What is Alternobaric Vertigo?
Alternobaric vertigo is a harmless condition that often affects individuals in situations where the pressure in the environment is constantly changing. This may occur during activities such as scuba diving, flying, or even when a person uses devices to help them breathe, like positive airway pressure machines. This condition happens because of a mismatch in pressures in the middle part of the ears, usually when moving from high pressure to lower pressure areas. This situation is often due to inadequate equalization of pressure.
Factors that can increase the chances of experiencing alternobaric vertigo include having a recent cold or sinus infection, using decongestants, or having an abnormal structure of the Eustachian tube (the tube that connects the middle ear to the back of the nose). Even though the episodes of vertigo, or the sensation of spinning, are typically mild and tend to resolve as one ascends to higher elevations or by using techniques to balance the pressure in the ears, there have been reports of these symptoms lasting for a few days or weeks.
What Causes Alternobaric Vertigo?
Alternobaric vertigo is a condition that occurs due to uneven pressure across the middle ear chambers. This means that the pressure in one ear is different from the pressure in the other ear.
Risk Factors and Frequency for Alternobaric Vertigo
Alternobaric vertigo is a type of dizziness caused by changes in pressure. Earlier studies indicated that 10 to 17% of people involved in activities where they are exposed to such pressure changes experience this condition. However, a recent study on Portuguese Air Force pilots found that 29% of them had symptoms of alternobaric vertigo, suggesting that the condition might be more common than previously thought. It’s also believed that the actual number might be higher, as many people don’t report the condition because it’s typically harmless and goes away on its own. Studies with smaller groups of people have also suggested that women are more prone to alternobaric vertigo than men.
- Alternobaric vertigo is a kind of dizziness resulting from changing pressures.
- Initial data showed that the condition affects 10 to 17% of people taking part in activities involving such pressure changes.
- Recent research on air force pilots pointed to a higher prevalence, with 29% reporting symptoms.
- The actual occurrence rate might be even higher due to underreporting, especially given the condition is generally benign (harmless).
- Some small-sample studies indicate women might experience alternobaric vertigo more often than men.
Signs and Symptoms of Alternobaric Vertigo
Peripheral vertigo is a condition that affects your balance, and it’s something doctors can often spot through certain symptoms and physical exam findings. If a person has peripheral vertigo, they might struggle with their balance, especially when walking. These issues can get worse depending on their body position, and standing upright can sometimes be the toughest. They may also experience a symptom known as horizontal nystagmus, where their eyes make repetitive, uncontrolled movements. People with peripheral vertigo often feel like things are spinning in the direction of the ear with more pressure in the middle. Tests like the head impulse test and test of skew can help confirm a diagnosis of peripheral vertigo. Importantly, apart from these symptoms, the person’s neurological examination would usually show normal results.
- Struggles with balance, particularly when walking
- Worsening symptoms based on body position, with standing up being the most challenging
- Presence of horizontal nystagmus – uncontrolled eye movements
- Sensation of spinning towards the ear with increased middle ear pressure
- Positive results on the head impulse test and test of skew, which indicate peripheral vertigo
- Normal results from a neurological examination, apart from these symptoms
Testing for Alternobaric Vertigo
If your doctor suspects that you have alternobaric vertigo, which is a type of dizziness caused by pressure changes in the ear, they’ll start by asking you about your symptoms and examining you. They may also perform a few tests to check how your Eustachian tube is working.
The Eustachian tube is a small canal that connects your middle ear to the back of your throat. It plays a crucial role in maintaining equal pressure on both sides of the eardrum, which is important for normal hearing and balance.
These tests may include sonotubometry and impedance testing. Sonotubometry uses sound to measure the opening of the Eustachian tube. Impedance testing is a way of checking how air flows through the Eustachian tube. If these tests reveal that the tube is narrower than it should be – a condition known as tubal stenosis – it could be a sign that you’re suffering from alternobaric vertigo.
Treatment Options for Alternobaric Vertigo
The primary way to treat alternobaric vertigo, an inner ear condition, is to balance the pressure between both middle ears. Generally, this involves closing one’s nostrils and trying to exhale forcefully with a closed mouth. This process is designed to open up the Eustachian tubes – the small tubes that connect your throat to your middle ears and help regulate pressure – to allow the pressure to equalize between each middle ear and the throat area.
It’s crucial for those suffering from vertigo not to panic; panic can worsen the situation, particularly if the person is in a potentially dangerous environment where poor judgment could lead to injury. For instance, if vertigo occurs while diving, the person should stop moving up or down and attempt to stay at the same depth in the water. They can then try the pressure equalization technique described above. Over time, this should help reduce their vertigo symptoms.
What else can Alternobaric Vertigo be?
Vertigo, especially while diving, can be a symptom of various health conditions – some mild and others severe. When symptoms are brief and last less than a minute, it’s often less serious. However, symptoms lasting more than a minute should be taken seriously and might indicate severe conditions. Here are some common causes of vertigo in situations of changing pressure:
Transient (Symptoms Last Less Than a Minute)
- Alternobaric vertigo: This is caused by unequal pressure in the middle ear spaces.
- Caloric: This type of vertigo is triggered by temperature differences between the left and right ears.
Persistent (Symptoms Last More Than a Minute)
- Inner ear barotrauma: A significant failure to balance the pressure in the middle ear chambers can cause actual damage to the inner ear.
- Vestibular decompression sickness: This condition occurs when air bubbles form in the circulatory system and tissue. If this is the cause of vertigo, other neurological issues may also present. This is a serious condition that needs immediate medical attention with oxygen administration and a trip to the nearest hyperbaric facility.
- Arterial gas embolism: Similar to decompression sickness, this results from an air bubble forming in the circulation, hindering blood flow and causing a stroke. Like decompression sickness, this is a serious emergency that requires hyperbaric treatment.
What to expect with Alternobaric Vertigo
The outlook for this condition is generally excellent. Most people will find relief from symptoms within seconds to minutes once the pressure in the middle ears has been equalized. However, in some cases, these symptoms might last for days or even weeks. In such situations, it’s crucial to check for any more serious causes of dizziness.
