VERTIGO: Understanding Causes, Symptoms, and Effective Treatments

INTRODUCTION

Vertigo is a condition in which there is a perception of movement or whirling – either of the self or surrounding objects when they are not. It is not a disease but a symptom of an underlying condition.

If bouts are very frequent, do not ignore them and immediately visit an ENT doctor or NEURO-OTOLOGIST.

Let us get familiar with the causes, symptoms, and available vertigo treatments.

Many different conditions can cause vertigo. The causes of vertigo are categorized into two groups: central and peripheral.

It can also be caused by psychological factors.

Clinical, otological, and vestibular examinations are important to differentiate between central and peripheral vestibular disorders. The most important step in diagnosis is proper history-taking.

What Are The Vertigo Symptoms?

Vertigo is itself a symptom caused by other diseases or health conditions. It is often triggered by a change in the position of your head. It is mostly accompanied by several other symptoms, which are as follows:

• Waking up dizzy
• Light headed and dizzy
• Dizzy and nauseated
• Motion sickness
• A feeling of air inside your ears
• Tinnitus or ringing in the ears
• Problem in balancing
• Dizziness and Headache

What Causes Vertigo?

Disorders of the vestibular system cause vertigo and are divided into:

1.  Peripheral Vertigo:- Vertigo that is caused by problems with the inner ear or vestibular system which controls balance. They are responsible for 85% of all cases of vertigo.

2. Central Vertigo:- which involves the central nervous system means Brain.

Types of Vertigo:

Peripheral Vertigo includes –

1) Benign paroxysmal positional vertigo (BPPV) –

BPPV is the most common cause, the problem is caused by the movement of our head. The movement causes the tiny calcium carbonate crystals in the inner ear to move around, and the movement causes the crystals to touch the sensory cells in the semi-circular canal, which trigger bouts of severe dizziness

2) Meniere’s disease –

It is characterized by vertigo, fluctuating hearing loss, tinnitus, and a sense of pressure in the involved ear.

3) Vestibular neuronitis –

This condition is almost similar to labyrinthitis, but here the vestibular nerve gets inflamed. But in this condition, the person does not face hearing loss, which is an important symptom in the case of labyrinthitis. The symptoms of vestibular neuritis are nausea, blurred vision, and balance problem.

4) Labyrinthitis –

The problem takes place due to an inflammation in the labyrinth of the inner ear due to an infection. The vestibulocochlear nerve endings in this area stimulate the brain cells, which leads to random dizziness and other issues, such as pain in the ear or even blurry vision.

5) Vestibulotoxic drugs –

Several drugs cause ototoxicity by damaging the inner hair cells of the inner ear.

6) Head trauma

7) Perilymph fistula –

Perilymph Fistula is caused due to a ruptured eardrum or, in some cases, a tear in the ligament between the inner ear and middle ear. As a result, the fluid gets displaced, which leads to miscommunication with the brain.

8) Syphilis –

Syphilis of the inner ear, both acquired and congenital, causes

9) Acoustic neuroma –

Acoustic neuroma is a benign growth on the vestibulocochlear nerve near the inner ear. Acoustic neuroma can cause dizziness and balance issues.

Central Vertigo

1. Vertebrobasilar insufficiency
2. Basilar migraine
3. Cerebellar disease
4. Multiple sclerosis
5. Tumors of the brainstem and fourth ventricle
6. Epilepsy
7. Cervical vertigo

Other causes:

1. Ocular vertigo
2. Psychogenic vertigo

Evaluation of dizzy patient-

The history and examination provide important clues to the diagnosis. A patient’s history, which is of paramount importance in cases of balance disorders, often provides enough information to diagnose a cause for various types of dizziness.

The duration of episodes of vertigo helps in distinguishing certain causes of dizziness. The longer vertigo lasts, the greater the chances of a central cause.

Diagnosis made from Duration of vertigo –

• Seconds – Benign positional paroxysmal vertigo

• Minutes to hours – Transient ischemic attack, Meniere’s disease, and migraine

• Days – Vestibulat neuritis. Suppurative labyrinthitis, strokes, and multiple sclerosis

• Weeks – Psychogenic

Provoking factors like – changes in head position, neck movements, stress, changes in ear pressure and loud noises, excessive straining, and the events preceding the onset of vertigo usually prove useful in narrowing the differential diagnosis.

How Is Vertigo Diagnosed?

The Head Thrust Test

The Head thrust test or the head impulse test is to test the reflex system. The test determines the coordination of the eyes and the inner ear.

Romberg Test

The doctor will ask you to close your eyes and stand with your feet together. Your balance is observed.

Dix Hallpike Test

In the Dix-Hallpike Test or Dix-Hallpike maneuver, you will be asked to rotate your head to one side at an angle of 45 degrees and then to the other side; the doctor will observe your eyes to determine if the issue is in the inner ear or the brain. The turning of the head can trigger vertigo.

What Are The Vertigo Treatments?

• Vestibular rehabilitation is a physical therapy for dizziness; it will strengthen the vestibular system to improve balance and reduce dizziness and headaches.
• If it’s due to pregnancy, your doctor will prescribe drugs such as antihistamines that are mainly for nausea.
• In a situation of Benign Paroxysmal Positional Vertigo (BPVV), the medical expert may ask you to practice an unusual movement, the Epley repositioning maneuver, to clear the canalith particles (otoconia) in the inner ear to prevent dizziness.
• If the dizziness and headache are due to a cold or ear infection, the doctor will prescribe antibiotics.
• Prescribing medicines like – antihistamines, Benzodiazepines, and antiemetics.
• Diuretic medications are an option for Meniere’s disease.

Recommended Vertigo Treatment At Home

Though it is always good to take advice from medical professionals, some alternative vertigo treatments at home can be tried for immediate relief.

• Making some small changes in your lifestyle, such as making Epley maneuver a part of your exercise routine, can be very helpful.
• Sitting down or lying down with eyes closed during an episode.
• Bed rest gives relief to people suffering from a stroke.
• Keep an extra pillow under your head while sleeping.
• Wake up or stand up slowly to avoid sudden jerky movements that may aggravate or initiate sudden dizziness.
• Indulge in the right kind of food to keep the hormonal changes in control. Include items such as green leafy vegetables, eggs, almonds, salmon, fish, and dark chocolate in your diet, which is good for the central nervous system.
• Avoiding alcohol
• Acupuncture can also help to cure constant dizziness in some cases, it involves the insertion of tiny needles into the skin to trigger certain points on your body.
• Yoga is a good way to improve flexibility and balance, strengthen muscles, and reduce stress.

Some simple wellness measures can help you avoid a vertigo episode. These include:

• Staying Hydrated – drink enough fluids throughout the day to avoid vertigo episodes due to dehydration.
• Adequate amount of sleep-  Sleep deprivation can trigger episodes of vertigo. Try to get at least seven to eight hours of sleep at night.
• Eating a Healthy Diet Consuming nutritious, whole foods can help you feel better and maintain a healthy weight. Try to include lots of veggies, fruits, whole grains, and lean proteins in your diet. Avoid any foods that trigger or worsen your vertigo symptoms.
• Exercising Exercise can make you feel better overall. It might be difficult to exercise if you feel dizzy but start with simple activities, like walking. If your symptoms are severe, some exercises can be performed while sitting in a chair. Ask your doctor about a regimen that fits your needs. Also, drink plenty of water before, during, and after a workout.

THANK YOU

MEDICAL ADVICE DISCLAIMER:

This blog, including information, content, references, and opinions, is for informational purposes only.

The Author does not provide any medical advice on this platform.

Viewing, accessing, or reading this blog does not establish any doctor-patient relationship.

The information provided in this blog does not replace the services and opinions of a qualified medical professional who examines you and then prescribes medicines.

And if you have any questions of medical nature, please refer to your doctor or qualified medical personnel for evaluation and management at a clinic/hospital near you.

The content provided in this blog represents the Author’s own interpretation of research articles.