Scuba diving may cause vertigo
Scuba diving may cause vertigo. Not only unpleasant but extremely dangerous. Disorientation, dizziness and vertigo under water is not as uncommon as believed. A lot of scuba divers experience this to a certain degree but do not report it. There may be numerous causes but the end result may be disastrous, even fatal.
Dizziness may start on the boat being a part of the sea and motion sickness syndrome. Migraine may potentiate this. Simple hyperventilation, being short of breath or anxious my cause hyperventilation induced nystagmus and vertigo. This may especially occur if an underlying condition such as migraine, vestibular schwannoma, vestibular paroxysmia or peripheral vestibular weakness is present.
With descent, wax in the one ear can cause a caloric reaction with severe spinning vertigo in the other ear. This may be worse in colder water.
With ascent a condition called alternobaric vertigo may occur. One of the Eustachian tubes may temporarily be blocked causing equalization only in one ear and this difference in pressure in the two middle ears may cause vertigo.
Barotrauma is a serious condition affecting all air filled cavities in the human body. In the ear it can cause rupture of the tympanic membrane and inner ear membranes with subsequent perilymph fistula. In not so experienced, divers may descent with over equalizing, an increase in pressure and subsequent baro trauma to the inner ear.
Long dives, outside forced decompression stops may cause decompression sickness. When gasses in the blood goes from the soluble to the gaseous state it can cause blocking of blood vessels and damage to nerves, causing vertigo.
Often scuba divers are patients on chronic medication for numerous conditions. Under pressure, when scuba diving, the metabolism of these drugs change. Under pressure drugs behave differently and the side effects may include dizziness and vertigo.
Cave and night diving deprive a patient to a certain extent of visual cues and if an underlying vestibular disorder is present it may lead to disorientation.
It is advised that baseline vestibular function is assessed as part of the medical assessment before scuba diving.