Vertigo and TMS

[sacolucci23]

I experienced my second, severe BPPV episode three weeks ago (first was two years ago). The rehab therapist who initially helped me and who performs the one-time Epley Maneuver, was on vacation, so I did the Brandt-Daroff exercises at home for three days, and it was gone. Nevertheless, despite the assertion in #15, above, that BPPV is not TMS, I do believe - - in my case, at least - - that there was a TMS aspect at work. At the time, I was grappling with an issue that was causing me to be "off balance."

When you cure your BPPV, do you have any residual symptoms? My BPPV also happened during a really stressful time in my life also. I literally felt like my world was spinning from an emotional standpoint.

 

[sam908]

My experience with two disturbing episodes, two years apart, was that once it's cleared up, all seems to be back to normal. However, I should add that, once the BPPV was gone, I developed excruciating pain in my left foot and calf. That, too, is now history. That old Symptom Imperative keeps rearing its ugly head.

 

[sacolucci23]

See, with me, the BPPV is technically gone because the Dx-hallpike is negative now and more world spinning but i feel off balance all the time like I am rocking or not solid. This gets worse when I pay attention to it or am anxious. I also have a lot of anxiety like this is Meniere's or something they are not finding. The ENT says it's not Menieres because I don't have ear ringing but I do get aural fullness sometimes in this morning that dissipates as the day goes on. With all the anxiety I have it's probably what Claire Weekes explains as nervous illness.

 

[MindBodyPT]

Hello MindbodyPT and thank you for responding to me. Initially, I know I had BPPV. It would happen when I tilted my head to the right to do things like talk on the phone or reach over to the passenger seat to put my wallet in my purse. I would get a spinning/dizzy sensation. I went to the chiropractor and they laid me down to see if I would spin but I didn't so they assumed it was my neck. In reality, they didn't do the dx hall-pike test to confirm so they were erroneous in their diagnosis. I believe they made my BPPV at the time worse because they used this vibrating machine on my neck and after that, all hell broke loose. The episodes of positional vertigo became closer together and I ended up in the ER. Not one person did the dx hallpike but based on my symptoms were sure it was BPPV. They sent me home with the Epley worksheet.

When I laid back, head hung over to the right, I waited for 10 seconds and the spinning would come up rapidly. It would subside in about 10 seconds and then I would turn, etc. Eventually, the true spinning subsided but since then I am left with constant dizziness. I have gone to a vestibular rehabilitation therapist who then, did the dx-hallpike and there was no spinning so she confirmed it was gone. But what stumps me is when I look down now or to the side or even sit at the computer it sometimes feels like I am "about to spin" - it's strange. And when I talk (as I move my head around) I get dizzy bursts. I also have a constant sense of unsteadiness. According to the standard tests, I no longer have BPPV, so what does that leave me with?

Again, the neurologist says it now sounds like Migraine Associated Vertigo (dizziness/vertigo, room tilting, quick spins, headaches on left side, ear fullness on left side, no hearing loss). I do have some faint tinnitus which is not characteristic of MAV.

I have also developed extreme anxiety over this. I am always scared I will "spin out" even though I haven't since back in June when I technically cured the BPPV. I got up from that and OMG, the world was spinning. The ER doctor said it was a great sign that the particles had moved. But what do I have now? It is weird! Since you deal with vertigo can you help me understand MAV? I heard MAV is more episodic and not constantly...

This residual feeling of dizziness could definitely be TMS. Sounds like the original BPPV is resolved. Often tinnitus is also TMS. If you've been thoroughly worked up by all thee different doctors and therapists and nothing was found to cause the symptoms at this point, you can safely conclude it is TMS and treat it as such. MAV occurs due to migraines (as the name says!), which themselves are a form of TMS. Vestibular rehab or PT will not help in a TMS case, of course! It's just like pain. If the cause is truly structural like BPPV or other things (which have been ruled out for you), you treat them structurally. If the cause of vertigo is TMS, you treat the TMS. Let me know if you have a question!

 

[MindBodyPT]

I experienced my second, severe BPPV episode three weeks ago (first was two years ago). The rehab therapist who initially helped me and who performs the one-time Epley Maneuver, was on vacation, so I did the Brandt-Daroff exercises at home for three days, and it was gone. Nevertheless, despite the assertion in #15, above, that BPPV is not TMS, I do believe - - in my case, at least - - that there was a TMS aspect at work. At the time, I was grappling with an issue that was causing me to be "off balance."

This is a good point you make, that some symptoms you could experience might have a TMS factor at work. Though true BPPV is structural, just like pain syndromes, the TMS caused vertigo could "piggyback" off of an original case of BPPV. This happens all the time with TMS pain. So after the BPPV was resolved the dizziness may have persisted for you due to TMS...and doing the Brandt-Daroff exercises may have been a placebo cure at that point.

 

[sacolucci23]

MindBody, I am also getting adrenaline rush sensations randomly when I talk a lot or tense up at the computer, for example. It feels like an electrical pulse running through my brain. It's so scary!

 

[SawyerRhiannon]

See, with me, the BPPV is technically gone because the Dx-hallpike is negative now and more world spinning but i feel off balance all the time like I am rocking or not solid. This gets worse when I pay attention to it or am anxious. I also have a lot of anxiety like this is Meniere's or something they are not finding. The ENT says it's not Menieres because I don't have ear ringing but I do get aural fullness sometimes in this morning that dissipates as the day goes on. With all the anxiety I have it's probably what Claire Weekes explains as nervous illness.

How are you? I have this exact type of dizziness but cant tell if its TMS or a neck injury