiny calcium crystals that sense gravity, found within the chambers of the inner ear. Imagine a hill with blades of grass, and on top of each blade is a crystal. Together, these crystals form an interconnected matrix. Whenever the blades of grass move, so do the crystals.

The blades of grass represent cilia, hair-like processes that are attached to tiny nerves in your inner ear. When the crystals move, it stimulates the nerves to fire which tells the brain your head is moving.

This crystal matrix serves as a reliable motion-sensing map—until crystals break free, drifting into one of the ear’s three semicircular “balance” canals and creates havoc.

Why do loose crystals make you dizzy?

Normally, the fluid in the semicircular canals and the small, direction-sensing cupula in your inner ear move only when your head moves.

When the crystals are all connected, the fluid in the canals settles down as soon as your head stops. But when the crystals are disconnected, they keep moving in the fluid for up to a few seconds afterward.

Then your brain has to figure out, “Why is there movement when I don’t see it? And that is what makes you dizzy.” The fact that your eyes continue to move in response to this false cue gives doctors another way to confirm that you have BPPV.

Three factors make it more likely that ear crystals may loosen:

  • Age over 65 years
  • Head injury
  • Viral inner ear infections

You don’t need expensive tests to get a diagnosis of BPPV. Your doctor can diagnose it based on your pattern of symptoms and medical evaluation.  However, my personal opinion is that you must see an ENT (ear nose and throat specialist) because your family physician will prescribe a drug, Serc (betahistine) for dizziness and send you on your way.

How do you fix loose crystals?

An ENT doctor or vestibular physical therapist (PT) can show you how to do self-repositioning exercises at home. Collectively called the Epley maneuver, they move the ear crystals back into place, and are easy to do on a bed or on the floor.

When done in a medical setting, the success rate for these exercises is up to 90 per cent. Doing them properly on your own can be very effective but once the condition clears, the exercises should stop.

If the Epley maneuver isn’t helping you it may be because:

  • You have too many loose crystals
  • Crystals have drifted into more than one semicircular canal.
  • Both of your ears are affected
  • Your dizziness has a different cause

In these cases seek help from an ear nose and throat specialist—or go straight to a vestibular PT who can diagnose and treat BPPV. They can put you through additional exercises to move the crystals back into place.

Do ear crystals always cause vertigo?

Having loose crystals in your ear doesn’t necessarily make the room spin. Many people with BPPV don’t even feel dizzy—just lightheaded, unsteady or a bit “off”—but usually if you get tested they find crystals. You could even have leftover crystals without knowing it if you consistently avoid turning your head in the direction that triggered your symptoms. But the goal of the exercises is to get you back fully to normal function.

Is there a cure for BPPV?

It is something that just happens and cannot be prevented. It also affects different people in different ways. If it is caused by head trauma, it will diminish over time. Usually the Epley maneuver will allow you to stop the spinning sensations and light-headedness when the crystals get loose. However, if you get so nauseous that you cannot hold down liquids, or if weakness, numbness, tingling or changes in vision occur, you must seek help. It could be an indication of something more serious such as a stroke. That’s when you call 911.

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