Vertigo: Symptoms, Causes and Treatment

Overview

Vertigo is the feeling that you or your environment is moving or spinning. It differs from dizziness because vertigo is an illusion of movement. Vertigo can be temporary or long-term. Persistent vertigo is linked to mental health issues. Vertigo is a symptom of a medical condition, not a disease. It can happen when there is a problem with the inner ear, brain, or sensory nerve pathway, which classifies vertigo into two types: peripheral vertigo and central vertigo. Vertigo may affect a person’s ability to function in daily life, potentially leading to depression or anxiety. Dizziness, or vertigo, can happen at any age, but it is common in people over 65 years old.

Causes

There
are a number of different causes of vertigo. Some of the most common causes
include:

  • Benign paroxysmal positional vertigo (BPPV). BPPV occurs when tiny calcium particles clump up in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps people keep balance. BPPV can occur for no known reason and may be associated with age. BPPV normally affects older adults, It has been linked to dementia and twice as common in women as in men.

  • Meniere’s disease. This is an inner ear disorder caused by a buildup of fluid and changing pressure in the ear. It can cause symptoms of vertigo along with ringing in the ears and hearing loss. It tends to affect people between the ages of 40 and 60 years.

  • Vestibular neuritis or labyrinthitis. This is an infection of the vestibular nerve. The infection causes inflammation in the inner ear around nerves that are important for the body sense balance.

Other
possible causes may include:

  • head or neck injury
  • migraine headaches
  • ear surgery
  • acoustic neuroma
  • otosclerosis
  • multiple sclerosis
  • prolonged bed rest
  • perilymphatic fistula
  • herpes zoster oticus, also known as Ramsay Hunt syndrome
  • syphilis
  • transient ischemic attack
  • brain problems such as stroke or tumor
  • side effects of medication or drug toxicity

Symptoms

People with vertigo typically have the
following symptoms:

  • Spinning or whirling
  • Swaying
  • Loss of balance
  • Pulled to one direction
  • Feeling nauseated
  • Vomiting
  • Abnormal eye movements
  • 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

To diagnose vertigo, the doctor may carry out a physical examination first and ask about the patient’s medical history, including any history of migraine headache or a recent head injury or ear infection. The doctor will also evaluate the patient’s eye to look for abnormal jerking movements. The pattern of the eye movements may help to determine if the problem is peripheral or central. If the doctor suspects you have the symptoms of vertigo, you may be recommended to take blood tests, and imaging tests such as a head CT or MRI scan. It is important to diagnose the cause of vertigo or dizziness as quickly as possible to rule out serious conditions such as cardiovascular disease, stroke, hemorrhage, or tumor.

Treatment

Treatment
for vertigo depends on its causes. In some cases, vertigo goes away without any
treatment because your brain is able to adapt, at least in part, to
the inner ear changes. There are a variety of treatments for vertigo including
home remedies, medications, and physical therapy maneuvers.

Home therapy should only be undertaken if you have already been diagnosed with vertigo and are under the supervision of a doctor. There are some common home remedies that may help relieve the symptoms of vertigo.

  • Vitamin D supplementation may be beneficial for patients diagnosed with BPPV.

  • Herbal remedies such as ginger root, ginkgo biloba, and coriander may help reduce vertigo symptoms for some people.

  • Acupuncture may provide relief for symptoms of some types of vertigo.

  • Avoid substances that can affect circulation, including caffeine, tobacco, or alcohol.

  • Drink plenty of fluids.

  • A consistent low-salt (low-sodium) diet

Medications may provide some relief but are not recommended for long-term use. Medical professionals often prescribe medications for persistent vertigo symptoms and may be effective to suppress the activity of the inner ear, such as meclizine, dimenhydrinate or promethazine; anticholinergic medications such as scopolamine; or a tranquilizer, such as diazepam. However, people should notice the side effect of the medicine. Medications can treat the symptoms but do not cure the vertigo.

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. For people with BPPV, doctors may move the patient’s head
and body through a series of positions. The most common method is the Epley
maneuver. Doctors also may provide specific maneuvers for patients to continue
at home. For more persistent vertigo, doctors may recommend other types of
vestibular rehabilitation, also called balance rehabilitation.

In a few cases, surgery may be needed for vertigo.

Keywords: Vertigo

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