HomeAnswersOtolaryngology (E.N.T)benign paroxysmal positional vertigoI am suffering from constant vertigo for more than a month. Please help.

What could be the reason for constant vertigo for more than a month?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Oliyath Ali

Medically reviewed by

iCliniq medical review team

Published At July 21, 2023
Reviewed AtSeptember 19, 2023

Patient's Query

Hello doctor,

I have had constant vertigo for more than a month. The vertigo feeling lasts for a second but is constant during the day. I feel it while standing, sitting, at every moment but I can say that it worsens with movement, for example: when I bend my head to eat something, when I brush my teeth, and on moving my head up and down I feel it. I have no other symptoms, no tinnitus, no hearing problem, no headache, and no nausea. Only these constant vertigo episodes. Eight months back I had an episode of benign paroxysmal positional vertigo (BPPV) at night when everything was spinning on one side. Could it have anything to do with that? That episode was very strong and severe, instead, these daily vertigo feelings are mild but constant and very annoying. Or could it be a central vertigo? Thank you.

Answered by Dr. Oliyath Ali

Hello,

Welcome to icliniq.com.

I read your query and understand your concern. Momentary vertigo associated with movement of the head is benign paroxysmal positional vertigo most commonly due to dislodging of the otoconia or otoliths in the posterior semicircular canal. You need to get the Dix-Hallpike maneuver to diagnose it and get correction maneuvers like Epley to get it corrected.

Hope this helps. Thank you.

Patient's Query

Hello doctor,

Is it possible that I do not anymore have that strong feeling I had at night but have this little one-second vertigo during the day? If left untreated, will it eventually go away on its own, and how long will it take?

Thank you.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Get the Dix-Hallpike Maneuver done. If it comes positive get the correction maneuvers, and you will get permanent relief. It hardly takes more than five to seven minutes. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

I have tried doing the Brandt-Daroff exercises but did not get the dizziness. Does it mean that it is not benign paroxysmal positional vertigo (BPPV) or can it still be BPPV even without getting it during the exercises?

Thank you.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes, the Brandt-Daroff exercise can speed up the compensation process of vertigo. But the conclusive test is Dix-Hallpike Maneuver. If it comes negative then it is not BPPV.

I hope this helps. Thank you.

Patient's Query

Hello doctor,

Can you please help me understand if it should be BPPV or not? If not, what else could it be? Also could you please let me know how I can find out if it is not a central cause of vertigo? If it was a central cause, what other symptoms should I have?

Thank you.

Answered by Dr. Oliyath Ali

Hello,

Glad to have you back! I am here to help you get the best medical advice.

If vertigo is a true rotatory sensation that is a feeling of self or the surrounding rotating and is only provoked by changes in head positions like suddenly looking up, taking turns in bed, hanging head from bed edge, and lasts for only a few seconds then it is BPPV.

Thank you.

Patient's Query

Hello doctor,

Yes, mine lasts for only one second but it is constant throughout the day. Can you please tell me that the fact that I did not get dizziness while doing Brandt-Daroff exercises means that it is not BPPV or is it also possible that you can do these exercises without getting it? Can you please also tell me if eventually, it will go away on its own?

Thank you.

Answered by Dr. Oliyath Ali

Hello,

I understand your concern. Dizziness and vertigo are different. Do you feel the surroundings or self-rotating? Or it is just unsteady or a feeling of sinking?

Thank you.

Patient's Query

Hi doctor,

I feel I am self rotating for one second (not the surrounding). For example I bend my head to eat and it is like I enter a vortex of one second and then it stops but it is many little episodes like this all day long. Please advise what you think based on the above.

Answered by Dr. Oliyath Ali

Hi,

Welcome back to icliniq.com.

I read your query and understood your concern. Sometimes after a positional vertigo a minor vertigo sensation remains which will be completely recovered after an Epley's or Simmonts maneuver. Your symptoms suggest you had a Frank positional vertigo, which is on the path of recovery but the maneuvers will speed up the recovery. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks for the reply doctor.

This seems realistic. What does it mean frank positional vertigo? Also, if the Epley maneuver is not done, will this little vertigo sensation eventually go away on its own? I do not have any other symptoms so I hope it is not a central cause vertigo.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Frank means full blown. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thank you doctor for the reply.

I had a genuine BPPV episode, and what I am experiencing now is a milder lingering sensation because it has not been resolved completely, correct? Can you please address this question as well: Will this residual vertigo sensation eventually dissipate on its own if the Epley maneuver is not performed? Kindly help.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes, eventually it will go away but will take some time. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thank you doctor,

It does not seem like a central cause vertigo, right? What are the warning signs of a central cause vertigo? Kindly help.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Central Vertigo lasts for longer duration and is associated with other neurological symptoms like headache and loss of sensation. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks doctor for the reply,

I do not experience any of those symptoms. Do you think that medication containing Cinnarizine and Dimenhydrinate will help?

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. No, those medications you mentioned will not help. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Hello doctor,

I am performing the Brandt-Daroff exercises at home twice a day, but I am not experiencing vertigo during the exercises. Does this lack of vertigo sensation mean it is not BPPV, or could BPPV still be present even if it is not triggered by these exercises? Thank you.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. It is still BPPV even if not provoked by these exercises because you are on the recovery phase when most of the otoliths have settled to their normal position and significant compensation has happened. BPPV or other positional vertigo of the other two canals are provoked by head movements mostly in the acute phase. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks doctor for the reply,

Another thing I wanted to ask is that sometimes I notice that I get scared from loud noises. Does that have anything to do with this problem? It is like I am feeling increased sensitivity to sound. Please advise

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes that is a significant history. I suggest you get a Pure Tone Audiometry test done. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks for the reply doctor,

Could this symptom be linked to BPPV? Or is it possible that it is occurring due to increased stress, making me more sensitive to various sensations?

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. If there is sound sensitivity, it is unlikely to be related to BPPV. It could suggest that the issue is not BPPV, but rather another condition involving both the vestibular and cochlear systems, or it may be attributable to stress. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks for the reply doctor,

A few years ago I suffered again from dizziness and my ENT reported this: nystagmus directed to the right in the supine position with the head rotated to the left, in this case was it BPPV? What is a nystagmus directed to the right mean? Kindly explain.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Nystagmus is rhythmic eye movements during vertigo, can indicate the direction of the fast component. In BPPV, brief episodes of nystagmus lasting only a few seconds can be observed. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks doctor for the reply,

I have another question that is unrelated to BPPV, but since you are a doctor, I would like to ask anyway. Two people I have never met before have told me that the right side of my face, specifically my right cheek, appears more swollen than the left. This is starting to concern me. What potential issue could be causing this, and which type of specialist should I consult for further evaluation? It is not causing me any discomfort, but if two individuals have noticed it, I feel there may be an underlying concern. Thank you.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. For that you need to get on a video consultation, So that I can have a look at the signs. And it we be better to have a one to one discussion to clear all your doubts and to get a an accurate diagnosis. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks for the reply doctor,

I understand but what are the possible causes for that? Kindly suggest.

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. One side facial swelling can be caused by multiple factors like parotid swelling, facial nerve weakness, any infection or inflammation in the subcutaneous tissues. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Patient's Query

Thanks for the reply doctor,

Is it possible that dental malocclusion or issues with the jaw bones could be contributing to this observation of facial asymmetry?

Answered by Dr. Oliyath Ali

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. Yes, that can also cause facial asymmetry. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Oliyath Ali
Dr. Oliyath Ali

Otolaryngology (E.N.T)

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