Onset of positional vertigo during exposure to combined G loading and chest-to-spine vibration.

BACKGROUND Aerospace environments commonly expose pilots to vibration and sustained acceleration, alone and in combination. CASE REPORTS Of 16 experimental research participants, 3 reported symptoms of vertigo and signs of torsional nystagmus during or shortly following exposure to sustained chest-to-spine (+3.8 Gx) acceleration (G loading) and chest-to-spine (0.5 g(x)) vibration in the 8-16 Hz band. Two of the participants reported intermittent vertigo for up to 2 wk, were diagnosed with benign paroxysmal positional vertigo (BPPV), and were treated successfully with the Epley Maneuver. On a follow-up survey, a third participant reported transient BPPV-like vertigo, which resolved spontaneously. The follow-up survey also prompted participants to self-report other effects following research protocol exposure to vibration and G loading, revealing details about other minor and transient, but more common, effects that resolved within 3 h. DISCUSSION Our studies indicated a significantly elevated incidence of BPPV following exposure to vibration plus G loading compared to vibration alone that was positively correlated with participant age. One mechanism for the rolling sensation in BPPV involves broken or dislodged otoconia floating within one of the posterior semicircular canals, making the canal gravity-sensitive. Our observations highlight a heretofore unforeseen risk of otolith damage sustained during launch, undetectable in space, potentially contributing to vertigo and perceived tumbling upon re-entry from microgravity.