Vertigo

Do you feel dizzy and out of sorts while doing your daily chores? If so then this feeling could be related to a phenomenon called vertigo. Vertigo creates a false sensation of either you or your surroundings moving or spinning. This condition might feel similar to motion sickness or lightheadedness but vertigo is not the same thing. 

Vertigo makes you feel off-balance and creates a hallucination of movement. Vertigo is not a condition in itself but is more like a symptom of something deeper. Vertigo causes are most often related to some problems in the inner ear like benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniere's disease, etc. Though they are all different diseases they similarly affect the ear which topples the brain’s sense of balance.

This sensation can present itself in many forms. At times it could be barely noticeable and other times it may be so severe that you are unable to find balance and it may disrupt your daily activities. 

A vertigo attack can come over all of a sudden and may last for a few seconds (or much longer at times). Severe vertigo may persist for several days and make life difficult for the patient. Apart from the loss of balance certain other symptoms associated with vertigo are:

• Dizziness

• Unable to stand or walk

• General malaise or feeling of sickness.

• Being pulled in one direction

• Swaying

• Tilting

• Nausea

• Headache

• Sweating

• Hearing loss or ringing in the ear.

• Nystagmus (Jerking or abnormal eye movement).

We will look into a few different vertigo reasons, vertigo treatment, and a few other factors associated with this condition.

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Types of Vertigo 

Vertigo is a symptom of many underlying conditions. The symptoms of a vertigo episode depend on the type of vertigo you have. Some of the major types of vertigo are mentioned below:

1. Peripheral Vertigo 

This is the most common type of vertigo which is caused by problems in the vestibular nerve or areas of the inner ear and the balance mechanism of the brain. The most common causes of this type of vertigo are BPPV, labyrinthitis, being on a certain type of medication, head injury, Meniere's disease, etc.

2. Central Vertigo 

There is an area in the brain called the cerebellum which is also referred to as “little brain” (located at the bottom part of the brain) and is responsible for many functions including motor control. The cerebellum has a role in coordination, timing of movements, and precision. When there is an issue in this part of the brain one might experience central vertigo. Central vertigo is also related to the brain stem which is the lower part of the brain that connects to the spine. Vertigo reasons for central type include migraines, multiple sclerosis, acoustic neuroma, brain tumour in the cerebellum, and being on certain types of medications. 

3. Cervical Vertigo 

This is also called cervicogenic dizziness and it is a neck-related sensation. This type of vertigo is caused due to poor neck position, trauma or injury to the cervical spine, neck disorders, etc. Cervical vertigo could also be caused by injury to the head which results in a whiplash or disruption of head and neck alignment.

Vertigo Causes

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As we know by now that the inner ear is the most common cause of vertigo, let us look at some of the diseases that are associated with vertigo:

• Benign Paroxysmal Positional Vertigo - Positional vertigo occurs when tiny calcium particles or canaliths get dislodged from their normal position (i.e. the utricle) and get collected in the inner ear (or semicircular canal). There is no specific reason for BPPV and it is assumed to be associated with age. Positional vertigo can cause mild to severe sensations of dizziness.

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• Meniere's Disease - This condition is caused due to fluid buildup in the inner ear and a change of pressure in the ear. This can lead to vertigo, hearing loss, or ringing in the ear (also called tinnitus). 

• Labyrinthitis or Vestibular Neuritis - This condition is again related to inner ear issues which are caused by infection (mostly viral). There are nerves in the inner ear which are responsible for balance in the body. When an infection occurs it causes inflammation around these nerves. 

Few other vertigo causes which are not so common are:

• Neck or head injury

• Migraine headaches

• Problems in the brain like tumours or stroke.

Vertigo Treatment 

Some vertigo cases do not need treatment and they improve with time. This happens because our brains can adapt to inner ear changes (at least in parts) and are able to rely on other mechanisms for maintaining balance. Whereas some cases of vertigo might need treatment if the patient has repeated episodes for several months (it could even be years). Some of the vertigo treatments are:

• Vestibular Rehabilitation - This dizziness treatment is a kind of physiotherapy which aims at strengthening the vestibular system. Our vestibular system functions in a way that sends signals to our brains about our body and head movements in relation to gravity. A person with recurrent bouts of vertigo would be recommended for vestibular rehabilitation. With the help of this therapy, other senses in our system are trained to compensate for vertigo.

• Canalith Repositioning Maneuvers - This is also called the Epley maneuver and is one of the most common exercises recommended to treat vertigo especially benign paroxysmal positional vertigo. In this vertigo cure, a series of simple body movements are taught as outlined in the guide given by the American Academy of Neurology. With the help of these movements, calcium deposits are moved out of the canal into a chamber within the inner ear, enabling the body to absorb it. During the procedure, one might experience vertigo due to the movement of canaliths. These movements are usually guided by a therapist or a doctor. These are very safe and effective movements.

• Medicine - In some cases, antihistamine medicines or prochlorperazine can help in the early stages of most vertigo cases. Symptoms such as nausea or motion sickness can be reduced by such medicines. In case the vertigo reason is inflammation or infection then steroids or antibiotics can help in reducing the swelling and getting rid of the infection.

• Surgery - If the underlying vertigo causes are more severe such as an injury to the brain, tumour, or injury to the neck then surgery might be needed.