Jamal Mashburn sat out last night's deciding game of the New Jersey Nets-Charlotte Hornets playoff series with positional vertigo. What is positional vertigo, and how do you treat it?
Positional vertigo feels like a wave of dizziness and nausea, as if the sufferer has just stepped off a high-speed merry-go-round. It's caused by loose calcium carbonate crystals—or "ear rocks"—floating about the inner ear. The ear rocks are dislodged from a sac in the inner earby head injuries, viruses (as in Mashburn's case), or degeneration of the ear (as in most patients over 50). When the head is tilted, the rocks rub against nerve endings that affect balance.
Doctors sometimes prescribe sedatives like Valium to alleviate the symptoms. But a pharmacological approach was not appropriate in Mashburn's case; it would be tough to crash the boards while doped up on chill pills. Instead, doctors treated the star forward by performing a series of maneuvers designed to nudge the ear rocks back into place. The most popular of these exercises is the so-called Epley maneuver, which involves sequential side-to-side head movements (occasionally aided by a vibrator placed behind the ear). About 75 percent of patients are cured after a single 10-minute session, provided they spend the following two nights sleeping with their heads tilted at a 45-degree angle.
But Mashburn's ear rocks seem particularly stubborn. He has been forced to perform a more rigorous set of maneuvers, which usually involve three sets of head twists and full-body flops per day. The program has a 95-percent cure rate, but it takes at least two weeks to complete. In extremely rare cases, when exercise fails, the calcium crystals must be immobilized through a surgical procedure, which can lead to partial deafness.
But odds are that Mashburn's ear rocks will eventually settle without surgery, and he'll be ready to play next season—albeit as a member of the soon-to-be-relocated New Orleans Hornets.
Explainer thanks Dr. Jeffrey P. Harris of the University of California-San Diego.