Health: Spin doctors you can trust

It's making your head spin and it's highly unpleasant - dizziness is no joke.
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Gail Bilkus's morning exercises on the platform at Southgate Tube station have made her something of a local celebrity. Each day she stares at the moving carriages of the train, waves her arms, and carries out a set of hand-eye coordination exercises. On the train, she goes through a second set of neck exercises and then reads a book until she feels sick.

This bizarre start to the working day for 36-year-old Gail is not another novel spiritual fitness regime, but a new treatment she has been prescribed for her dizziness.

A team of psychologists at University College, London, have found that many people who suffer with dizziness can reduce their problems with the help of a treatment designed to re-educate the brain.

New research suggests that one in four people in Britain suffers with bouts of dizziness, and that, for half of them, the episodes are severe enough to impinge on their everyday activities. As many as a quarter of all people who suffer dizziness also say they faint, and a third have anxiety symptoms too.

One of the obstacles to diagnosing and treating the condition is that the causes of dizziness are diverse, and can range from the terminal to the trivial, from inner ear problems, anxiety and allergy, to heart problems, cancer, and a delayed version of seasickness when the dizziness remains for up to a week after getting back on to dry land.

"Dizziness is a condition which makes a doctor's heart drop, because it can be caused by just about anything. A lot of the causes have no easy cure, and patients' fears about dizziness prevent them from leading a normal life,'' says Dr Lucy Yardley, who led the research at UCL.

Dizziness is most frequently caused by a malfunction of the brain's sense of balance. At the heart of this system are three tiny, liquid-filled semicircular tubes in the inner ear, which act like spirit levels. These canals are positioned in three planes so that, whichever way the head is moved, one of the tubes will detect the movement and report back to the brain.

"The brain receives impulses from these balance organs in the inner ear, but it also receives information from other sensors too, including the eyes and what they see, and pressure receptors in the joints and muscles, which tell the brain which parts of the body are moving or in contact with the surface,'' says Professor John Birchall, professor of otolaryngology at Nottingham University.

It is when the brain starts to get different signals from the sensors that the problems of dizziness for many sufferers can occur.

Disorders of blood circulation are among the causes of dizziness. If the brain does not get enough blood, a feeling of light-headedness results. Many people get this feeling when they stand up quickly from lying down, but chronic sufferers get it much of the time.

Viral infections of the inner ear are another cause of dizziness, as are conditions involving the nerves, including multiple sclerosis. Allergies, too, can bring on vertigo when sufferers are exposed to food or dust particles to which they are sensitive. Dizziness is also part of the motion sickness suffered by many when they travel by car, plane or ship.

"With seasickness, your brain is getting conflicting signals. On the one hand your balance system is telling you that the body is moving, but your eyes see the ship's bar in front of you and it is stationary relative to you. The brain wonders what is going on, and you get a sense of dizziness when these messages conflict,'' says Professor Birchall.

In the biggest research project of its kind, Dr Yardley surveyed a large group of patients suffering from dizziness, and offered some of them a special trial programme.

"We looked at people whose dizziness might be caused by problems with the balance organ in the inner ear, which are very difficult to diagnose,'' says Dr Yardley.

The treatment regime offered is designed to re-educate the brain on interpreting the signals it is getting from the balance sensors. It is based on the theory that if there is a problem with the balance system itself, the brain can reprogramme itself.

"But the reprogramming occurs only if you do all the things that make you dizzy; that's the only way the brain can learn. But dizzy people,of course, tend to avoid the things that make them dizzy, so their brains don't have a chance to reprogramme,'' says Dr Yardley.

She and her team gave the sufferers a four-times-a-day, five-minute exercise routine involving rapid head, eye and body exercises.

After six weeks, patients who had been given the special treatment were four times more likely than a control group of other patients to report improvements, and nearly 80 per cent said they felt better.

Gail Bilkus, who has been taking part in the treatment, traces her dizziness and inner ear problems back to an early age: "At school, I did a forward somersault and felt very odd - I found myself hanging on to the floor, trying not to fall off.''

The symptoms disappeared for some time, largely because she avoided anything that triggered it.

"A few years ago, I was doing a lot of typing, and I also had a bout of flu, and suddenly my balance was all over the place. I was walking down the street as if I were on dope, and one day when I was lying on the bed, the ceiling started spinning around.

"People did all sorts of tests - I was spun round in a chair, had several scans, and had electrodes stuck on my head. In one test they got me to shut my eyes and march on the spot. If you have perfect balance you walk up and down on the spot, but if one ear is stronger than the other, you will drift across the room.''

She was eventually told that the canal in one of her ears wasn't working, but that there was little that could be done. "Then I found about this new treatment and I have been given these exercises that I carry out,'' she says. "They do look very bizarre to people on Southgate Tube, but as long as they are doing me good - and they are - I don't care.

"When I sit on the Tube I have to read a book until I feel queasy. It's sometimes a fine balance between stopping and being sick, but so far I haven't thrown up on any of my fellow passengers.''

How to Keep your Head

How to reduce dizziness:

Avoid rapid changes in position, from lying down to standing up, and from side to side.

Avoid extremes of head movement.

Cut down on caffeine, salt and nicotine, which impair circulation.

Minimise exposure to stress, and anything to which you are allergic.

Always travel where your eyes will see the same motion that your ear and body feel - so always sit in the front of a car, or go on to the deck of a ship to look at the horizon, or sit by the window in a plane.

Do not read while travelling.

Do not sit in a rear-facing seat.

Avoid strong odours and spicy food.

Taken from the American Academy of Otolaryngology's advice leaflet for dizziness sufferers