Vertigo: Symptoms, Causes and Treatment

vertigo

Have you ever had a feeling or sensation that the world around you is spinning or moving? Or you may feel like that the things around you that don’t move are apparently moving. This condition is called Vertigo.

Vertigo is a sensation of feeling that everything around you is moving or spinning while you stand perfectly still. This article discusses the symptoms, causes, and treatment of Vertigo. Keep reading to know more.

understanding vertigo

Understanding Vertigo

Some people often confuse vertigo with a feeling of dizziness as the symptoms are often the same. 

This feeling may last up to a few hours or days or may lead up to weeks. If a person has severe vertigo and finds it difficult to maintain balance in everyday routine, he may consider visiting a doctor or a health care professional as soon as possible. 

Most healthcare professionals consider vertigo to be a specific complaint that involves the inner ear and the brain.

To understand how vertigo is different from dizziness one should consider the workings of the ear and how it is connected to the brain.

The human ear consists of three parts. 

  • The outer ear
  • Middle year
  • Inner ear 

The sound waves travel from the outer ear towards the middle ear until they reach the eardrum.

From there, when the sound waves collide with the eardrum, they produce vibrations that then travel from the three bones of the middle ear. 

The inner ear controls both hearing and balance. The hearing part of the ear is called the cochlea and it contains thousands of sensory cells.

A vestibular system is a part of the inner ear that contains fluid in the semicircular canals. This fluid helps us to maintain balance. 

When these vibrations reach the last bone of the middle ear, they are then transmitted to the vestibular nerve that is connected to the human brain. 

Therefore the brain interprets the impulses or vibrations as sound.

For instance, a lot of children while playing or riding a merry-go-round creates a sense of dizziness or vertigo. This is caused because of the movement of fluid in our ear. 

This type of self-infused vertigo is temporary and lasts for a few seconds while vertigo occurs spontaneously.

It can also result from injury or illness and may last for many hours or days until properly treated.

symptoms

Symptoms

A number of symptoms are related to cases of vertigo but only a health professional can diagnose it. 

Some common symptoms of vertigo are:

  • A sensation or feeling of spinning or moving while a person is standing or not moving
  • Tingling
  • Loss of balance
  • Nausea or Vomiting
  • Headache or migraine
  • Ringing in the ear or loss of hearing.

These symptoms can last for a few seconds to a few hours or days if not treated properly. 

During the evaluation of vertigo, doctors often ask questions related to the history of the patient and symptoms a patient may be experiencing. 

These include:

  • History of medication or any medications being used.
  • Any recent illness or illness faced in past.
  • Sometimes even unrelated problems may lead to the cause of vertigo. 

After taking the medical history, the doctor or health care professional then moves towards a physical examination of the patient.

This includes the neurologic functioning of the brain that might lead to either peripheral or central causes of vertigo. These examinations include: 

  • The sign of nystagmus

The uncoordinated movement of the eye.

  • Dix- Hallpike test

This test is performed by the doctor that involves the abrupt repositioning of the patient’s head and monitoring the symptoms. 

  • Roll test

This test is performed when the patient is laying on the bed while the head is moved rapidly from side to side. This test is somewhat similar to Dex- Hallpike test as it may provoke symptoms of vertigo. 

Some tests are also done in order to diagnose vertigo. These are

  • Blood tests
  • Brain stem auditory evoked potential studies
  • Caloric stimulation
  • CT Scan of head 
  • Lumbar puncture
  • MRI scan or MRA (of blood vessels of the brain)

Sometimes when the diagnosis is not made, the doctor may consult to vestibular physical therapist to help diagnose and treat the patient at the same time. 

However, some causes of vertigo may require an MRI or a CT Scan to diagnose whether the patient is suffering from: 

  • Tumour in the brain or spinal cord
  • Multiple sclerosis
  • Tinnitus 
  • Hearing loss. 

If the diagnosis is hearing loss, the doctor or health care professional may take the audiometry test.

Though, hearing loss is not associated with BPPV or other common causes of vertigo.

To check whether the cause of vertigo is peripheral or central, the doctor may conduct the Electronystagmography, or electrical evaluation of vertigo, which may help distinguish. 

vertigo causes

Causes of vertigo

To some extent, it is uncommon to link dizziness with any illness but if accompanied by any of the following, consult the doctor.  These are:

  • Severe headaches
  • Fever
  • Blurred vision, double vision or loss of vision
  • Trouble in speaking
  • You might have difficulty in hearing
  • Sudden loss of consciousness
  • Difficulty in walking or maintaining balance
  • Sensations or tingling 

Moreover, there are also a number of causes of vertigo depending on whether they are central or peripheral. 

Central causes occur due to the spinal cord or brain while peripheral causes are due to ear problems. 

These ear problems are a follows:

Peripheral Vertigo

Some of the peripheral Vertigo that leads to vertigo are:

  • Inflammation in the ear

Small crystals found in the inner ear if displaced can cause irritation in hair cells and can lead to vertigo. This is known as Benign paroxysmal positional vertigo (BPPV).

The signs and symptoms of BPPV may come and go and usually last for up to a minute or so. The episode of BPPV may go for some time and then reoccur. 

  • Infection of the vestibular nerve

This can cause dizziness or vertigo and is called Vestibular Neuronitis or labyrinthitis. 

Moreover, Vestibular Neuritis can cause hearing problems, trouble in hearing, and ringing sensation in the ears.

It is due to a number of reasons including measles, flu, rubella, mumps, etc. 

  • Fluid build-ups

Fluid build-ups within the inner ear can cause Meniere’s loss or tinnitus (ringing in the ear).

It is due to ear injury, a problem related to the circulatory system, or an increase in age. 

  • Tumors

Moreover, there may be tumors of the vestibular nerve. 

central causes

Central causes

Some central causes that lead to vertigo are:

  • Concussion or brain injury

A concussion is a traumatic injury to the brain due to an accident or any daily activity.

Sometimes concussion or a traumatic brain injury may lead to vertigo.

  • Strokes

When a person experiences stroke (which may be due to illness) may cause vertigo.

Therefore, a stroke may be due to changes in blood pressure, increase in blood sugar levels or cholesterol. 

This is due to the disruption of myelin that protects and insulates nerve cells of spinal nerve and brain cells.

Therefore, any disruption may lead to vertigo.

  • Acoustic neuroma

It is a rare, noncancerous brain tumor that grows on the acoustic nerves that help to control balance and hearing. 

  • Tumors

If a patient is diagnosed with brain or spinal tumors, he may face vertigo.

In some patients, migraines may lead to vertigo. 

  • Taking certain kinds of medications. 

vertigo treatment

Treatment Options

The treatment of vertigo depends upon the diagnosis made by the doctor or a health care professional. 

Most often, This condition goes away without treatment because our brain is continuously adapting, changes in the inner ear or other mechanisms that help us maintain balance. 

But in some cases, an individual needs treatment. 

Epley maneuver or canalith repositioning procedure

The loose crystals within the ear move during this procedure due to the continuous movement of an individual’s head. Professionals carry out this treatment as it may cause irritation at first.

Brandt-Daroff

This procedure helps to cure the symptoms of positional vertigo.

This involves moving in a seated position quickly while pointing your head away from the side that causes vertigo. 

Vestibular rehabilitation

This therapy helps to strengthen the vestibular system as the vestibular system maintains the movement of the body relative to gravity, by sending signals to the brain. 

Therefore, in this therapy, the doctor helps patients to train other senses to compensate for vertigo.

The Epley maneuver

This process involves the movement of the head in four different positions that help to move the fragments to a place where they cause no symptoms of vertigo.

A patient may experience vertigo during this process. 

However, the patient improves after the Epley maneuver.

Hence, it may take up to 2 weeks for a patient to fully recover. 

Medication

Your doctor will prescribe medicines for 3 to 14 days depending on the condition.  The medications prescribed usually are 

  • Prochlorperazine
  • Antihistamines

You can get a supply of these medicines if they reduce your symptoms. 

However, in some cases, doctors prescribe medications to patients with central vertigo to relieve the symptoms of motion sickness or nausea. These medications are: 

  • Steroids

To reduce swelling or cure an infection.

  • Antibiotics

For the treatment of infection or inflammation.

  • Diuretics (water pills)

This medication is given to a patient with Meniere’s disease to reduce pressure from fluid build-up. 

The doctor may prescribe the following medications. 

  • Meclizine
  •  glycopyrrolate 
  •  Lorazepam to help relieve the symptoms of dizziness. 

Other options may include

  • Using pressure pulse treatment
  • Injecting antibiotics or corticosteroids with the help of a doctor
  • Avoiding caffeine, alcohol and chocolate.

Surgery

In some cases, surgery might be important to treat underlying problems such as brain or spinal injury or tumor. 

unknown causes

Vertigo with Unknown Causes

Your doctor may have to admit you, If they are unable to know the cause of a patient’s vertigo:

  • There is frequent vomiting or nausea 
  • Fluids can’t be kept down
  • Possibility of central vertigo
  • May experience sudden hearing loss 

Hence, if a patient is experiencing vertigo, he may want to take some precautionary steps to avoid any inconvenience. 

That may include informing the employer and seeking advice to reduce risks and making one’s home safe. 

overview of vertigo

Who is at the Risk?

The risk factors are great in people:

  • Overage 50
  • being a woman
  • A head injury
  • Certain medications like antidepressants, antipsychotics
  • Certain medical conditions that cause ear problems
  • Family history

These are the certain risk factors for developing this disease.

Conclusion

If you do not treat your vertigo properly, it can cause severe health challenges. This is especially applicable in the case of central vertigo. 

You must consult your doctor immediately if your vertigo indicates an underlying issue.

Most often it occurs spontaneously, but maintaining a healthy lifestyle and balanced diet can help reduce the chances of experiencing it. 

Some changes are:

  • Keeping a check on one’s diabetes, blood pressure, and cholesterol.
  • Avoiding tobacco products.
  • Regular exercise. 

 

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