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Q: Occasionally I get dizzy. If I roll over in bed it happens sometimes, or if I am playing tennis it can be terrible. But then it goes away. Is it caused by an ear infection, or am I just getting old and batty? — Susan F., Palo Alto, California

A: Chances are the answer is “neither.” What you are describing sounds like benign paroxysmal positional vertigo — although when it strikes, it hardly feels benign. In addition to dizziness that can knock you off your feet, it can cause nausea and vomiting. Episodes may last a few minutes or for hours, depending on what’s going on in your inner ear.

Where it begins: In your inner ear there are cilia — thread-like structures that are attached to tiny nerves that help your brain know when you are moving, what your position is and how to orient yourself to the outside world. Tiny calcium crystals sit atop each cilium — when you move, they move, and that starts the cascade of “messages” that let you know what’s going on with your body in space and time.

Unfortunately, sometimes those crystals just keep moving even if you’re not in motion, or they become dislodged from their perch, and the nerves signal your brain that you are in motion when you are not. That sends conflicting messages from your inner ear and your eyes (they perceive that you are still), and the result is dizziness.

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How to manage it: There are some effective exercises — called the Epley maneuver — that can reverse the dizziness pretty quickly. “When done in a medical setting, the success rate for these exercises is up to 90%,” says the Cleveland Clinic’s neurologist Dr. Neil Cherian. You should have your doctor go through a simple test to figure out which ear is affected — or if it is both. You can then learn a five-step Epley routine to quiet those cantankerous crystals. Make an appointment today.

Health pioneer Michael Roizen, M.D., is chief wellness officer emeritus at the Cleveland Clinic and author of four No. 1 New York Times bestsellers. His next book is “The Great Age Reboot: Cracking the Longevity Code for a Younger Tomorrow.” Do you have a topic Dr. Mike should cover in a future column? If so, please email questions@GreatAgeReboot.com.

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