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From a medical terminology standpoint, vertigo is the sensation that the world is spinning around you, or that the world is still and you are spinning. But what’s it really like?

From a personal standpoint, everyone experiences vertigo differently. I have had many patients who seem to have a mild case, and find it to be mainly an annoyance. In the case of BPPV (Benign Paroxysmal Positional Vertigo), there are some patients who only experience the spinning when getting in and out of bed, and since the spinning only lasts less than a minute, the person finds it to be more of a nuisance than anything else.

I have also had patients who complain of dizziness and imbalance only (not a spinning sensation), and then when I test them for BPPV it turns out they have BPPV after all. There have even been times when the nystagmus (spinning of the eyes) is extremely strong, and the patient denies feeling dizziness or spinning at all!

On the other hand, I have some BPPV patients who have an incredibly strong case of BPPV, and the vertigo sensation feels incredibly violent and awful. Sometimes it causes nausea, and can be very frightening. One of my new BPPV patients last week had such a strong sensation of spinning that she said she would rather get her other hip replaced than have to have vertigo again. She felt like she could control her pain with a hip replacement, but she couldn’t control her vertigo.

I have also had BPPV patients who are so afraid of their vertigo, that they don’t want to do the repositioning maneuver because they might feel the spinning again. Of course, this is not a logical or viable option, because if they don’t get treated they are very likely to have continued vertigo, but if they do get treated they are very likely to make the vertigo stop. What would you choose? So far, no one has refused treatment once they really understand that this is their best alternative. 

Luckily for those with BPPV, the vertigo only lasts for seconds. And again, luckily for BPPV, most people respond to the repositioning maneuvers, and we are able to stop their vertigo.

Flying People by Karel Appel, 1971