Post-traumatic vertigo is a balance disorder that often occurs after a head or neck injury. The condition is common among victims of car crashes, slip and fall accidents, and sports injuries. For some people, symptoms persist for weeks or months after the trauma. For others, life-altering effects last years. In severe cases, victims never fully recover.
Understanding Vertigo
Vertigo creates a sensation that the individual is in motion when no movement exists. Individuals with vertigo may complain that the room feels as if it is “spinning.”
Vertigo is caused by problems within the inner ear that disrupt signals from the vestibular system. These are the three pairs of canals that are located behind the ears and their function is to convey to the brain what position the cranium is in as the body moves. This helps keep the body balanced and tells the brain how to move the eyes, neck, and limbs as the body moves.
When these signals are disrupted, it disturbs the person’s balance and can affect coordination. When the individual suffers a TBI or neck injury, damage to the ears and nervous system can make the victim feel faint and lightheaded. It can also cause the person to have double-vision and experience bouts of nausea and vomiting.
Benign Paroxysmal Positional Vertigo
People who suffer from post-traumatic vertigo can experience a wide range of symptoms. Approximately 60% of victims with post-traumatic vertigo suffer from benign paroxysmal positional vertigo (BPPV). This occurs when trauma causes the otoconia, or debris, within the ear canals to break free from the utricle and float within the inner ear. In people with BPPV, symptoms only appear when the head is placed in certain positions.
Other causes of post-traumatic vertigo can include damage to the membranes, damage to the otolith organs, or damage to the temporal bone.
Post-Traumatic Meniere’s Syndrome
People with post-traumatic Meniere’s Syndrome experience episodes of dizziness accompanied by hearing loss, tinnitus, or pressure in the ear after head or neck trauma. Symptoms are caused when scarring of the drainage pathways causes fluid build-up after a head injury. While some victims experience symptoms of post-traumatic Meniere’s Syndrome immediately, others show no signs for months after the incident occurred. People who experience severe head injuries and those who have pre-existing conditions are at increased risk of suffering from post-traumatic Meniere’s Syndrome.
Cervical Vertigo
Cervical vertigo is characterized by dizziness that occurs when the head is turned about the vertical axis regardless of the orientation of the head to gravity. For example, a victim with cervical vertigo may experience dizziness when turning the head while sitting upright.
Cervical vertigo occurs following a severe neck injury, such as whiplash, that disrupts the function of the vestibular system. Likewise, a temporal bone fracture can occur when the individual suffers a blunt head injury. Most often, temporal bone fractures occur when the individual suffers an extra-axial hemorrhage or cerebral contusion. This can result in permanent hearing loss if left untreated.
Testing and Diagnosis for Post-Traumatic Vertigo
It is vital that people who are experiencing dizziness after a head or neck injury receive a medical evaluation from a qualified ear, nose, and throat specialist. The physician will determine what factors occurred and how they may have impacted the function of the ear. For instance, contact with a hard surface or the deployment of an airbag in a motor vehicle accident can cause post-traumatic vertigo.
Doctors often evaluate victims for dizziness using a balance test. This is often done via a moving platform posturography but can be done with video Frenzel goggles. The physician may also request an audiogram, and possibly an MRI or CT scan. Finally, the physician may order an IMPACT test to determine the psychological impact of the injury. This assesses the impact of the injury on the individual’s cognitive functions, personality, etc. Combined, these tests help rule out medications, dehydration, migraines, anxiety, mood disorders, etc. as potential causes of the individual’s symptoms.
Treatment for post-traumatic vertigo is essential. Most people with the condition will suffer persistent symptoms including sharp headaches and dizziness. Post-traumatic vertigo can also cause significant psychological distress, anxiety, and limit the victim’s ability to work. It is rare for these injuries to heal without medical treatment.
The canalith repositioning procedure is a non-surgical treatment that requires the individual to make a series of head movements to help remove the loosened debris within the ear canal. By removing the debris, it can no longer disrupt the signals between the ear canal and the brain.
Other treatments for post-traumatic vertigo include rest, prescription anti-nausea medication, and vestibular rehabilitation therapy. Treatments may also require the removal of triggers within the victim’s environment and treatment of any migraines the individual experiences as a result of the TBI.
