VERTIGO - Watsons Health

VERTIGO

Vertigo is a sensation of rotation, rocking or spinning when perfectly still.  When you feel that you are moving, that is called subjective vertigo, when you feel that the environment is moving, that is known as objective vertigo.

Causes of Vertigo

Vertigo is often caused by an inner ear problem. Some of the most common causes include:

  • Benign Paroxysmal Positional Vertigo (BPPV). This is the most common type of vertigo and lasts for 15 seconds to a few minutes. BPPV occurs when tiny calcium particles (canaliths) clump up in canals of the inner ear, which sends signals to the brain about head and body movements relative to gravity. This can be initiated by sudden head movement.
  • Meniere’s disease. This is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears (tinnitus) and hearing loss. This is composed of triad of symptoms including, vertigo, ringing in the ears (tinnitus), and hearing loss.
  • Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection (usually viral). This is characterized by sudden onset of vertigo with hearing loss that lasts for days until inflammations subsides.

Vertigo is often triggered by a change in the position of your head.

People with vertigo typically describe it as feeling like they are:

  • Spinning
  • Tilting
  • Swaying
  • Unbalanced
  • Pulled to one direction
  • Feeling nauseated
  • Abnormal or jerking eye movements (nystagmus)
  • Headache
  • Sweating
  • Ringing in the ears or hearing loss

Symptoms can last a few minutes to a few hours or more and may come and go.

DIAGNOSIS

During an evaluation for vertigo, the health care professional may obtain a full history of the events and symptoms. This includes medications that have been taken (even over-the-counter medications), recent illnesses, and prior medical problems (if any).

After the history is obtained, a physical examination is performed. This often involves a full neurologic exam to evaluate brain function and determine whether the vertigo is due to a central or peripheral cause.

The Dix-Hallpike test is done to try to recreate symptoms of vertigo; this test involves abruptly repositioning the patient’s head and monitoring the symptoms which might then occur. However, not every patient is a good candidate for this type of assessment, and a physician might instead perform a “roll test,” during which a patient lies flat and the head is rapidly moved from side to side. Like the Dix-Hallpike test, this may recreate vertigo symptoms and may be quite helpful in determining the underlying cause of the vertigo.

If the cause of your signs and symptoms is difficult to determine, your doctor may order additional testing, such as:

  • Electronystagmography (ENG) or videonystagmography (VNG). ENG (which uses electrodes) or VNG (which uses small cameras) can help determine if dizziness is due to inner ear disease by measuring involuntary eye movements while your head is placed in different positions or your balance organs are stimulated with water or air.
  • Magnetic resonance imaging (MRI). MRI may be performed to rule out other possible causes of vertigo.

 

RECOMMENDED MEDICATIONS

Treatment for vertigo depends on what’s causing it. In many cases, vertigo goes away without any treatment. This is because your brain is able to adapt, at least in part, to the inner ear changes, relying on other mechanisms to maintain balance.

For some, treatment is needed and may include:

Vestibular rehabilitation. This is a type of physical therapy aimed at helping strengthen the vestibular system. The function of the vestibular system is to send signals to the brain about head and body movements relative to gravity.

Canalith repositioning maneuvers. The movements are done to move the calcium deposits out of the canal into an inner ear chamber so they can be absorbed by the body. You will likely have vertigo symptoms during the procedure as the canaliths move.

Medicine. In some cases, medication may be given to relieve symptoms such as nausea or motion sickness associated with vertigo.  If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling and cure infection.  For Meniere’s disease, diuretics (water pills) may be prescribed to reduce pressure from fluid buildup.

Surgery. In a few cases, surgery may be needed for vertigo.  If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain or neck, treatment for those problems may help to alleviate the vertigo.

Home remedies  

  • Vitamin D supplementation.
  • Herbal remedies such as gingkgo biloba, giner root, coriander reduce symptoms.
  • Avoid substances that can trigger vertigo such as caffeine, tobacco or alcohol.
  • Drink plenty of fluids.

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