The Anterior Canal: Vertigo Has a New Player

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February 7, 2015

Think about what you do all day. If you are like many of us in the American culture you probably thought about texting, watching television, sitting at work, computer usage, some exercise and a myriad of other activities that you do throughout the day. There is a common theme among most of us, we're in chronic flexion, or head forward/down position. Well, we know that's not good for posture, but what about its effect on the vestibular system, or the part of our brain that is a major contributor to balance, proprioception, spatial awareness, and eye movement/reflexes. If we have a problem in this area, we can experience vertigo and spatial imbalance. It's very serious and is extremely uncomfortable to experience. 

The most common cause of vertigo is BPPV, or benign posterior positional vertigo, that occurs when tiny crystals in our inner ear become dislodged and travel to a part of our vestibular apparatus called the semicircular canals. This causes an abnormal or excessive activation of this region and results in vertigo, or spinning. It is most commonly associated with the posterior canal, but can be in other canals. Historically, it is rare in the anterior and horizontal canals due to their angles, but clinically we are seeing an increase in benign anterior positional vertigo that affects the Anterior Canal of the semicircular vestibular system as opposed to the posterior canal. This causes a slow phase superiorly and in extorsion with a quick phase, or nystagmus inferiorly and with intorsion. We are seeing this in relationship to the contralateral posterior canal, especially in those who do not respond to posterior canal epley's maneuver, but maintain positional vertigo symptoms. It can also result from faulty Epley's maneuvers during which the crystals become located in the anterior canal.

At Portland Chiropractic Neurology, located in Portland Maine, we are experts in the field of vestibular rehabilitation, holding fellowships in this area that allow us to diagnose and treat the most common to the most rare of vertigo and dizziness associated with vestibular conditions.