Our internet searches with the symptoms as described revealed a condition called BPPV - Benign Paroxysmal Positioal Vertigo. It is not a diving related illness but it can be triggered by several common activities including diving. It is more commonly associated with flying and can also be triggered by something as simple as standing up quickly. It is the most common form of vertigo and can have all of the symptoms that my son experienced or just mild dizziness at the other end of the spectrum.
Within the
labyrinth of the inner
ear lie collections of calcium crystals known as
otoconia. In patients with BPPV, the otoconia are dislodged from their usual position within the
utricle and they migrate over time into one of the
semicircular canals (the posterior canal is most commonly affected due to its anatomical position). When the head is reoriented relative to gravity, the gravity-dependent movement of the heavier otoconial debris (colloquially "
ear rocks") within the affected semicircular canal causes abnormal (pathological) fluid
endolymph displacement and a resultant sensation of
vertigo. This more common condition is known as
canalithiasis
We also found a series of physiotherapy manoeuvres to releave the symptoms.
The Epley maneuver (particle repositioning) does not address the actual presence of the particles (otoconia), rather it changes their location. The maneuver aims to move these particles from areas in the inner ear which cause symptoms, such as vertigo, and repositions them to where they do not cause these problems.
The Brandt-Daroff exercises may be prescribed by the clinician as a home treatment method usually in conjunction with particle repositioning maneuvers or in lieu of the particle repositioning maneuver. The exercise is a form of habituation exercise, designed to allow the patient to become accustom to the position which causes the
vertigo symptoms. The Brandt-Daroff exercises are performed in a similar fashion to the Semont maneuver; however, as the patient rolls onto the unaffected side, the head is rotated toward the affected side.
[11] The exercise is typically performed 3 times a day with 5-10 repetitions each time, until symptoms of vertigo have resolved for at least 2 days.
Yesterday afternoon after several Epley Maneuver applications the sypmtoms all but disappeared. He felt well enough that this morning we took the Tank-Ha trip to Cozumael and did two dives. The dives were no problem. The slight underlying feeling of dizziness is still there but it could persist for a couple of days according to the information we garnered. He will repeat the Epley again a couple times tonight and still plan to dive tomorrow. After the rough boat ride back from Cozumel I haven't found my land legs yet either.
He will be making an appointment to see his doctor and get referred to ENT as soon as he gets home even it the symtoms are completely gone.
