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Jai Ganesh

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Registered: 2005-06-28

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Vertigo

Vertigo

Gist

Vertigo is a sensation of spinning, swaying, or tilting, usually caused by inner ear problems (peripheral) or brain issues (central). Common causes include BPPV, vestibular neuritis, and migraines. Symptoms include nausea, vomiting, sweating, and loss of balance, typically lasting from a few seconds to several days. (BPPV: Benign Paroxysmal Positional Vertigo).

Is vertigo a permanent condition?

No, vertigo is not always permanent; it depends on the underlying cause, with many cases being temporary, curable with specific maneuvers like for BPPV, or manageable with treatment, though some conditions like Ménière's disease can cause recurring or chronic episodes. Proper diagnosis is key, as treatments range from simple repositioning exercises to medications or therapies, often resolving symptoms or significantly reducing their impact.

Summary

Vertigo is a sensation of feeling off balance. If you have these dizzy spells, you might feel like you are spinning or that the world around you is spinning.

Vertigo is a sensation that you or the world around you is spinning. It's usually a symptom of a problem with the part of your inner ear or brain that keeps you balanced. Treating a connected health issue may help to relieve vertigo.

Vertigo Causes

Vertigo often happens because of an inner ear problem. Some of the most common causes include:

Benign paroxysmal positional vertigo (BPPV). This inner ear disorder happens when tiny calcium particles (canaliths) get dislodged from their normal location and collect in the inner ear. The inner ear sends signals to the brain about your head and body movements to help you keep your balance.

BPPV can occur for no known reason and may worsen as you get older.

* Meniere's disease. This inner ear disorder may 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.

* Vestibular neuritis or labyrinthitis. This inner ear problem is usually related to a viral infection such as chickenpox, measles, or hepatitis. The infection inflames nerves that help your brain keep you balanced.

Details

Vertigo causes dizziness and makes you feel like you’re spinning when you’re not. It most commonly occurs when there’s an issue with your inner ear. But you can also develop it if you have a condition affecting your brain, like a tumor or stroke. Treatments vary and can include medication, repositioning maneuvers or surgery.

Overview:

What is vertigo?
Vertigo is a sensation that the environment around you is spinning in circles. It can make you feel dizzy and off-balance. Vertigo is a symptom of lots of health conditions rather than a disease itself, but it can occur along with other symptoms.

Other symptoms you might experience when you have vertigo include:

* Nausea and vomiting.
* Dizziness.
* Balance issues.
* Hearing loss in one or both ears.
* Tinnitus (ringing in your ears).
* Headaches.
* Motion sickness.
* A feeling of fullness in your ear.
* Nystagmus (a condition that causes your eyes to move from side to side rapidly and uncontrollably).

Types of vertigo

There are two main types of vertigo: peripheral and central.

* Peripheral vertigo is the most common type. It happens when there’s an issue with your inner ear or vestibular nerve. (Both help with your sense of balance.)

Subtypes of peripheral vertigo include:

** Benign paroxysmal positional vertigo (BPPV).
** Labyrinthitis.
** Vestibular neuritis.
** Ménière’s disease.

* Central vertigo is less common. It occurs when you have a condition affecting your brain, like an infection, stroke or traumatic brain injury. People with central vertigo usually have more severe symptoms like severe instability or difficulty walking.

Possible Causes:

What causes vertigo?

Vertigo causes vary from person to person and may include:

* Migraine headaches.
* Certain medications, including some antibiotics, anti-inflammatories and cardiovascular drugs.
* Stroke.
* Arrhythmia.
* Diabetes.
* Head injuries.
* Prolonged bed rest.
* Shingles in or near your ear.
* Ear surgery.
* Perilymphatic fistula (when inner ear fluid leaks into your middle ear).
* Hyperventilation (rapid breathing).
* Low blood pressure (your blood pressure decreases when you stand up).
* Ataxia (muscle weakness).
* Syphilis.
* Otosclerosis (a bone growth issue affecting your middle ear).
* Brain diseases.
* Multiple sclerosis (MS).
* Acoustic neuroma.

What are the possible complications of vertigo?

Vertigo can cause falls, which may result in bone fractures (broken bones) or other injuries. Vertigo can also interfere with your quality of life and hinder your ability to drive or go to work.

Care and Treatment:

How do healthcare providers diagnose vertigo?

A healthcare provider will perform a physical exam and ask questions about your vertigo symptoms. They may also recommend one or more tests to confirm your diagnosis.

Vertigo diagnostic tests

Healthcare providers may perform some tests to diagnose vertigo. These tests can include:

* Fukuda-Unterberger test. Your healthcare provider will ask you to march in place for 30 seconds with your eyes closed. If you rotate or lean to one side, it could mean that you have an issue with your inner ear labyrinth. This could cause vertigo.
* Romberg’s test. During this assessment, your provider will ask you to close your eyes while standing with your feet together and your arms to your side. If you feel unbalanced or unsteady, it could mean that you have an issue with your central nervous system (your brain or spinal cord).
* Head impulse test. For this test, your provider will gently move your head to each side while you focus your eyes on a stationary target (for example a spot on the wall or your provider’s nose). As they move your head, they’ll pay close attention to your eye movements. This can tell them if there’s an issue with the balance system in your inner ear.
* Vestibular test battery. This includes several different tests to check the vestibular portion of your inner ear system. A vestibular test battery can help determine whether your symptoms are a result of an inner ear issue or a brain issue.
* Imaging tests: These may include CT (computed tomography) scans or MRI (magnetic resonance imaging).

How do healthcare providers treat vertigo?

Vertigo treatment depends on the underlying cause. Healthcare providers use a variety of treatments, which may include:

* Repositioning maneuvers.
* Vertigo medication.
* Vestibular rehabilitation therapy (vertigo exercises).
* Surgery.

Repositioning maneuvers

Benign paroxysmal positional vertigo (BPPV) occurs when tiny calcium carbonate crystals (canaliths) move out of the utricle in your inner ear (where they belong) into your semicircular canals. This can cause vertigo symptoms, especially when you change your head position.

Canalith repositioning procedures, like the Epley maneuver, can help shift the crystals out of your semicircular canals back into your utricle. These maneuvers consist of a series of specific head movements. A healthcare provider can perform a canalith repositioning procedure during an office visit. They can also teach you how to do it at home.

Vertigo medication

Medication may help in some cases of acute (sudden onset, short duration) vertigo. Healthcare providers may recommend motion sickness medications (like meclizine or dimenhydrinate) or antihistamines (like cyclizine) to ease vertigo symptoms.

Vestibular rehabilitation therapy (vertigo exercises)

Vestibular rehabilitation therapy usually involves a range of exercises to improve common vertigo symptoms like dizziness, unstable vision and balance issues. A healthcare provider will tailor your treatment according to your unique needs. Exercises may include stretching, strengthening, eye movement control and marching in place. Your provider can teach you how to do these exercises at home so you can manage your symptoms whenever you have a vertigo episode.

Surgery

It’s rare, but you might need surgery when a serious underlying health issue — like a brain tumor or neck injury — causes vertigo. Providers typically only recommend surgery when other treatments don’t work. Your provider or surgeon will tell you which type of procedure you need and what to expect.

How do you get vertigo to go away on its own?

It’s not always possible to get rid of vertigo without the help of a healthcare provider. But here are some things you can try at home to ease your symptoms:

* Move slowly when standing up, turning your head or performing other triggering movements.
* Sleep with your head elevated on two pillows.
* Lie in a dark, quiet room to reduce the spinning sensation.
* Sit down as soon as you feel dizzy.
* Squat down instead of bending over at the waist when picking something up.
* Turn on the lights if you get up during the night.
* Use a cane or walking stick if you feel like you might fall.

How to cure vertigo permanently

Unfortunately, there’s no surefire way to get rid of vertigo permanently and keep it from coming back. Some people have vertigo once and never have it again. Others experience recurring (returning) episodes.

If you have severe or frequent vertigo, talk to your healthcare provider about ways to manage your symptoms and improve your quality of life.

Additional Information

Vertigo is a symptom, rather than a condition itself. It’s the feeling that you, or the environment around you, is moving or spinning.

This feeling may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks.

Vertigo can develop suddenly and last for a few seconds or much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making daily life very difficult.

Symptoms of vertigo may include:

* loss of balance – which can make it difficult to stand or walk
* feeling sick or being sick
* dizziness

When to get medical advice

Speak to your GP practice if:

* your vertigo comes on suddenly
* you have vertigo that will not go away
* you have vertigo that keeps coming back
* vertigo is affecting your daily life

Diagnosing vertigo

Your GP will ask about your symptoms and can carry out an examination to help determine some types of vertigo. They may also refer you for further tests.

What causes vertigo?

Inner ear problems, which affect balance, are the most common causes of vertigo. It can also be caused by problems in certain parts of the brain.

Common causes of vertigo may include:

* benign paroxysmal positional vertigo (BPPV) – where certain head movements trigger vertigo
* migraine
* labyrinthitis or vestibular neuronitis – an inner ear infection
* persistent postural-perceptual dizziness (PPPD)
* Ménière’s disease

Less commonly, vertigo can sometimes be caused by conditions that affect certain parts of the brain. This can include:

* a stroke
* multiple sclerosis
* brain tumours

Depending on the condition causing vertigo, you may have other symptoms, such as:

* a high temperature
* ringing in your ears (tinnitus)
* hearing loss

Treatment for vertigo

Treatment will depend on the cause. Gentle movement is encouraged as soon as you are able to. This will help the balance systems in your body reset.

Medicines (such as prochlorperazine and some antihistamines) may help in most cases of vertigo. These should only be used for a short amount of time (3-5 days). Long term use may slow the recovery process.

Many people with vertigo get better without treatment. If you’re still experiencing vertigo or balance problems after 6 weeks, you may be referred to a Vestibular (balance) Physiotherapist or an ENT (Ear, nose & throat) consultant.

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