Category: Vertigo

What Causes Vertigo

Vertigo is one of the most common medical problems. It refers to a sensation of dizziness or off balance. When you experience vertigo, you feel like you’re moving when you’re actually not or it feels the world around you is spinning when it’s not. People who have experienced vertigo describe the sensation to be similar to motion sickness, feeling dizzy, or feeling like the things around them are moving. However, vertigo is completely different from lightheadedness. Many people think that vertigo is a fear of heights, but it’s not. The condition can be associated with looking down from a great height, but it can refer to any ongoing or temporary spells of dizziness. Vertigo has two categories, peripheral and central. Peripheral vertigo is a result of a problem in the vestibular nerve or the inner ear. The vestibular nerve is the nerve that connects the inner ear with the brain. Central vertigo happens when there’s a problem in your brain, particularly in your cerebellum. The cerebellum is the part of the hindbrain that controls the coordination of balance and movements. 

Most cases of vertigo are peripheral vertigo, making up around 93 percent of cases. Some of the most common causes are:

  • Benign paroxysmal positional vertigo (BPPV) is believed to stem from a disturbance in the otolith particles. The inner ear has a function to send signals to your brain about your position and helps keep your balance. When you have BPPV, specific changes in your head’s position can bring on vertigo.
  • Labyrinthitis is an inflammation that occurs in the inner ear labyrinth and the nerve within that’s responsible to encode your body’s head motion and position, as well as sound. This condition is usually caused by a viral infection.
  • Meniere’s disease is a disorder in your inner ear caused by a build-up of fluid and changing pressure in your ear. This condition can lead to vertigo with ringing in the ear (tinnitus) and hearing loss. 

Vertigo may also be associated with other problems, such as migraine headaches, certain medications, brain problems (including stroke and tumor), head or neck injuries/trauma, ear surgery, perilymphatic fistula, prolonged bed rest, otosclerosis, herpes zoster oticus, syphilis, transient ischemic attack, acoustic neuroma, and multiple sclerosis.

A change in the position of your head often triggers vertigo. People who experience vertigo usually describe it as feeling like they’re swaying, spinning, tilting, unbalanced, and pulled in one direction. Vertigo may be a symptom of other conditions, but it also has its own related symptoms. Other symptoms include:

  • Jerking or abnormal eye movements
  • Nausea
  • Vomiting
  • Sweating
  • Headache
  • Ringing in the ears (tinnitus) or hearing loss

All of these symptoms can last from a few minutes to a few hours or longer. They also may come and go and you also will need to be aware of vertigo’s warning signs, as it can result in serious complications. These include:

  • Vertigo related to deafness and no history of Meniere’s disease
  • Vertigo related to neurological signs, such as new weakness or lack of muscle coordination
  • Sudden vertigo that isn’t affected by a change of position.

If you experience any of these symptoms, you should make an appointment with your doctor. Your diagnosis of vertigo depends on whether the cause is peripheral or central, you have true vertigo, and any life-threatening conditions are present. To determine the type of vertigo you have, your doctor may perform a head-thrust test, Romberg test, Dix-Hallpike test, and Fukuda-Unterberger test. Your doctor may also ask you to do imaging tests, such as CT scan and MRI.

The treatment for vertigo depends on the cause. Some types of vertigo will go away without treatment because your brain is able to adapt to the inner ear changes. However, if there’s an underlying problem, it will need medical attention. For instance, if your vertigo is caused by a bacterial infection, you may need antibiotic therapy. Treatment for vertigo may include:

  • Medicines can relieve some symptoms. Antihistamines (betahistine, promethazine) or anti-emetics (metoclopramide, prochlorperazine) can reduce nausea and motion sickness. If you have an acute vestibular disorder associated with a middle ear infection, your doctor may prescribe steroids, antibiotics, and antiviral drugs. 
  • Vestibular rehabilitation is a type of physical therapy that can help strengthen the vestibular system. The vestibular system’s main function is to send signals to the brain about the body and head movements. If you have recurrent attacks of vertigo, vestibular rebab can train your other senses to compensate for vertigo.
  • Canalith repositioning maneuvers is a recommended series of specifying body and head movements for people with BPPV. These movements are done to move the calcium deposits in your inner canal to enter an inner ear chamber so your body can absorb them. During the procedure, you may experience vertigo symptoms as the canalith moves. These movements are effective and safe.

If your vertigo is caused by Meniere’s disease, you have to treat the disease. Treatment usually includes prescription medicine, such as glycopyrrolate, lorazepam, and meclizine, to relieve the dizziness you feel. Other treatment options usually include:

  • Taking diuretic therapy and restricting salt
  • Avoiding chocolate, alcohol, cigarettes, and caffeine
  • Pressure pulse treatment
  • Surgery.

You can also perform a number of exercises to improve the symptoms of vertigo without visiting the doctor. These exercises are:

  • Epley maneuver for BPPV aims to move particles from the semi-circular canals to the vestibule of the inner ear so your body can resorb them more easily. 
  • Brandt-Daroff exercises are used to break up the particles or crystals that lead to vertigo. You are advised to repeat the exercises five times in the morning, afternoon, and evening. These exercises are normally performed for two weeks.

Home remedies may help resolve your vertigo and limit its impact on your daily life. These home remedies consist of lifestyle changes and herbal solutions. To help reduce the impact of vertigo, do the following steps:

  • As soon as you feel dizzy, sit down
  • If you know a movement can make you feel symptoms, do it slowly
  • If you get up at night, use good lighting
  • If your ability to walk or sense of balance is affected by vertigo, use a cane to prevent falls.

You also need to avoid driving or using a ladder. It is advisable for you to make some changes in your home to prevent falls and serious injuries. To help alleviate the problem, try to get up slowly. It is also important for you to take care when looking upward and you should avoid making sudden changes in your head position.

Categories: Medical Vertigo