In my last article prior to this one I said that my next article will be on Vertigo and Meniere’s disease. If you have not read the Part 1 of this series, you can do so here-
https://raodoctor.com/inner-ear-disorder-tinnitus-vertigo-menieres
Now let us get on with learning about these two conditions.
Understanding Vertigo-What is it?
Vertigo is a sensation of spinning or dizziness that can cause nausea, vomiting, and loss of balance.
It is a feeling or illusion of movement or rotation, which is usually due to some underlying middle ear disease.”
It is a common symptom of various underlying conditions such as
- inner ear disorders,
- migraines, and
- head injuries.
Vertigo can be a severe condition that can affect a person’s ability to carry out daily activities.
Causes of Vertigo
Vertigo can be caused by various factors, but the most common ones include inner ear disorders, migraines, head injuries, and medication side effects. Inner ear disorders such as labyrinthitis and Meniere’s disease can affect the balance organs in the inner ear, leading to vertigo.
Migraines can also cause vertigo, especially if accompanied by visual disturbances. Head injuries can damage the balance organs in the inner ear, leading to vertigo. Finally, certain medications such as antibiotics and blood pressure drugs can cause vertigo as a side effect.
Symptoms of Vertigo
The most common symptom of vertigo is a spinning or whirling sensation in the head.
Other symptoms may include dizziness, nausea, vomiting, and loss of balance.
The symptoms can last for a few seconds to several hours, depending on the underlying cause.
What is the difference between dizziness and vertigo?
Vertigo and dizziness are not always the same. The image below will let you understand the difference between the two with related examples.
How is Vertigo diagnosed?
Vertigo is a symptom, not a diagnosis, so clinical methods are used to determine the underlying cause of the vertigo.
The first step taken by your doctor in diagnosing vertigo is a thorough medical history and physical examination, which may include checking blood pressure, heart rate, and neurological function.
If these are inconclusive, your doctor might suggest undergoing some specific clinical tests.
Some of the specific clinical methods that can be used include:
Dix-Hallpike maneuver:
This test is used to diagnose benign paroxysmal positional vertigo (BPPV), a common cause of vertigo. The patient is quickly moved from an upright position to a lying down position with their head turned to one side. If vertigo is triggered by this maneuver, it indicates BPPV.
Head impulse test (HIT):
This test is used to evaluate the function of the vestibulo-ocular reflex (VOR), which helps to stabilize vision during head movements. The patient is asked to focus on a target while the examiner quickly moves their head to the side. If the patient’s eyes do not stay fixed on the target, it suggests dysfunction in the VOR.
Romberg test:
This test assesses the patient’s balance and proprioception. The patient is asked to stand with their feet together and eyes closed. If they sway or lose balance, it could indicate a problem with the central nervous system or inner ear.
Audiometry:
Since hearing loss can sometimes be associated with vertigo, an audiometry test may be performed to evaluate the patient’s hearing function.
Electronystagmography (ENG):
This test measures involuntary eye movements (nystagmus) and can help identify inner ear abnormalities or vestibular dysfunction.
Magnetic resonance imaging (MRI):
In some cases, an MRI may be ordered to rule out any structural abnormalities or tumors like acoustic neuroma, which could be causing vertigo.
It is worth noting that these clinical methods are just a starting point, and additional tests or consultations with specialists, such as an otolaryngologist or neurologist, may be required to make a definitive diagnosis.
Treatment for Vertigo
The treatment for vertigo depends on the underlying cause or the type of vertigo you may have. To know the type of vertigo, you can read it here- Types of Vertigo.
In some cases, vertigo may resolve on its own, but in other cases, medication or physical therapy may be required.
Medications include:
- anti-nausea drugs like dimenhydrinate [Avomine, Dramamine] and
- vestibular suppressants like
- cinnarazine [Vertigon, Diziron] and
- betahistine [Vertin]
can help manage the symptoms of vertigo.
Physical therapy, such as the Epley maneuver, can help reposition the balance organs in the inner ear, reducing the severity and frequency of vertigo attacks.
Useful Resource:
To be concluded….
We will take a break here. In my next article that I will publish shortly, we will learn about a related topic – Meniere’s disease.
