What is vertigo?
Vertigo refers to a feeling of spinning, rocking or rotating, while otherwise being completely still. It is experienced in form of a sensation of the world moving around a person. It may develop suddenly and last for a short while, or may remain continuous in more severe cases. Vertigo is a manifestation of a condition, and not a condition by itself.
What are the causes of the disorder?
The main cause of vertigo is an issue with the balancing mechanism of the inner ear. Conditions that can cause this include:
- Benign paroxysmal positional vertigo (BPPV) – The inner ear canals get plugged with tiny particles of calcium (canaliths).
- Meniere’s disease – A build up of fluids and change in pressure of the inner ear causes vertigo that is accompanied with hearing loss and a ringing in ears (tinnitus).
- Labyrinthitis or vestibular neuritis – An infection (commonly viral) causes inner ear inflammation around the nerves responsible for maintaining balance.
Other less common causes of vertigo include:
- Head/neck injury
- Certain medications (for blood pressure, seizure, depression, etc.) that may cause ear damage
- Migraine headache
What one needs to know about symptoms or signs?
Triggered by a change in the head’s positions, the various symptoms of vertigo include:
- Feeling of being swayed
- Loss of balance
- Being pulled to one direction
- Jerky eye movements
- Hearing loss or ringing in the ears
Which specialist should be consulted in case of signs and symptoms?
An ear, nose and throat (ENT) specialist must be consulted in case of vertigo symptoms.
What are the screening tests and investigations done to confirm or rule out the disorder?
Diagnosis is done through:
- Medical history – Patient’s symptom history is noted, along with any recent medical illness or clue that could explain vertigo symptoms.
- Physical examination – The doctor looks for abnormal neurological activity, eye movements and lack of coordination. The patient’s head is moved to recreate and monitor vertigo symptoms.
- Imaging tests – Some cases may require an MRI or CT scan of the inner ear or brain to look for structural issues like stroke.
- Audiometry – This is done if hearing loss is suspected.
- Electronystagmography – Vertigo is examined electrically to differentiate between central and peripheral vertigo.
What treatment modalities are available for management of the disorder?
Many cases of vertigo improve without any treatment. However, treatment method depends on its cause. Different methodologies involve:
- Vestibular rehabilitation – The vestibular system, which sends signals about head and body motions to the brain, is strengthened using physical therapy for recurrent cases.
- Medication – Medicines can help relieve symptoms like nausea or motion sickness. Vertigo caused by infection can be treated with antibiotics or steroids to reduce swelling.
- Surgery – A deeper condition like brain or neck injury or tumour that is causing vertigo requires surgery.
What precautions or steps are necessary to stay healthy and happy during the treatment?
Depending on the cause of vertigo, the following measures can help relieve symptoms:
- Careful movements, like getting out of bed slowly and avoiding sharp bending
- Simple exercises
- Raising head slightly with pillows while sleeping
- Avoiding stretching of neck
How can the disorder be prevented from happening or recurring?
- Controlling risk factors like stroke (blood pressure, cholesterol), Meniere’s disease (salt intake), etc.
- Physical therapy to condition brain with movements that cause vertigo to reduce recurrence.
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“Benign paroxysmal positional vertigo (BPPV),” MayoClinic.org, Mayo Clinic Staff, https://www.mayoclinic.org/diseases-conditions/vertigo/basics/definition/con-20028216
“Dizziness and Vertigo,” MeddlinePlus.com, NLM, NIH, https://www.nlm.nih.gov/medlineplus/dizzinessandvertigo.html
“Vertigo,” MedicineNet.com, Danette C. Taylor, https://www.medicinenet.com/vertigo_overview/article.htm
“Vertigo,” NHS.uk, https://www.nhs.uk/conditions/vertigo/Pages/Introduction.aspx
“Vertigo,” WebMD.com, https://www.webmd.com/brain/vertigo-symptoms-causes-treatment