• Shruti GOCHHWAL

Understanding Vertigo and What to Do About It

Have you ever suddenly felt like you’re on a tilt-a-whirl when you’re sitting in your office or walking down the street? If yes, vertigo might be the reason.

Vertigo is a type of dizziness where you feel a sudden sensation that the world around you is spinning or that you are! This feeling can come and go or it can last for hours or even days. With the dizziness, you may also experience vomiting or nausea, headaches, a racing heartbeat or double vision.

Difference Between Vertigo and Dizziness

Dizziness is one of the most common reasons why people go to the emergency room. However, not all of them have vertigo.

Vertigo symptom dizziness

Caption: Vertigo is a common symptom of dizziness  Credits: Commons wikimedia


Vertigo is characterized as an illusion of motion. Most of the time, vertigo implies a spinning sensation. Other illusions of motion such as rising, falling, accelerating in one direction, are also vertigo, but they aren’t usually experienced.

Dizziness is more of a relaxed term that includes vertigo. It is a collection of symptoms like vertigo, imbalance, lightheadedness, and a sensation that one might pass out.

Dizziness is sometimes a symptom of serious brain conditions such as stroke, multiple sclerosis or bleeding in the brain.

Cause

The most typical causes of vertigo include diseases of the ear or inner ear infections such as BPPV (benign paroxysmal positional vertigo), Meniere’s disease, and vestibular neuritis.

BPPV may occur when calcium increases in the canals of the inner ear, leading to brief dizziness that lasts from 20 to 60 seconds.

It is generally brought on by moving the head in certain positions or by trauma to the head.

Vestibular neuritis is brought on by an inner ear infection that causes inflammation around the nerves that creates a sense of body balance.

It leads to a severe bout of vertigo that can last a day or more and at times includes hearing loss.

You may feel dizzy for a day or two and then off balance. The Cleveland Clinic says 95 percent of people make a full recovery and never experience it again.

Meniere’s disease is caused by the increase in pressure and fluid in the inner ear and can cause dizziness along with hearing loss and ringing in the ears.

Less common causes of vertigo are brain or head injuries or migraines.

Diagnostic Tools

Vertigo is usually diagnosed using the video electronystagmography test (eye movement test), an audiogram (hearing test), and the rotatory chair test in which eye movements are noted when a patient sits in a chair that spins slowly.

Treatments

Vertigo sometimes is a once-in-a-lifetime thing that comes and goes quickly, and shouldn’t normally be cause for alarm. It just happens. Vertigo that is due to BPPV can be treated using physical therapy where patients learn a series of exercises known as the Canalith repositioning procedure. This involves slow manoeuvres for positioning your head to move particles in the inner ear.

Apple's maneuver

Caption: Apple’s maneuver. Credits: Wikipedia


A single treatment cures BPPV nearly 75 percent of the time. It is often done the same day the diagnosis is made. However, it does tend to come back with a 30 percent chance of another round within a year from the first time it occurred.

Treatment of vertigo due to migraine takes longer. Usually, it starts with lifestyle changes including diet, and if it doesn’t work, more preventive medications such as verapamil, nortriptyline, or topiramate are given.

These medications take nearly a month to work. Sometimes one must try multiple types before finding one that works. With vestibular neuritis, generally, the individual is back to their usual activities by two weeks. Treatment is just waiting for it to improve, combined with exercises.

If an individual has Meniere’s disease, a doctor might prescribe a diuretic and a low sodium diet to decrease fluid pressure in the inner ear.

Few vertigo patients can also be treated using certain prescription medications like calcium channel blockers, tricyclic antidepressants and beta-blockers.

Although it can be disorienting, vertigo is not a critical condition.

For those with BPPV, it can become hazardous if the person is working on something like scaffolding where they get a sense of vertigo.

If you experience repeated rounds of dizziness and hearing loss, it is advised to see an ear, nose and throat (ENT) specialist to seek appropriate treatment.

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