Vertigo

Overview

Vertigo is a sensation of spinning or moving, usually described as the inside of your head or the surrounding environment spinning around you. It can be accompanied by dizziness, loss of balance, and unsteadiness. Vertigo is commonly associated with conditions like benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and persistent postural-perceptual dizziness (PPPD). The signs and symptoms of vertigo can come and go and may vary in intensity and duration. If you experience recurrent, sudden, severe, or prolonged vertigo, it's important to consult your doctor for proper evaluation and treatment.

Understanding the disease

Symptoms

The symptoms of vertigo include a sense that you or your surroundings are spinning or moving, dizziness, a loss of balance or unsteadiness, nausea, vomiting, and a feeling of faintness or lightheadedness (presyncope). Vertigo can be associated with various conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and persistent postural-perceptual dizziness. It is essential to see a doctor if you experience any recurrent, sudden, severe, or prolonged and unexplained vertigo or dizziness, especially if accompanied by a new, different, or severe headache, fever, or other concerning symptoms.

Risk Factors

Risk factors for developing vertigo may include:

1. Age: Vertigo is more common in people aged 50 and older, but it can occur at any age.
2. Gender: Women are more likely to experience vertigo than men.
3. Head injury: A history of head injury or other disorders affecting the balance organs in the ear may increase the risk of vertigo.
4. Certain medical conditions: Conditions such as Meniere's disease, migraine, acoustic neuroma, and Ramsay Hunt syndrome can cause vertigo. It is important to note that the specific risk factors may vary depending on the underlying cause of vertigo.

Development

Vertigo can develop due to several conditions, including inflammation of the nerves in the balance portion of the inner ear (vestibular neuritis), an inflammatory disorder (persistent postural-perceptual dizziness), and the displacement of calcium crystals in the inner ear (benign paroxysmal positional vertigo or BPPV). These conditions can cause a sense of motion or spinning, unsteadiness, loss of balance, nausea, and other symptoms related to balance problems. Vertigo may also result from disorders of the balance organs in the ear or head injuries. It is essential to consult a doctor for an accurate diagnosis and appropriate treatment.

Assessment and Diagnosis

Triage

You should see a doctor if you experience recurrent, sudden, severe, or prolonged and unexplained vertigo or dizziness. This is especially important if vertigo is accompanied by a new, different, or severe headache, a fever, or any symptoms that could indicate a more serious issue, such as confusion, vision changes, or loss of balance.

Diagnosis

To diagnose vertigo, your doctor will likely start by reviewing your medical history and conducting a physical and neurological examination. They may also recommend some tests to determine the cause of your dizziness, such as:

1. Electronystagmography (ENG) or videonystagmography (VNG): These tests measure involuntary eye movements while your head is placed in different positions or your balance organs are stimulated with water or air to help determine if dizziness is due to inner ear disease.
2. Magnetic resonance imaging (MRI): This test uses magnetic fields and radio waves to create cross-sectional images of your head and body, which can help identify and diagnose a range of conditions. MRI may be performed to rule out other possible causes of vertigo.
3. Rotary chair test: Your eye movements are analyzed while you sit in a computer-controlled chair that moves slowly in a circle.
4. Dix-Hallpike maneuver: Your doctor carefully turns your head in different positions while watching your eye movements to determine whether you have a false sense of motion or spinning.
5. Vestibular evoked myogenic potentials test: Sensor pads attached to your neck and forehead and under your eyes measure tiny changes in muscle contractions in reaction to sounds.
6. Imaging tests: MRI and CT scans can determine if underlying medical conditions might be causing your balance problems.
7. Blood pressure and heart rate tests: Your blood pressure might be checked when sitting and then after standing for two to three minutes to determine if you have significant drops in blood pressure. Your heart rate might be checked when standing to help determine if a heart condition is causing your symptoms. These tests can help your doctor determine the cause of your vertigo and guide appropriate treatment.

Management and Treatment

Complications

Potential complications of vertigo may include an increased risk of falls, especially in elderly individuals or those with impaired vision or hearing. The persistent dizziness and unsteadiness associated with vertigo can lead to a fear of falling, which may cause individuals to limit their activities and become less active. This can result in decreased mobility and social isolation. In rare cases, severe and persistent vertigo may contribute to psychological distress or depression. It is important to consult a healthcare professional for proper diagnosis and treatment to manage vertigo symptoms and reduce potential complications.

Home Remedies

It is important to consult a healthcare professional for proper evaluation and treatment of vertigo.

Treatment

Treatments for vertigo depend on the underlying cause. Some common treatments for various types of vertigo include:

1. Benign paroxysmal positional vertigo (BPPV): BPPV can be treated with maneuvers called canalith repositioning procedures (CRP). These are specific head movements that help reposition the dislodged calcium crystals in your inner ear, restoring balance. Your doctor or a specialist trained in vestibular rehabilitation can perform these maneuvers.
2. Vestibular neuritis: In most cases, vestibular neuritis symptoms improve on their own over time, usually within a few days to a week. There is no specific treatment for this condition, but your healthcare provider might recommend medications to help relieve symptoms like nausea and dizziness.
3. Persistent postural-perceptual dizziness (PPPD): PPPD is challenging to treat, and there is no definitive cure. However, various therapies can help manage symptoms, including physical therapy, vestibular rehabilitation, and relaxation techniques. Your healthcare provider may also recommend medications to help alleviate symptoms. It is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan tailored to your specific condition.

Preparing for medical consultation

To prepare for an appointment for vertigo, you should:

1. Keep a detailed symptoms calendar: Record the time, symptoms experienced, and duration of each vertigo episode.
2. Note down key personal information: Include any major stresses, recent life changes, and other medical conditions you have.
3. Make a list of your medications, vitamins, or supplements: This will help your healthcare provider be aware of any medication interactions or side effects that could be contributing to your vertigo.
4. Bring any recent brain scans on a CD to your appointment: This will help your doctor review your medical history and make an informed diagnosis.
5. Invite a family member or friend to accompany you: They can help remember important details and provide additional insight into your symptoms, especially if they have witnessed your vertigo episodes.
6. Prepare a list of questions to ask your doctor: This will ensure you cover all the information you need during your appointment. Remember to follow any pre-appointment instructions provided by your healthcare provider, and be ready to share any relevant information about your vertigo symptoms, medical history, and current medications.