Vertigo is a feeling that makes you think that you are moving when you are not or the feeling that things around you are moving when they are not.

Vertigo is similar to motion sickness. People who experience vertigo describe the sensation as “feeling dizzy” or feeling as if the room is spinning.

Some affected persons use the term vertigo interchangeably with dizziness to describe a variety of symptoms ranging from balance disorders and difficulty with walking to motion sickness or lightheadedness.

Most health care professionals consider vertigo to be a specific complaint that involves the balance centers of the inner ear and the brain.

Many children try to create a sense of vertigo when they spin or ride a merry-go-round or rollercoaster. Induced vertigo is self-limiting because it lasts for a few moments and then disappears.

When vertigo occurs spontaneously or as a result of an injury or illness, it may last for many hours or days before resolving compared to self-induced vertigo.

The main difference between vertigo and common dizziness is that; vertigo can cause nausea and vomiting and may be a symptom of a severe balance disorder, whereas dizziness just makes you feel momentarily unbalanced.

 

What are the signs and symptoms of vertigo?

The symptoms of vertigo include a sense of spinning, loss of balance, or whirling. These symptoms can be present even when the person is perfectly still.

Movement of the head or body, like rolling over in bed can worsen the symptoms. Some people experience associated with nausea or vomiting.

While a patient says he is dizzy, a health care professional would try to diagnose the problem to understand whether the patient is describing a sensation of spinning (vertigo) or whether dizziness is described as another symptom like lightheadedness, fainting, or nearly passing (syncope, near-syncope).

Physical examination mostly shows signs of abnormal eye movements (called nystagmus).

Your doctor would try to confirm whether the inner ear or the cerebellum (the balance centers of the brain) is the cause of vertigo. The patient may be asked to perform coordination tasks to ensure that the brain usually performs.

 

Causes of vertigo

Vertigo may be defined based upon whether the cause is peripheral (problem within the inner ear) or central (arise in the brain).

 

a doctor is supporting a old woman

 

Peripheral causes:

  • The structures in the inner ear may be inflamed spontaneously. Small crystals found in the inner ear can become displaced and cause irritation to the tiny hair cells within the semicircular canals, leading to vertigo. This is called benign paroxysmal positional vertigo (BPPV).
  • Infection of the vestibular nerve can cause vertigo (it is called vestibular neuronitis, vestibular neuritis or labyrinthitis).
  • Fluid buildup within the inner ear causes Ménière’s disease, i.e., vertigo that includes hearing loss and tinnitus (ringing in the ear). The cause of this fluid accumulation is not known.

 

Central causes:

  • Strokes can cause vertigo and loss of coordination.
  • Multiple sclerosis
  • Tumors of the brain and spinal cord.
  • Vestibular migraine may develop vertigo as a symptom.
  • Traumatic brain injury may be associated with vertigo.

 

Treatment

The most effective treatment for peripheral vertigo includes particle repositioning movements. The most well-known of these treatments is the Epley manoeuvre. During this procedure, specific head movements lead to the movement of the loose crystals (canaliths) within the inner ear.

By repositioning these loosed crystals, they cause less irritation to the inner ear, and symptoms can resolve. These movements should be supervised by an experienced health care professional or physical therapist to avoid the worsening of vertigo.

Brandt-Daroff exercises can also help alleviate symptoms of positional vertigo. This involves quickly lying flat from a seated position with your head pointed away from the side that causes vertigo.

 

a male doctor giving consultation in a room

 

This needs to be repeated multiple times daily for the best result. Other movements that have been identified to reduce symptoms of vertigo include the Semont manoeuvre and the Foster manoeuvre (half somersault).

Medications can also provide some relief but are not prescribed for long-term use. Medical professionals mostly prescribe meclizine for persistent vertigo symptoms. Benzodiazepine medications are also useful but may cause significant drowsiness as a side effect.

 

For individuals with Ménière’s disease, a consistent low-salt (low-sodium) diet is often advised. This helps to reduce the fluctuations of fluid within the vestibular system, diminishing some of the symptoms caused by Ménière’s disease.

Lastly, the use of an hearing aid is also able to alleviate vertigo and the dizziness associated with balance disorders. Certainly, the hearing test for balance disorders, namely balance assessment/vestibular should be conducted by an audiologist before the next course of action can be taken.

 

In a Nutshell

Bear in mind that all treatment must be taken after consulting a doctor. This is to prevent the condition from becoming worst and to prevent other problems.

For those who live locally, if you require a professional consultation on vertigo, please feel free to get in touch with our specialists for a hearing test in Malaysia.

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