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Vertigo

vertigo
By Medicover Hospitals / 12 Jan 2021
Home | symptoms | vertigo
  • A person with vertigo will have a spinning, dizzy sensation. Vertigo is a symptom of a wide range of conditions. This will happen anytime there is an issue with the inner ear, brain, or sensory nerve pathway.
  • Article Context:

    1. What is vertigo?
    2. Causes
    3. Diagnosis
    4. Treatment
    5. When to visit a Doctor?
    6. Home Remedies
    7. FAQ's

    What is vertigo?

  • Vertigo is a feeling of imbalance. If you have this dizziness, you may feel you are spinning or the world around you is spinning. Many people use the term to describe the fear of heights, but this is not correct. Vertigo can occur when a person looks down from a great height but refers to episodes of temporary or continuous dizziness that occur because of problems in the inner ear or brain.
  • It is not a disease but a symptom. Many conditions can cause vertigo. Vertigo is a sign, but it can also lead to or occur alongside other signs. These may include:
  • Types:

  • There are two categories of vertigo:
    • Peripheral vertigo
    • Central vertigo
  • Peripheral vertigo arises because of complications in the inner ear or the vestibular nerve. The vestibular nerve connects the inner ear to the brain.
  • Central vertigo happens when there is a problem in the brain. Causes can include stroke, traumatic brain injury, infection, brain tumor, or multiple sclerosis.
  • Causes:

  • Several conditions can lead to vertigo, which usually involves an imbalance in the inner ear or a problem with the central nervous system (CNS). Conditions that can cause vertigo include the following.
    • Benign paroxysmal positional vertigo (BPPV): This is the most common cause of vertigo and creates a brief, intense feeling that you are spinning or moving. These episodes are caused by a sudden shift in the brain's movement, such as a blow to the head.
    • Infection: A viral infection of the vestibular nerve, called vestibular neuritis, can cause severe and constant vertigo.
    • Meniere's disease: When extra fluid builds up in the inner ear, the result can be unexpected episodes of dizziness that last for a few hours.
    • Migraine: Migraine-induced vertigo can last from minutes to hours.
  • Other causes are:
    • Migraines
    • A head injury
    • Ear surgery
    • Perilymphatic fistula, when fluid from the inner ear leaks into the middle ear because of a tear in either of the two membranes between the middle ear and the inner ear
    • Herpes zoster in or around the ear (herpes zoster oticus)
    • Otosclerosis, when a bone growth problem in the middle ear leads to hearing loss
    • Syphilis
    • Ataxia, which leads to muscle weakness
    • A stroke or transient ischemic attack, which people sometimes refer to as a mini-stroke
    • Cerebellar or brainstem disease
    • Acoustic neuroma, which is a benign growth that develops on the vestibulocochlear nerve near the inner ear
    • Multiple sclerosis
    • Multiple sclerosis
    • Prolonged bed rest and the use of some medications can also cause vertigo.

    Diagnosis:

  • The doctor will try to figure out what triggers the dizziness. They will perform a physical exam, ask the person how dizziness makes them feel, and take their medical history. The doctor can also perform some simple tests.
  • Romberg test: The doctor will ask the person to stand with their arms at their sides and their feet together and ask them to close their eyes. If the person becomes unstable when closing their eyes, this could be a sign of a CNS problem.
  • Fukuda-Unterberger test: The doctor will ask the patient to walk with his eyes closed for 30 seconds. If they roll to one side, this may show injury to the inner ear labyrinth, which could cause peripheral vertigo.
  • Depending on the results of these and other tests, your doctor may recommend a CT scan or MRI of the head to get more details.
  • Treatment:

  • Treatment for vertigo depends on the cause. In certain cases, vertigo is gone with no treatment. This is because your brain can adapt to changes in the inner ear, relying on other mechanisms to maintain balance.
  • For some, treatment is necessary and may include:
    • Vestibular rehabilitation: This is a physical therapy that helps improve the vestibular system. The function of the vestibular system is to signal the brain about the movements of the head and body about gravity.
    • Canalith repositioning maneuvers: Movements move calcium concentrations out of the canal to the chamber in the inner ear so that the body can absorb them. You will probably have vertigo signs during the procedure as the canalitos move.
    • A psychiatrist or physical therapist will direct you through your movements. Movements are secure and sometimes effective.
    • Medicine: Sometimes medications may give to relieve signs such as nausea or dizziness associated with vertigo.
    • If vertigo caused by infection or inflammation, antibiotics or steroids can reduce swelling and cure an infection.
    • For Meniere's disease, diuretics (water pills) may prescribe to reduce the pressure of fluid build-up.
    • Surgery: In some cases, surgery may be necessary for vertigo
    • If vertigo caused by a more serious underlying problem, such as a tumor or injury to the brain or neck, treatment for those problems can help relieve vertigo.

    Vertigo vs. dizziness:

  • People who experience vertigo will say that they feel they are moving or that the world is spinning the sensation of movement when there is no movement, While with dizziness, although it is an ambiguous term, patients often interpret it as a feeling of imbalance within their own space.
  • When to visit a Doctor?

  • See the doctor if you have any chronic, sudden, extreme, or persistent unexplained dizziness or vertigo. Get emergency medical attention if you experience new and severe dizziness or vertigo, along with any of:
    • Sudden severe headache
    • Chest pain
    • Shortness of breath
    • Numbness or paralysis of the arms or legs
    • Fainting
    • Double vision
    • Fast or irregular heartbeat
    • Confusion or trouble speaking
    • Stumbling or difficulty walking
    • Continual vomiting
    • Seizures
    • A sudden change in hearing
    • Facial numbness or weakness
  • In the meantime, the following self-care tips will help:
  • Move slowly: Step slowly as you get up from sitting down. Many people experience dizziness if they get up too quickly.
  • Drink much liquid: Staying well-hydrated can help prevent or relieve various types of dizziness.
  • Avoid caffeine and tobacco: By blocking the supply of blood, these substances may make signs worse.
  • Home Remedies:

  • People can take steps at home to help resolve vertigo and limit its effects. Measures that may help reduce the signs of vertigo include:
    • standstill in a dark, quiet room when the spin is intense
    • sit down as soon as the feeling of dizziness appears
    • take more time to perform movements that may trigger signs, such as getting up, looking up, or turning your head
    • squatting instead of bending over to pick something up
    • use a cane when walking if necessary
    • sleep with your head raised on two or more pillows
    • make home adaptations
    • turn on lights when getting up at night to help prevent falls

    Frequently Asked Questions:

  • If vertigo is the result of a health complication that you are not treating, your vertigo signs may get worse.
  • Foods high in sodium such as soy sauce, potato chips, popcorn, cheese, pickles, potato chips, and canned foods should be avoided. You can replace your regular salt with low sodium salt, as sodium is the main culprit in aggravating vertigo.
  • Many experts recommend that you try to sleep on your back, as the crystals within the ear canals are less likely to be disturbed and lead to a vertigo attack.
  • Depending on its cause, vertigo can last for just a few seconds or last for weeks or months.
  • Citations:

  • Neurology - https://n.neurology.org/content/56/4/436.short
  • Europe PMC - https://europepmc.org/article/med/10431888
  • Vertigo Baseline Assessment - https://www.aafp.org/afp/2006/0115/p244.html