Dizziness and Fibromyalgia

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Vertigo is the false sense that one is in motion or spinning. Vertigo typically results from a problem with the body’s balance-regulating system, which is located in the inner ear. This system, known as the vestibular system, senses changes in movement and head position. For individuals with vertigo, moving around may make symptoms worse, even to the point of causing nausea, vomiting and imbalance.

Vertigo may be caused by a number of conditions and situations. Benign paroxysmal positional vertigo, or BPPV, is the most common cause and is characterized by brief episodes of vertigo following a change in head positioning. Examples include turning over in bed or sitting up first thing in the morning. Other potential causes of vertigo include inflammation of the inner ear (labrynthitis), Meniere’s disease (excess buildup of fluid in the inner ear), migraines, acoustic neuroma (a benign tumor on the vestibular nerve), as well as stroke, brain hemorrhage, and multiple sclerosis

The dizziness that is caused by vertigo can increase an individual’s risk of falling and can make driving a car or operating machinery extremely dangerous. Diagnosis of vertigo is usually made by evaluating an individual’s eye movements, posture and balance, and in some cases through the use of magnetic resonance imaging (MRI; an imaging technique that uses a magnetic field and radio waves to create detailed pictures of the inside of your body).

Vertigo is treated in a number of different ways. Individuals whose vertigo is caused by BPPV can be treated with something known as canalith repositioning, in which a doctor or physical therapist maneuvers the individual’s head position. Individuals with inner ear problems, such as labrynthitis, may benefit from balance retraining exercises as well as medications like beclizine and dimenhydrinate (Dramamine) to offset nausea and dizziness. Diuretics can help relieve vertigo in individuals with Meniere’s disease, and avoiding migraine triggers can help prevent migraine-associated vertigo. Natural remedies that have been investigated to help ease the symptoms of vertigo include ginger and ginkgo, both of which have demonstrated some effectiveness in research studies (Grontved & Hentzer, 1986; Diamond et al., 2000; Cesarani et al., 1998; Haguenauer et al., 1986).

Dizziness and Fibromyalgia

Dizziness is a common symptom reported by fibromyalgia patients, however there is a lack of research related to its specific association with the disease. A 1996 study found a prevalence of vertigo and dizziness in 72% of the 168 patients studied (Rosenhall et al., 1996).  A 2002 study by Bayazit et al. assessed the ear-related symptoms in 24 female patients with fibromyalgia. The authors performed physical exams and a number of ear and hearing tests on each subject and found that 50% of the patients had either dizziness, ringing in the ears, hearing loss, or vertigo. Many of the patients complained of these symptoms in the absence of any clinically detectible ear disease, which lead the authors to suggest that perhaps the occurrence of vertigo and other ear-related disturbances in fibromyalgia patients are the result of some type of nerve dysfunction (Bayazit et al., 2002). A 2009 study evaluated the frequency of various neurological signs and symptoms in both fibromyalgia patients and healthy control subjects. Each subject completed a physical examination by a neurologist as well as a questionnaire designed to assess neurologic symptoms over the previous three months. The researchers found that 30% of the 166 fibromyalgia patients had vertigo versus only 1% of the 66 healthy control subjects (Watson et al., 2009).

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References

1.        Bayazit YA, Gursoy S, Ozer E, Karakurum G, Madenci E. Neurotologic manifestations of the fibromyalgia syndrome. J Neurol Sci. 2002;196(1-2):77-80.

2.        Cesarani A, Meloni F, Alpini D, et al. Ginkgo biloba (EGb 761) in the treatment of equilibrium disorders. Adv Ther. 1998;15:291-304.

3.        Diamond BJ, Shiflett SC, Reiwel N, et al. Ginkgo biloba extract: mechanisms and clinical indications. Arch Phys Med Rehabil. 2000;81:668-678.

4.        Grontved A, Hentzer E. Vertigo-reducing effect of ginger root. A controlled clinical study. ORL J Otorhinolaryngol Relat Spec.1986;48(5):282-286.

5.        Haguenauer JP, Cantenot F, Koskas H, Pierart H. [Treatment of equilibrium disorders with Ginkgo biloba extract. A multicenter, double-blind drug vs. placebo study]. Presse Med. 1986;15:1569-1572.

6.        Rosenhall U, Johansson G, Orndahl G. Otoneurologic and audiologic findings in fibromyalgia. Sancd J Rehabil Med. 1996;28(4):225-232.

7.      Watson NF, Buchwald D, Goldberg J, Noonan C, Ellenbogen RG. Neurological signs and symptoms in fibromyalgia. Arthritis Rheum. 2009;60(9):2839-2844.

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