Vertigo (Dizziness): Symptoms, and Treatment

Contents

In this article we will look at:

• What is vertigo?
• How does vertigo occur?
• Who is prone to vertigo?
• What are the causes of vertigo?
• What are the symptoms of vertigo?
• How is vertigo diagnosed?
• What are the complications of vertigo?
• What is the treatment for vertigo?

You can click on any of the links above to navigate to the section of your interest. 

What is vertigo?

Vertigo in plain terms is severe dizziness, or giddiness, the feeling that you or your environment seems to be reeling or spinning. It differs from simple dizziness or lightheadedness, in that, the experience is one of being in the illusion of a continuous spinning movement for a long period.
If you feel you are spinning that’s called subjective vertigo, and the feeling that the area around you is spinning is called objective vertigo.

How does vertigo occur?

Depending on the cause, there are different types of vertigo:

• Peripheral vertigo problem occurs when there is a problem with your inner ear, which controls balance. The passage of the inner ear has tiny organs that enable messages to be sent to the brain, in response to gravity. These messages relay to the brain when there is movement away from the vertical position, which enables people to keep their balance when they stand up. Malfunctioning of this system produces vertigo.

         There are different forms of peripheral vertigo, such as:

• 
  
  • Labyrinthitis
  • Benign paroxysmal positional vertigo (BPPV)
  • Vestibular neuronitis
  • Meniere’s disease
• Central vertigo occurs when there is a disturbance in the sensory nerve pathways of the brain.

It involves a disturbance in one of the following areas:

• the brainstem and cerebellum, which are the parts that deal with interaction between the senses of vision and balance
• sensory messages to and from the part of the brain known as the thalamus

Migraine headache is the most common cause of central vertigo. At least 40% of the patients with migraine experience vertigo.

Who is prone to vertigo?

Some people are more prone to vertigo than others:

• people 50 years and older
• people suffering from migraine
• people with problems in the inner ear
• people who have had a head injury
• people who have a reduced blood flow in part of the brain, known as vertebrobasilar ischemia
• people who have undergone ear surgery
• people who are undergoing prolonged bedrest due to any illness

What are the causes of vertigo?

As has already been mentioned the main types of vertigo are peripheral vertigo and central vertigo.

There are many types of peripheral vertigo based on different causes:

• Labyrinthitis: Labyrinthitis is caused by an inner ear infection. It is often accompanied by other symptoms such as fever and earache. Illnesses such as viral fever, cold, flu, or bacterial ear infection often cause this infection. Labyrinthitis makes you feel dizziness or a feeling that you’re moving when you aren’t.
• Benign paroxysmal positional vertigo (BPPV): This is the most common form of peripheral vertigo. Tiny calcium particles (canaliths) clump up in canals of the inner ear, stimulating the small hairs that line your inner ear and then certain head movements trigger BPPV. This confuses your brain, producing the sensation of dizziness.
• Vestibular neuronitis: This condition is caused as a result of an infection that has spread to the vestibular nerve, which controls balance. This happens after a viral infection such as a cold, flu, or any other viral infection. Other symptoms can accompany this condition such as unsteadiness, earache, nausea, and vomiting
• Meniere’s disease: This condition causes vertigo which can last for up to 24 hours. It usually affects people between the ages of 40 years and 60 years. In this condition there is a buildup of fluid in the inner ear can lead to attacks of vertigo. It is accompanied by symptoms such as nausea and vomiting. Meniere’s disease can cause hearing loss, ringing in your ears, and a feeling of fullness in your ears.

Peripheral vertigo can also be caused by:

• a head injury
• reduced blood flow in part of the brain, known as vertebrobasilar ischemia
• labyrinthitis
• ear surgery
• prolonged bed rest
• drug toxicity
• syphilis
• herpes zoster oticus, a viral infection of the ear, also known as Ramsay Hunt syndrome
• otosclerosis, a genetic ear bone problem that causes hearing loss
• perilymphatic fistula, a tear in one or both of the membranes separating the middle and inner ear

Central vertigo, on the other hand, is caused mainly by migraine.

What are the symptoms of vertigo? How is vertigo diagnosed?

Vertigo is a symptom, but it can also be accompanied by other symptoms such as. 

• Blurred vision
• Fatigue
• Weakness
• Headache
• Lightheadedness
• Heart palpitations (rapid fluttering of the heart)
• Imbalance
• Inability to concentrate
• Sense of motion sickness
• Inability to speak
• Increased risk for motion sickness
• Muscle ache (especially neck pain and back pain)
• Nausea and vomiting
• Lack of coordination
• Reduced cognitive function (i.e., thinking and memory)
• Sensitivity to bright lights and noise
• Sweating
• Tinnitus

Diagnosis

For a diagnosis, the doctor, who can be a general physician will ask your complete medical history and also perform a physical examination. He may ask you to undergo a blood test to check your blood sugar levels. Based on your condition he may also suggest you undertake a CT scan, or MRI, and also an ECG. Depending on your particular condition you may also be referred to an ENT specialist, or a neurologist, and/or a physiotherapist.

What are the complications of vertigo?

Severe vertigo can be disabling and may result in complications such as:

• irritability
• loss of self-esteem
• depression
• injuries from falls
• double vision(diplopia)
• impaired consciousness
• inability to speak due to muscle impairment(dysarthria)
• lack of coordination

What is the treatment for vertigo?

Medical Treatment For Vertigo

The doctor may prescribe medications for vertigo depending on your condition. The medications may cause drowsiness.

Managing Vertigo

Epley Maneuver

Research shows that the Epley maneuver is extremely effective for people with BPPV. You can perform this procedure at home easily:

1. Sit upright on a flat surface, with a pillow behind you and with your legs outstretched.
2. Turn your head slowly 45 degrees to the right.
3. Keeping your head tilted, quickly recline with your head on the pillow. Stay in this position for at least 30 seconds.
4. Gradually turn your head to the left, a full 90 degrees, without lifting your neck.
5. Now engaging your whole body, turn it to the left so that you are completely on your left side.
6. Slowly return to your original position, looking forward and sitting straight up.

You can repeat this exercise three times in a row, and you may feel dizzy during each movement.

Semont-Toupet Maneuver

The Semont-Toupet maneuver is  similar to the Epley Maneuver but requires less neck flexibility:

1. Place a pillow behind you, sit upright on a flat surface, and stretch out your legs.
2. Next lie down, turn to your right, and look to your left side, looking upward.
3. Swiftly sit up and turn to your left side, keeping your head facing to your left. You will now be looking down toward the ground.
4. Now very slowly return to your original position, looking forward and sitting straight up.

Brandt-Daroff Exercise

You can perform this exercise at home without any supervision:

1. Sit on a flat surface, with your legs dangling as they would from a chair.
2. Turn your head as far as you can to the left side, then lay your head and torso down on your right side. Stay in this position for at least 30 seconds. Do not move your legs.
3. Sit up and turn your head back to the center position.
4. Repeat this exercise on your left side this time by turning your head as far as you can to the right side, then laying down on your left side.

You can repeat this exercise 5 times and do it 3 times a day, twice a week.

Manage Your Stress

Learning to do away with stress by being aware of the cause of the stress can do away with vertigo. You can practice meditation, or mindfulness techniques. Learn some deep-breathing techniques. This can drastically reduce your stress.