Guide to an Effective Vertigo Management
People who have vertigo experience a sensation of spinning and tend to lose their balance. Although vertigo is not a serious disease, it can lead to accidents that can result in injuries upon losing balance and falling. Read this article to learn more about what is vertigo, its causes, symptoms, and treatment measures.
What is vertigo?
In the medical context, vertigo is known as benign paroxysmal positional vertigo (BPPV). Vertigo is defined as a sensation of spinning or dizziness, wherein people sense that the environment around them is spinning even though there is no movement.
Although the English dictionary puts vertigo as "dizziness or spinning due to heights", its medical definition does not state the same. Vertigo, in medical terms, is not even considered as a disease, but rather recognized as a symptom of an underlying illness that a person may be having.
The Two Types of Vertigo
There are primarily two types of vertigo: central vertigo and peripheral vertigo. There are medications and treatments for both types. However, the same is administered to patients upon diagnosing the correct cause of its occurrence. Let us learn more about the two types of vertigo.
1. Peripheral Vertigo
It is the more common form of vertigo found in most cases. This condition is associated with an issue arising in the central ear, which is the region that controls the balance of the body. The most common causes that lead to peripheral vertigo are:
- Benign Paroxysmal Positional Vertigo (BPPV): This type of peripheral vertigo is characterized by a condition wherein small crystals get loose and start to float in the fluid particles of the inner ear. The movement of these crystals creates the sensation of spinning or dizziness. An ear injury can often result in BPPV.
- Vestibular Neuronitis: Causes severe dizziness in patients and the reason for its occurrence has been associated with a virus attack. The dizziness can start suddenly and may go on for about two to three weeks.
- Meniere's Disease: While the exact cause of this disease is yet to be researched, the condition is characterized by an excessive buildup of the fluid called "endolymph" in the inner ear. This fluid buildup creates a pressure in the parts of the inner ear, which controls balance in the body. The excess pressure created leads to dizziness.
2. Central Vertigo
Central vertigo is a form of vertigo that occurs due to a brain disease or an injury to the brain or the central nervous system. Some of the medical conditions that can result in central vertigo are:
- Head injuries
- Multiple sclerosis
- Infections
- Migraines
- Brain tumors
- Stroke
What are the symptoms associated with vertigo?
Vertigo is more of a symptom in itself rather than being a disease. One of the major symptoms of vertigo is dizziness. Some of the common symptoms of vertigo include nausea, vomiting, sweating, and ear-related problems.
In the case of peripheral vertigo, which happens as a result of an inner ear infection, patients may experience some pain or a feeling of fullness in their ear. When the cause of vertigo is associated with medical conditions such as labyrinthitis and Meniere's disease, patients may experience hearing loss and tinnitus (ringing in the ears). These symptoms may be experienced in one or both ears.
The symptoms of peripheral vertigo are generally short-term and pass rather quickly. On the other hand, central vertigo comes suddenly and may last for a longer duration. The symptoms experienced are more intense compared to peripheral vertigo symptoms. While some symptoms such as uncontrolled eye movements are common in both types, people having a central vertigo experience a longer duration of the movements. Patients may also find it difficult to focus on a specific point in the case of central vertigo. Other symptoms of central vertigo include headaches, weakness, and trouble swallowing.
Diagnosing Vertigo
A few tests and a detailed analysis of symptoms are generally the common courses adopted by doctors in diagnosing vertigo. At first, the doctor may want to determine the nature of vertigo attacks and asks relevant questions such as:
- Details of the first attack, the symptoms observed, and their level of intensity
- Other symptoms experienced, which include reduced or loss of hearing, tinnitus, nausea, and vomiting
- Frequency of the occurrence of the symptoms and the duration for which they normally last
- Whether the symptoms affect the patient in carrying out everyday routine tasks
- Whether there are any particular triggers that the patient can associate with the vertigo symptoms
What can you do to feel better?
Physical Exam
To confirm a diagnosis, the doctor checks for the symptoms of vertigo by conducting a detailed physical examination. As a part of this examination, the doctor is likely to check the eyes and ears to look for the first signs of vertigo. To check the balance ability of the patient, the doctor might instruct the patient to either move quickly or get up quickly from a lying to a sitting position.
A few tests depending upon the symptoms are also likely to be recommended by the doctor. They include:
Hearing Tests
In cases when patients experience symptoms such as tinnitus, which is described by a ringing sound in their ears or hearing loss, the doctor may refer the patient to an ear, nose, and throat (ENT) specialist, who can carry out some hearing tests. These tests may include:
- Audiometry Test – In this test, the patient is made to listen to sounds by way of headphones through an audiometer. Upon listening to various pitches of sounds generated by the machine, the patient signals, through hand movements or through a button.
- Tuning Fork Test – A tuning fork is a device through which sound waves are produced on a tap. The tester creates a sound by tapping the tuning fork before holding it at either side of the patient’s head to know the strength of the sound received.
Videonystagmography
Videonystagmography (VNG) is the technique used to diagnose symptoms of nystagmus. Nystagmus can indicate a problem with the body organs that help create balance. As a part of this test, specialized goggles are placed over the patient’s eyes and the patient is made to observe still and moving objects. The goggles have a video camera that helps in the recording of eye movements for further diagnosis.
Caloric Testing
In a caloric test, warm, cool water, or air is left running into the patient’s ears for about 30 seconds. The changes in temperature stimulate the balance organ in the ear, helping the specialists understand its function levels. This test isn't painful, although it can lead to dizziness in some cases.
Posturography
A machine is used to test the balance of the patient to understand vision sensations that pass from the feet and joints, and the input from the ear in maintaining body balance. This goes a long way in planning the treatment course for the patient.
Scans
Sometimes, a doctor may recommend a scan of the head to look for vertigo-inducing causes such as acoustic neuroma (a non-cancerous brain tumor).
For these brain scans, MRI or CT scans are generally used. MRI scans produce detailed images of patient’s brain through magnetic fields and radio waves. A CT scan, on the other hand, uses X-rays to produce internal images.
