Vertigo when snorkeling/never while diving

[cinderella]

Hi everybody...
I hope to get some answers from you. I have been diving for the last 13 years without problems. Five years back a had an episode of heavy dizziness that lasted for 1 week and it was so bad that i couldnt move for 3 days withouth vomiting. After that I went to the doctor, did some test and told me it was probably vertigo, however he told there is no explanation accepted till moment for that. After that never experienced it again.
For the last 6 month i have been snorkeling frequently without problems, however the last 2 times, I experienced the same dizziness. Usually is only 2 meters depth (only!!!). first time it started after 1 hr inside the water, after that the dizziness increased to a level i was knocked out, couldnt drove back home and do anything for 2 days, then I was perfectly fine. Last time was less severe, conditions were similar 2 hrs snorkeling, same depth. This time I was all right, when I came out of water I was not dizzy but I felt like " pressure on my head", I drove back home and when I reached I felt dizzy again, and once I started vomiting and couldt stop,this because just a slight movement and I felt dizzy. 24 hr later I was perfectly fine, like nothing happened. I havent went for diving since then..Went to the doctor and told me it could be bening positional vertigo and there is nothing I can do...that it might never come back again....and that sending me to MR studies will be just waste of time and money...., I need to keep doing this activities for my research...but Im wondering how can I reduce the risk of having this kind of crisis...or how should I react on this..hope to hear from you... any suggestions are most welcome!!!

Cinderella

 

[headsqueeze]

You may be experiencing problems from otoliths. Epley maneuvers might help. google 'epley maneuver' for links.

 

[DocVikingo]

Hi Cinderella,

How odd and unfortunate. However, it does not appear that the medical work-up and treatment to date have been sufficient to justify hanging up one's fins forever.

Let's begin with some questions for follow-up:

1. Have you even experienced one of these episodes when not diving/snorkeling?

2. Do you dive/snorkel in cold or warm water?

3. Do you wear a hood?

4. Do you tend to snorkel with one ear submerged more often than the other?

5. Do you take any particular medications prior to diving/snorkeling, e.g., motion sickness, antihistamine, decongestant drugs?

In the meantime, as "headsqueeze" has suggested, what is described could be a disorder of the "ear rocks," tiny crystals known as canaliths, otoliths or cupuloliths, depending upon their precise location. As such, the diver will want to contact an ENT who specializes in benign paroxysmal positional vertigo (BPPV) and similar inner ear disorders for a proper evaluation. The patient and the ENT will then jointly decide if procedures such as MRI, CT, electronystagmography (ENG), rotation tests and computerized dynamic posturography (CDP) are indicated or "just a waste of time and money."

One way of evaluating for the possibility return of symptoms is by having an ENT perform the Dix-Hallpike test (Dix-Hallpike test for vertigo). If the test is positive, diving and snorkeling probably would be contraindicated.

Treatment with repositioning protocols like the Epley and Semont maneuvers (BPPV -- BENIGN PAROXYSMAL POSITIONAL VERTIGO) or Brandt-Daroff exercises (Brandt-Daroff exercise for vertigo) is effective in some cases of BPPV and similar conditions, although about 30 percent of patients will have a recurrence within three years. The return of such attacks are thought to be a result of the crystals having moved to another location within the inner ear, either spontaneously or as a result of repositioning procedures, but over a period of time again migrating to an area (e.g., the posterior semi-circular canal) where vertigo can be triggered.

Diving or snorkeling with an even remotely recent history of unexplained vertigo would be considered risky business. One would not want to do so without the expressed consent of a physician expert in this disorder.

Helpful?

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[buddhasummer]

had a very similar thing twice, first time lasted about two weeks severe and then about 2-3 months on and off and then went away then I got it again about 5 years later this time much worse spent about a week in bed and everytime I moved even the slightest Id throw it got a little better i.e. no more throwing up but I had symptoms on and off for about 3 months, went to the doctor they told me prob a virus of the inner ear said there is nothing they could do except prescribe anti vomit meds, said I might get it again or I might never get it again, anyway I feel for you it absolutely sucked, without a doubt the worst illness Ive had even worse than a kidney stione at least that only lasted 6 days and then was done. I know this isnt helpful but just wanted you to know I feel for ya. Goodluck I hope it goes away.

 

[BlueDevil]

Firstly let me state I am not a medical expert but thought it worth mentioning this in case it may be of benefit to you. Sometimes vertigo can result from problems with the neck, a condition called cervical vertigo. Some years ago I was treated for suspected inner ear decompression illness as I was having periods of dizziness after doing some deep dives. However some time later I got identical symptoms of dizziness at a time when I had not been diving for some time. I just happened to mention this to my osteopath while I was having my lumbar back worked on and she said it could be coming from my neck. She did some work on my neck and my symptoms fully resolved. I have returned to the osteopath several times over the years for the same problem with good results. I now suspect that I probably didn't have inner ear DCS, but rather cervical vertigo. Note that I had absolutely no symptoms of neck pain nor had I had any significant neck injury.

I was talking with a diving doctor recently and he mentioned that a colleague of his specialised in dizziness disorders. He said that this colleague refers many of his patients to a physiotherapist for assessment of possible neck problems.

I raise this because I have a belief that diving may exacerbate this problem. Diving tends to put the neck into extension often for long periods. When you are diving/snorkelling you tend to be horizontal in the water but looking ahead to see where you are going which places the neck in an unnatural position.

Now of course this may not be the cause of the problem that the original poster has experienced and I don't want to pretend to have any medical diagnostic abilities in this area. Benign positional vertigo as suggested would certainly be one of the possibilities, along with labyrinthitis etc. However assessment by an osteopath or physiotherapist couldn't do any harm. Necks can also cause headaches and feelings of "heavy headedness" or "clouding" (I note you mention "pressure on my head").

Here is an article you could have a look at (I can't attest to its medical accuracy):
American Hearing Research Foundation (AHRF) Cervical Vertigo
Or just do a Google search on cervical vertigo.

 

[DandyDon]

You've already received good posts from DrV and some others using words I've never heard so I certainly have nothing to add, but would like to ask about a couple of your statements...

I have been diving for the last 13 years without problems. Five years back a had an episode of heavy dizziness that lasted for 1 week and it was so bad that i couldnt move for 3 days withouth vomiting. After that I went to the doctor, did some test and told me it was probably vertigo, however he told there is no explanation accepted till moment for that. After that never experienced it again.

Was that episode from scuba diving? If so, what were the conditions, including particulate in the water?

For the last 6 month i have been snorkeling frequently without problems, however the last 2 times, I experienced the same dizziness. Usually is only 2 meters depth (only!!!). first time it started after 1 hr inside the water, after that the dizziness increased to a level i was knocked out, couldnt drove back home and do anything for 2 days...

Well, you were not snorkeling at 2 meters. I take it that you were snorkeling and free diving to 2 meters repeatedly to get to the floor in shallow water - lots of ups and downs while looking at a shallow floor? Is this correct?

A couple more: Did you have any problems equalizing to 2 meters or did you just accept the slight squeeze? And have you ever had sinus or hay fever type problems, do you take meds for such, did you before that free diving?

 

[cinderella]

Thanks to everybody, ill consider your suggestions and let you know the result....positive hopefully...thanks again

 

[DocVikingo]

Thanks to everybody, ill consider your suggestions and let you know the result....positive hopefully...thanks again

Hi Cinderella,

Yes, since both Don and I have asked you numerous questions which have as to be answered, we would appreciate the courtesy of knowing the result.

Thanks,

DocVikingo