Getting up from bed in the morning is what marks the start of a new day for most people, but for 45-year-old Linda Teo, it meant lying down again to recover from a dizzy spell.
The dizziness started three years ago. She would turn over in bed and suddenly feel the room spinning around her. The same happened when she got out of bed, and when she was hanging clothes to dry. She had to stop going to the beauty salon because it would also happen when she tilted her head back for a hair wash or facial.
The mum of two is an operations manager in a distribution centre and put her dizziness down to work stress. But she had to seek help when the attacks became more frequent, ranging from a mild attack of five minutes where the room did not spin so fast, to an eight-minute attack where she felt her eyes were out of control and she would be left feeling nauseous for the rest of the day.
Dr Eng Soh Ping, Consultant Otolaryngologist who saw Linda diagnosed her as suffering from Benign Paroxysmal Positional Vertigo, or BPPV.
“BPPV is the most common cause of dizziness in the ear, nose and throat clinic. Out of 10 patients complaining of dizziness, as many as four or five will be due to BPPV,” he said.
He explained that the inner ear is a balance organ, and BPPV is thought to be caused by debris (formed from small crystals) which has dislodged and collected in another part of the inner ear.
“The problem is that these crystals have an important function. When we dip our head to the left or the right, these crystals send signals to the brain so that it can interpret exactly
where the position of your head is with relation to gravity,” said Dr Eng.
If the crystals are deposited in an outlying area, they start to send mixed signals. And because of these mixed signals, the brain cannot interpret what is going on, leading to dizziness. “But if you right your head again, the dizziness dissipates,” he added.
According to Dr Eng, 90 per cent of patients can recover with rest combined with the Epley maneuver or the particle repositioning procedure.
Linda started seeing Dr Eng every three months for her Epley maneuver. He would tilt her head into various positions and move the crystal particles out of the sensitive part of the ear.
The procedure helped Linda initially, but her attacks became more frequent. From an interval of months between each attack, it came down to weeks and then only days.
“The majority of patients recover but less than 10 per cent may not respond to anything you do. Linda is one of those patients. Under this circumstance, I might offer them surgery, which is posterior canal occlusion,” said Dr Eng.
The surgery, he explained, involved cutting behind the ear, drilling a hole all the way to the ear canal and plugging the area where the crystals are moving around. After the surgery, the patient will no longer experience dizziness even when turning the head as there is no movement of crystals. The surgery takes around two hours.
Linda was the first patient in CGH to undergo posterior canal occlusion, but she wasn’t nervous at all. She said, “I had full confidence in Dr Eng, and I really couldn't wait any more as we had tried everything else.” In January 2008, while everyone else was celebrating the New Year, Linda was celebrating getting her balance back.
“People suffer from this problem for years and do nothing because they probably think it is down to old age. It can be inconvenient and there is the technical expertise available to treat it,” said Dr Eng.
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