Introductory Remarks
What is vertigo?
Vertigo is a sensation that the surrounding around you is spinning in circles. It is not a disease, rather it is a symptom of various health conditions. It can occur along with other symptoms.
Alongside vertigo (the sensation that the environment is spinning in circles), one may experience the following signs and symptoms when they have vertigo:
- Dizziness.
- Nausea and vomiting.
- Motion sickness.
- Loss of hearing in one or both ears.
- Nystagmus.
- Balance problems.
Essential Statistics and Key Facts
- Common Condition: Vertigo affects about 20-30% of people at some point in their lives.
- Age Factor: It is more prevalent in older adults, particularly those over the age of 65.
Causal Factors
What are the causes of vertigo?
- There are several causes of vertigo.
- They vary from one individual to another.
- They include:
- Stroke.
- Medications such as antibiotics and anti-inflammatory drugs.
- Diabetes.
- Syphilis.
- Hyperventilation.
- Acoustic neuroma.
- Labyrinthitis (infection of the inner ear).
- Migraine headaches.
- Head injuries and brain diseases.
- Multiple sclerosis (MS).
- Ataxia (muscle weakness).
- Orthostatic hypotension (low blood pressure on standing up).
- Ear surgery.
- Perilymphatic fistula.
- Shingles in or near the ear.
- Otosclerosis.
- Certain medications. Some drugs used in the treatment of seizures, anxiety and depression may be associated with vertigo as a side effect. Examples are anti-convulsants.
Risk Elements
What are the factors that increase the likelihood of suffering from vertigo?
- Age. Vertigo is more prevalent in older adults, particularly those over the age of 65, due to age-related changes in the inner ear and vestibular system.
- Gender. Women are generally more likely to experience vertigo than men, particularly in conditions like Meniere’s disease.
- Previous Episodes. Individuals who have experienced vertigo in the past are at a higher risk of having future episodes.
- Medical Conditions. Inner Ear Disorders: Conditions like BPPV, vestibular neuritis, and Meniere’s disease. Neurological Disorders: Such as migraines, multiple sclerosis, or vestibular migraines can increase risk.
- Head Injuries. Trauma to the head can affect the inner ear and balance mechanisms, leading to vertigo.
- Family History. A family history of vestibular disorders or migraines may increase the likelihood of experiencing vertigo.
- Medications. Certain medications, particularly those that affect the inner ear or have dizziness as a side effect, can increase the risk.
- Dehydration and Nutritional Deficiencies. Poor hydration and deficiencies in essential nutrients (like vitamin B12 or potassium) can affect balance and increase susceptibility.
- Stress and Anxiety. High levels of stress and anxiety can exacerbate or trigger episodes of vertigo, particularly in individuals predisposed to vestibular issues.
- Environmental Factors. Prolonged exposure to certain environments, such as high altitudes or rapid changes in pressure, can trigger vertigo in susceptible individuals.
Signs & Symptoms Overview
Manifestations and Indicators of vertigo
- Sometimes patients describe vertigo as dizziness, but it is more than just filling dizzy. It is a sensation that everything around you is in motion or is spinning.
- Attacks can last for minutes or even hours, with severe vertigo lasting up to months.
- Vertigo symptoms may include:
- Nausea and vomiting.
- Light-headedness.
- Loss of balance.
- Dizziness
- Feelings of;
- Floating.
- Spinning.
- The floor tilting
- When you experience additional symptoms, this may be an indicator of other health conditions.
- These can be:
- Double vision.
- Vision loss.
- Hearing loss.
- Ringing in the ears.
- Ear drainage and pressure/ pain.
Types
What are the categories of vertigo?
There are two main categories of vertigo, which are:
- Peripheral vertigo.
- Central vertigo.
Peripheral vertigo
- Peripheral vertigo is the most common type of vertigo.
- It happens due to problems with the inner ear or vestibulocochlear nerve (cranial nerve VIII).
- Cranial nerve VIII is responsible for balance and hearing.
- Sub-categories of peripheral vertigo are:
- Labyrinthitis.
- Vestibular neuritis.
- Meniere’s disease.
- Benign paroxysmal positional vertigo (BPPV). BPPV occurs when tiny calcium carbonate crystals (canaliths) get dislodged from the utricle (in the inner ear) into the semi-circular canals causing symptoms of vertigo, especially when there is a change in the position of the head.
Central vertigo
- This type is less common.
- It occurs due to conditions that affect the brain. It can occur due to brain infections, stroke among other conditions that affect the brain.
- It is characterized by more severe symptoms such as difficulty walking.
Diagnostic Procedures
How is vertigo diagnosed?
Vertigo can be diagnosed using several ways, among them:
- Performance of a physical exam by a qualified healthcare practitioner.
- Patient-history taking (anamnesis).
- Tests.
Tests likely to be recommended include:
- Romberg’s test.
- Head impulse test.
- Fukuda-unterberger test.
- Vestibular test battery.
- Imaging tests.
- Heart monitoring.
- Electrocardiography (ECG).
- Caloric stimulation.
- Electroencephalogram (EEG).
- Romberg’s test. This is a balance and gait test.
- Fukuda-unterberger test. In this test, the healthcare provider usually asks the patient to march in a single location with the eyes closed for 30 seconds. If he/ she rotates or leans to one side, then there is an issue with the inner ear labyrinth, which could cause vertigo.
- Vestibular test battery. This is composed of several various tests which are aimed at checking the vestibular portion of the inner ear system.
- Imaging tests. Imaging tests that can be performed to help in diagnosis are computed tomography (CT) scans and magnetic resonance imaging (MRI) scans.
Treatment & Management
Care, treatment and management of vertigo.
- In vertigo, the kind of treatment that is initiated depends on the underlying cause.
- Various types of treatment are employed. These are:
- Vertigo medication.
- Repositioning maneuvers.
- Vestibular rehabilitation therapy.
- Surgery.
Vertigo medication
- Sometimes, motion sickness medications are recommended for this condition in order to ease symptoms of vertigo.
- These are;
- Anti-histamines.
- Meclizine
- Dimenhydrinate.
Repositioning maneuvers
Canalith repositioning maneuvers such as Epley maneuver can be used for benign paroxysmal positional vertigo (BPPV).
Surgery
- Surgical procedures become a necessity when the vertigo caused by brain tumors or neck injury.
- Surgery is performed when other treatments have failed to work.
Is vertigo completely curable?
There is no way yet that can help to permanently get rid of vertigo and keep it from coming back. Some people experience vertigo once, whereas others experience recurring episodes.
Complications & Risks
What are the most likely possible complications of vertigo?
- Falls. Vertigo can cause breakage of bones.
- Poor quality of life. It can interfere with activities such as operating machinery.
Recommendations
In order to ease your symptoms:
- Move slowly when turning the head or standing up from a chair.
- Sleep with the head elevated at angles. Use 2 pillows to achieve this.
- Lie in dark, quite room to reduce the spinning sensation.
- Squat when picking up objects. Do not bend over your waist.
- Use a walking stick to avoid falling.