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Sensory Conflict, nausea and some ANS info


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For those who suffere lots of constant motion sickness feelings or what I call perpetual morning sickness (though I was never pregnant!) or dizzieness, or evey experienced that feeling where the floor under you is diagonal and the room is spinning, an interesting article.

Many with POTS have these feelings and it was interesting to read about how this hits in our sleep though i guess I should've known that since the brain is always working...but I wonder if this is part of my alpha delta sleep disturbances?

Can't remember if I posted it here but it's on a couple other sites I visited.



Although there are many causes of dizziness, five major categories will be reviewed: sensory conflicts, psychological problems, blood flow disorders, pharmaceutical effects, and systemic disease (including aging). Of these causes, sensory conflicts will be discussed in greatest detail because they are most closely related to problems involving the visual system.

Sensory Conflicts

Sensory conflicts often produce dizziness, typically with a major vertigo component. Under normal circumstances, the brain compares inputs from all of its sensory systems to determine posture, position in space, and body movement. When the information from all of the systems agrees, there is no problem. But, when disagreement is noted, problems begin. Even in normal patients, these sensory disagreements can occur when riding in the back seat of a car or in an airplane.(24) This is because the vestibular system detects motion/acceleration, but the visual system sees only the inside of the vehicle which remains fixed in space with respect to the observer. Another example is viewing a wide screen movie in which the audience vicariously experiences flying a jet fighter. The visual system reports motion, but the vestibular apparatus does not.

For example, in an airplane your vestibular and muscle senses might tell you that you are going up and down, tipping over, hitting severe turbulence, about to crash, etc., but your visual system says that the walls of the airplane (which are really closing in on you) are not moving and neither is the seat in front of you (about 6 inches in front of you these days). This sets up a conflict which can result in dizziness, motion sickness, vertigo, panic, and other wonderful sensations.

In an aircraft, we understand why these sensations occur, but for some patients, the sensations occur either continuously or episodically without an external cause. Because they typically involve visual system information as part of the conflict (even though vision might be contributing normal information), these conditions are of interest to you as a vision care specialist. In addition you will need to know how to prescribe lenses for these patients and make appropriate referrals.

A side-effect of this sensory conflict is an excessive response by the autonomic nervous system. This causes the sweating, pallor, nausea, and vomiting experienced by patients with vertigo.(13,25) Dimenhydrinate (Dramamine?) and a number of other prescription and non-prescription antihistamines can control some of these symptoms, presumably by suppressing vestibular output and reducing the amount of conflicting information the brain must process.(26-28)

When vertigo is not associated with actual movement, peripheral sense organ problems account for about 85% of the cases, whereas central processing disorders account for only 15%.(29) (Central disorders refer to problems in the cerebellum, brain stem, or projections to parts of the cerebral cortex, especially the temporal lobe. Peripheral disorders refer to problems occurring at the end organs or in the peripheral nerves.(16))

Sleep Disturbances

Many dizzy patients report sleep disturbances such as restlessness, or frequent awakening. These symptoms do not seem related to dizziness until we understand that if vestibular problems are causing problems for the awake patient, these same "bogus" vestibular conflict signals are telling the sleeping patient that he or she is moving. This information can break through to a high enough mental level that it awakens the brain to deal with the "earthquake."

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This is a very interesting article, since there are a fair amount of people who have a hard time distinguishing between true vertigo and dizziness.

I have the true vertigo associated with meneires, but am dizzy every day with what I presume to be autonomic related dizziness. Neither one is pretty. It certainly explains the levels of nausea and being "off" that most of us feel.

I always sleep with a small light, as I am much dizzier in the dark than when there is light, which decreases the chance of falls.

The article does state dramamine as a med that helps, but my ENT prefers Bonine, which is over the counter also. However, both are anticholinergics, so I don't use either one, as they mess with my already messed up autonomic system. It's why I switched to the much maligned benzo, valium, which not only helps my vestibular symptoms, but also the ans symptoms. Very interesting read. morgan

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A couple years ago when my ANS/endo doc dx me with BPPV via exercise of hanging head over table and helping me sit up quickly to induce spinning, motion sickness-I am on amusement park or boat sensation, he mentioned Valium is the number one treatment not only for Menieres' but I THOUGHT he said for BPPV as well.

He knew I have handled low doses of xanax just fine for years and I said it seemed to help with my intermittent vertigo..though I have that subtle motion sickness thing lurking all the time. I could NEVER mention those antinausea meds. Besides UNBEARABLE cotton mouth it's all the other ANS off-feeling I could not bear.

I just have a fraction of what you live with but know many others have griped about the slanted room feeling..like dizzieness or vertigo.

I often get hit lying in bed and before doing the BPPV exercises I started last year, I would turn over in bed in the morning and trigger an entire event. So I found this article interesting and have had it bookmarked forever. Recent spells made me decide to post it to help others who sometimes don't know which is first, the chicken or the egg..ANS causing vertigo/dizzieness or vice versa.

And do I FEEL dizzy or do I feel like the room is spinning.

Morgan, I often get the sensation 'my bed is moving a bit' and my head feels like I am on a roller coaster. Is that mild vertigo or dizziness? I know when the room looks distorted and I feel like I am on a sloping boat, that is vertigo. But that subtle sensation, I have attributed to vertigo due to the 'rocks in my head' (calcium deposits) in middle ear. Though my doc LOVES saying "you have ROCKS IN YOUR HEAD". How many times would a doc LOVE to say that, lol!

Though the calcium deposits explains MY triggers of rolling over in bed that triggers tachy but then, where does POTS end and the inner ear deal begin??

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The only way I know is if you have been definitively been diagnosed with meneires or bppv. That would be the only way to tell.

The rocking/rollar coaster would most certainly be vertigo. When I have vertigo, because I have meneires in both ears, they fight each other to balance me. Yikes. So the room spins around and around and the floor rocks up and down. I have absolutely no sense of up or down and am completely incapable of standing up. I have to crawl.

The dizziness of ans stuff is much more subtle, although not very pleasant either. A little off balance, a little seasick, that sort of stuff. You just don't feel right, wheras with vertigo nothing is even close to being right.

With presyncpe, my head feels like it's floating off my shoulders.

So there are lots of very different symptoms that many lump into being dizzy. My ENT pumps and does not allow for vagueness, I have to be very specific about what I'm actually feeling.

With the loose calcium, that could be a problem for anyone here who's been syncopal and hit their head! Head injuries are the number one reason those little calcium rocks dislodge from the gel pad in your inner ear and float into the semi circles. So if you have a vertigo that is positional, and a history of introducing your head to the floor, it's wise to get it checked out. morgan

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