October 22, 2023

It seems like you've been feeling constantly dizzy, as if the world is spinning around you and you're being pulled in different directions.

If that's the case, this article provides you with the necessary information about vertigo: its symptoms, causes, and treatment methods.

What is vertigo?

Vertigo is a specific type of dizziness characterized by a false sensation of movement or spinning, either of the individual or their surroundings.

The way people describe dizziness isn't specific enough to pinpoint exactly what type of dizziness you're referring to. Dizziness can be expressed in various ways.

According to People experiencing vertigo often say it feels like they are

• Spinning,

• Swaying,

• Tilting,

• Being pulled in one direction.

Those feelings are symptoms rather than a condition itself and can be caused by various underlying issues.

What symptoms are related to vertigo?

Many people experiencing vertigo commonly report the following symptoms:

• Dizziness:

• A persistent feeling of lightheadedness or unsteadiness, as if you or your surroundings are spinning.

• Imbalance:

• Difficulty in maintaining balance, often leading to unsteady walking or a feeling of being pulled to one side.

• Nausea:

• Persistent feeling of queasiness or a strong urge to vomit, especially when the vertigo is severe.

• Vomiting:

• Some people with vertigo may experience vomiting, especially if their symptoms are intense.

• Sensitivity to Movement:

• Increased sensitivity to movement, particularly head movements, which can trigger or worsen vertigo.

• Difficulty in Concentration:

• Vertigo can make it challenging to concentrate on tasks, as the constant sensation of movement can be distracting.

• Fatigue:

• The effort of dealing with continuous imbalance and dizziness can lead to fatigue and a general sense of weakness.

• Sweating:

• Some individuals might experience sweating, especially during episodes of severe vertigo.

Of course, experiencing all these symptoms isn't necessary to be considered as having vertigo.

If you're experiencing two or more of these symptoms, particularly if they are intense and prolonged, you might be in a situation where you need to seek treatment for vertigo.

Why should vertigo be treated?

Why should vertigo be treated?

Since vertigo itself isn't a major illness, many people might think it's okay to just leave it untreated.
Yes, Vertigo itself is not inherently dangerous,

but the episodes of dizziness and loss of balance associated with vertigo can lead to situations that pose a risk to the affected person.

Here are a few reasons why vertigo can be potentially dangerous:

• Increased Risk of Falls: Vertigo can cause a sudden loss of balance and unsteadiness, increasing the risk of falls. Falls can lead to injuries such as fractures, sprains, and head trauma, which can be especially dangerous for older adults.

• Impaired Driving and Operating Machinery: Vertigo can affect a person's ability to drive safely or operate heavy machinery, leading to accidents and injuries for the person experiencing vertigo and others on the road or in the workplace.

• Impact on Daily Activities: Chronic or severe vertigo can significantly impact a person's ability to perform daily activities, including work and household chores, leading to a reduced quality of life. When vertigo becomes severe, it can make it difficult to concentrate on what others are saying and hinder everyday tasks, leading to emotional distress and potentially triggering depression.

• Underlying Medical Conditions: While vertigo itself may not be dangerous, it can be a symptom of underlying medical conditions such as Meniere's disease or vestibular migraines, which require proper diagnosis and management to prevent complications.

In fact, the most dangerous aspect of vertigo is the risk of falling unnoticed and sustaining significant head or body injuries.

So, let's explore why this vertigo occurs. Often, vertigo is a symptom of an underlying condition, so it's crucial to identify which category you might fall into.

What causes vertigo?

• Benign Paroxysmal Positional Vertigo (BPPV): BPPV is caused by the displacement of small crystals in the inner ear. These crystals can disrupt the normal flow of fluid within the inner ear, leading to vertigo when the head is moved in certain positions.

• Vestibular Neuritis: Vestibular neuritis is an inner ear disorder often caused by viral infections. It leads to inflammation of the vestibular nerve, causing vertigo, dizziness, and imbalance.

• Meniere's Disease: Meniere's disease is a disorder of the inner ear that can cause vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or congestion in the affected ear. The exact cause of Meniere's disease is not well understood.

• Labyrinthitis: Labyrinthitis is an inner ear disorder caused by viral or bacterial infections that result in inflammation of the labyrinth, leading to vertigo, hearing loss, and imbalance.

• Migraines: Vestibular migraines are a type of migraine headache that can cause vertigo and dizziness. These migraines are often accompanied by headache, light sensitivity, and sound sensitivity.

• Head Injuries: Trauma to the head can damage the inner ear or the vestibular nerve, leading to vertigo.

• Ear Disorders: Various disorders of the middle or inner ear, such as cholesteatoma (abnormal skin growth in the middle ear), can cause vertigo.

• Medications: Certain medications, especially those used to treat high blood pressure, can cause vertigo as a side effect.

• Anxiety Disorders: Severe anxiety and panic attacks can sometimes cause symptoms similar to vertigo, although the sensation of spinning may not be present.

• Other Neurological Disorders: Certain neurological conditions, such as multiple sclerosis or vestibular schwannoma (a benign tumor on the vestibular nerve), can lead to vertigo.

Vertigo is often closely related to the inner ear (also known as the labyrinth) and the vestibular system, which is responsible for balance and spatial orientation. The inner ear contains delicate structures, including the semicircular canals, which detect head movements and help maintain balance.

How is vertigo diagnosed?

The diagnosis process may include the following steps:

1. Medical History: The healthcare provider will ask about the patient's symptoms, including the duration, frequency, and intensity of vertigo episodes. They will also inquire about any recent illnesses, head injuries, or medication use.

2. Physical Examination: A thorough physical examination, including a neurological and ear examination, will be conducted to assess balance, coordination, and signs of inner ear or neurological disorders.

3. Dix-Hallpike Test: This specific maneuver is used to diagnose benign paroxysmal positional vertigo (BPPV). During the test, the patient's head is moved into different positions to provoke vertigo. Eye movements are observed to determine the presence of nystagmus (involuntary eye movement), which is indicative of BPPV.

4. Videonystagmography (VNG): VNG is a test that uses infrared cameras to record eye movements and assess the function of the vestibular system. It helps in identifying abnormalities in the inner ear.

5. Caloric Testing: This test involves irrigating the ear canal with warm and cool water to evaluate the response of the inner ear to temperature changes. It helps assess the function of the vestibular nerve.

6. MRI or CT Scan: Imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scans may be performed to rule out other underlying conditions such as tumors or multiple sclerosis.

7. Blood Tests: Blood tests may be conducted to check for infection or other systemic conditions that could be causing vertigo.

8. Electronystagmography (ENG): ENG measures involuntary eye movements (nystagmus) to assess the function of the vestibular system and may be used in conjunction with other tests.

Vertigo clearly distinguishes itself from general dizziness.

It primarily originates from ear-related issues, so undergoing the above diagnostic process is crucial to confirm whether you truly have vertigo.

Therefore, if dizziness is severe, it's essential to visit ENT and undergo a comprehensive evaluation to determine the root cause.

How is vertigo treated?

• Epley Maneuver (Canalith Repositioning Procedure): This technique is used to treat benign paroxysmal positional vertigo (BPPV). It involves a series of head movements to move displaced inner ear crystals back into the appropriate position, relieving vertigo symptoms.

• Vestibular Rehabilitation Therapy (VRT): VRT is a type of physical therapy specifically designed to improve balance and reduce dizziness-related problems. It includes exercises and activities that focus on enhancing the vestibular system's function.

• Medications: Depending on the cause of vertigo, various medications can be prescribed. Anti-vertigo medications like meclizine or vestibular suppressants can help alleviate symptoms. In some cases, medications to control nausea and vomiting may also be prescribed.

• Lifestyle Changes: Avoiding certain triggers, such as caffeine, alcohol, and tobacco, may help reduce the frequency and severity of vertigo episodes. Adequate hydration and regular exercise can also contribute to overall vestibular health.

• Canalith Repositioning Maneuvers: Different canalith repositioning maneuvers, such as the Semont maneuver or the Gufoni maneuver, can be used to treat specific types of BPPV.

• Treatment of Underlying Conditions: If vertigo is caused by an underlying medical condition, such as Meniere's disease or vestibular migraines, managing and treating that condition can help alleviate vertigo symptoms.

• Surgery: In some cases, especially when vertigo is caused by structural issues in the inner ear, surgical intervention may be necessary. Procedures like vestibular nerve section or labyrinthectomy may be considered in certain situations.