Crystals play an essential role in our inner ear to have good balance. They can therefore cause dizziness.
Crystals, medically called otoliths Or otoconiaare small mineral particles composed mainly of calcium carbonate. These crystals are naturally present in the inner ear, at the vestibule. “The ear is made up of the cochlea, for hearing, and the vestibule for balance” recalls Dr. Vincent Burcia, ENT. Thanks to these crystals, the inner ear sends information to the brain on the location of the head in space and its changes in position in order to maintain balance. Within the inner ear, the otolithic organs are composed of stuck eyelashes in gelatinous membrane. The crystals are located within this gel. “When we move the head, we create a phenomenon of centrifugal force while the crystals are sensitive to inertia. The brain then interprets “I turned my head 30 degrees to the left at this speed” “explains Dr. Burcia.
In pathological situations, crystals can to have moved and have migrated inside the semicircular canals of the inner ear, or to have agglutinated each other. This can give a feeling of movement very intense in one ear, discordant with the information from the ear which is fine.
“The patient may be overcome by vertigo”
It is this asymmetry of stimulation that causes the dizziness felt by patients. “When we talk about dizziness linked to crystals, we call it “stereotypical”. All dizziness is similar: intense, immediately maximal, brief – a few seconds up to a minute maximum – with a vegetative syndrome, nausea and vomiting… The patient may be overcome by dizziness, have the feeling that he cannot move and this may be until the fall.” It is important to point out that this dizziness, although uncomfortable and sometimes impressive, is benign.
In two thirds of cases, the cause is not found
In two thirds of cases, the cause is not found. We then talk about idiopathic syndrome. In a third of cases three mechanisms are involved :
- There dehydration
- L’prolonged bed rest
- THE trauma : “If you fall and hit your head, through a phenomenon of centrifugal force all the crystals will come to the area of the point of impact.”
Only treatment: the liberating maneuver
If the drug treatments anti-vertigo drugs can create a phenomenon of reduction of vertigo, “They don’t go on the other hand not cure him“assures Dr. Burcia. “The only effective therapy is liberating maneuver.” This manipulation can be carried out by an ENT specialist, or a physiotherapist or a trained general practitioner with expertise in vestibular diseases. A first maneuver – that of Dix-Hallpike – is carried out to allow a diagnosis. If this reveals dizziness, the practitioner carries out a so-called “liberating” maneuver, that of Epley or Semont. For that, “we make the patient’s head describe a fairly lively semi-circle movement so that the crystals follow the semi-circular shape of the canal and are found in an area of the inner ear where the body will subsequently have the capacity to reabsorb this accumulation of crystals“. In general, carry out the maneuver only once is enough. However, “it is estimated that a certain number of patients need a 2nd maneuver, either because there is a remainder of crystals, or because by performing the maneuver, the crystals tipped in another area of the ear. This can manifest itself later.. If crystal-related dizziness is always benign and of little concern, differential diagnoses, on the other hand, may require a emergency care. So, if you feel dizzy, it is important to contact 15 so that a doctor can rule out more serious pathologies that would require a trip to the emergency room.
Thanks to Dr. Vincent Burcia, ENT.