Vertigo

Vertigo dizziness

Last Updated February 20th, 2019

Overview of vertigo

Vestibular disorders have become a major global health concern at present. Epidemiological studies by Vestibular Disorders Association have shown that about 35% of adults above 40 years of age in the United States suffer from Vestibular disorders of some form or the other. The most critical among all these diseases is “Vertigo”. Earlier it was believed to be a symptom of old age only. But at present, children, adults and teens are also affected by the disease. But in general, people above 60 are more prone to vertigo and related disorders than other age groups.

 

What is vertigo?

Vertigo womanVertigo is a collective term for a group of symptoms such as lightheadedness, imbalance, unsteadiness, spatial disorientation and spinning sensation due to abrupt changes in position.

The disease should be clearly distinguished from similar disorders such as dizziness and syncope.

According to a recent global survey by American Academy of Family Physicians, nearly 5% of visits to the physicians on an annual basis is related to vertigo or associated clinical complications. Acute cases of the disease may lead to permanent damage of the vestibular system and eventual death.

 

What are the main causes of vertigo?

There are multiple etiological factors behind vertigo. These can be further classified into peripheral and central factors. These are described below-

Peripheral causes

  • Benign Paroxysmal Positional Vertigo (BPPV): It is characterized by transient episodes of vertigo, which occurs especially during head or neck movements. This is mainly induced by trauma (in 50% cases). It has a time duration of fewer than 45 seconds.
  • Vestibular neuritis: It is usually characterized by monophasic episodes lasting for days to weeks at a stretch. The conditions exacerbate in the later stages causing nausea and vomiting.
  • Ménière’s disease: In this condition, endolymphatic regulatory dysfunction occurs which lead to fluctuations in ear pressure. This condition is worsened by a diet rich in sodium.
  • Trauma: Mechanical or emotional trauma caused by external or internal factors trigger acute imbalance conditions.
  • Labyrinth dysfunction: Toxicity caused by certain medications such as streptomycin, amikacin trigger labyrinthine degeneration that directly impacts the vestibulo-ocular reflexes. This gradually progresses to imbalance and more severe conditions.
  • Perilymph fistula: Formation of perilymph fistula leads to loss of elasticity of the otic capsule, leakage of the perilymph and partial collapse of the labyrinth. These lead to pressure changes at the auditory receptors (maculae or capolae receptors) that progresses to vertigo.

Central causes

  • Brainstem infarction: Brain stem ischemia may lead to several clinical complications such as loss of sensitivity in the facial region and a few vascular dysfunctions which gradually progress to vertigo related symptoms.
  • Tumour: Tumours present in the nerve sheaths (vestibular/acoustic neuroma) gradually lead to vestibular malfunctions.
  • Migraine: Patients suffering from migraine cephalgia have high risks of developing episodic vertigo symptoms. 10-30% of the patients belong to this category.
  • Multiple sclerosis: Damage of myelin sheath of neurons often lead to vestibular lesions that give rise to associated vestibular symptoms.
  • Vestibular epilepsy: In this condition, epileptic discharges in the temporal lobes and parietal cortex occurs which might lead to imbalance conditions.

 

What are the warning signs?

Vertigo dizzinessVery often, symptoms of vertigo are confused with that of dizziness, syncope, and lightheadedness. Knowledge of the following symptoms is necessary to handle emergency situations-

  • The sensation of spinning immediately after quick head and neck movements (lasts for less than a minute)
  • Floating sensation and lightheadedness
  • Disorientation in 3D space
  • Overall body imbalance
  • Nausea and vomiting (critical cases)
  • Vision impairments, mostly double vision (in aged people)
  • Ringing sound in ears (Tinnitus)
  • The heaviness of arms and legs
  • Difficulty performing normal activities such as walking, running, climbing stairs
  • Temporary speech impairment (especially in epileptic patients)
  • Oscillopsia (a sensation that every object in the surrounding is oscillating)
  • Cognitive impairments ( Eg: Not being able to determine directions)
  • Mental instability and confusion
  • Shortness of breath
  • Numbness of hands and feet
  • Disturbed sleep cycle

 

What are the different types of vertigo?

The classification of vertigo is done mainly considering the etiological factors and characteristics in each type. The common classifications are as follows-

  • Vestibular: This disease occurs due to the dysfunctions of any of the vestibular organs, for example in the cochlea, labyrinth or anywhere within the middle ear. One of the primary causes of the disease is Benign Paroxysmal Positional Vertigo.
  • Peripheral: It stems from malfunctioning of the inner ear. Nearly 93% of vertigo cases belong to this category (source: healthline.com).
  • Migraine associated: Migraine related imbalance is usually associated with severe headache and photosensitivity.
  • Physiological: It is closely associated with motion sickness syndromes and results from improper functioning of the vestibule, vision and somatosensory receptors.
  • Psychogenic: In many cases, vertigo results from emotional stress conditions such as anxiety, neuroses and depression.

 

Can there be associated complications?

It must be clearly noted that vertigo not only causes temporary symptoms such as dizziness, lightheadedness and imbalance but also gives rise to numerous clinical complications within the patient’s body. Persistent vertigo conditions can severely damage the Central Nervous System and in the long run, may lead to cardiovascular disorders.

 

What diagnostic tests are important?

Vertigo heightVertigo needs an immediate diagnosis in order to pinpoint the root cause of the symptoms. The following tests are usually recommended-

  • Head thrust test (to determine response to quick changes in the environment)
  • Romberg test ( to detect occurrence of imbalance)
  • Fukuda Unterberger test
  • CT scan and MRI (to detect any brain damage)
  • Posturography test ( includes sensory organization test, stability test and motor control test)

 

Treatment & Prevention

The treatment depends mainly on the underlying cause. There are several factors and underlying conditions that lead to vertigo. Some of the conditions that lead to vertigo can be treated as follows:

  • Benign paroxysmal positional vertigo (BPPV) – In most of the cases, the condition resolves on its own within few weeks to few months. However, if persistent, a physical therapist or an audiologist can treat the condition with a sequence of movements known as the canalith repositioning procedure. In cases where the condition cannot be treated by the canalith repositioning procedure, surgical intervention is required. The surgery is known as canal plugging surgery. The success rate of this surgery is found to be nearly 90%.
  • Ear infection- Vertigo caused due to an ear infection can be treated by treating the infection. Antibiotics can be administered in order to get rid of the ear infection.
  • Meniere’s disease can be treated by use of medications such as glycopyrrolate, meclizine, or lorazepam. These drugs help to reduce the dizziness. Diuretic therapy and restriction of salt in the diet is essential for reducing the fluid retention in the body.  Consumption of caffeine, chocolate, alcohol, and tobacco is also restricted.
  • Exercises- Exercises such as the Epley maneuver for BPPV, Brandt-Daroff exercises etc. can help in getting rid of vertigo.

Anti-histamines and anti-emetic drugs should be administered for the associated symptoms such as nausea, vomiting, motion sickness etc.

Treating the underlying cause promptly can help in preventing vertigo. Preventing and treating ear infections promptly can prevent vertigo caused by ear infections. Maintaining the right posture and preventing head and spine injuries can also prevent vertigo.

Facts

  • According to the Vestibular Disorders Association (VEDA), nearly 1 out of 1000 individuals is affected by benign paroxysmal positional vertigo (BPPV).

Facts

  • Bouts of vertigo may result due to an inner ear infection as ears help to maintain balance owing to the fluid present in them.

Facts

  • According to the University of California San Francisco Medical Center, approximately 40% of the adults in the United States experience vertigo at least once in their lifetime.
  • Females are more susceptible to vertigo as compared to males.

 

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Dos and Don'ts

Dos
  • Use a cane for support while walking if you are at a risk of falling.
  • Use good lighting for the passage if you wake up at night for using the washroom.
  • Manage your stress levels. Learn common relaxation techniques such as meditation, yoga, progressive muscle relaxation, tai chi, mindful breathing etc.
Don'ts
  • Neglect any sort of head injury or ear infection. Seek medical care even if they are mild.
  • Continue walking if you feel dizzy. Sit down comfortably as soon as you experience dizziness.
  • Indulge in consumption of alcohol, drive, or use a ladder if you have vertigo.

 

 

 

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How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxidative Stress: Understanding the most lethal phenomenon happening in your body right now Free radicals cause damage to the body, which is known as oxidation.  The amount of oxidation caused by…
How accurate is the hair follicle drug test? Hair follicle drug test is one of the best ways to identify drug use in professional circles. But…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
hepatitis B envelope antigen
Hepatitis B Envelope Antigen (HBeAg) The HBeAg or hepatitis B envelope antigen test is a screening test used to diagnose the onset of…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
Tachycardia heart
Cardiac Profile Cardiac profile is panel of blood tests performed to check cholesterol level and other heart disease markers to…
Smiling-happy-pretty-woman-with-flowers
Laughter Therapy– The Best Medicine for Healthy Living Read how laughter influences your stress hormones, belly fat, heart health, and more. Use these simple tips to…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
boost immunity tips
Step up your defence: 15 proven tips on how to boost your immunity Want to naturally build up a stronger immunity? Tired of frequent colds and runny nose?You will never believe…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
Elderberry: More than just a folk medicine for cold and sinusitis While the raw elderberry can be a hazard, when consumed in the form of teas and syrup, elderberry…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
about mediterranean diet
Why you should be adopting a Mediterranean style of diet today Ever wondered why the Mediterranean diet is so healthy? One simple solution to lowering risk of several deadliest…