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Vertigo: Types, Symptoms, Causes, Diagnosis And Treatment

Vertigo is a sensation that causes you to feel off-balance. One of the most common medical problems, vertigo causes you to feel that you are moving when in fact you are not or feel like things around you are moving when they aren't.

It is similar to motion sickness and not the same as light-headedness.

Types Of Vertigo

The types of the condition are understood depending on its cause [1] .

The main two types of vertigo are peripheral vertigo and central vertigo.

  • Peripheral vertigo: It usually occurs when there is a disturbance in the balance organs of the inner ear. It can also develop due to inflammation or a viral infection that affects the inner ear.
  • Central vertigo: It is linked to problems with the central nervous system, and involves a disturbance in the brainstem or the cerebellum.

Symptoms Of Vertigo

The condition is often triggered by movements affecting your head. The symptoms can last a few minutes to a few hours. Some may last longer or can diminish and then develop later [2] .

Some of the common symptoms associated with vertigo are

  • swaying,
  • spinning,
  • tilting,
  • lack of balance and
  • being pulled to one direction.

The above mentioned are accompanied by other symptoms such as [3]

  • vomiting,
  • sweating,
  • feeling nauseated,
  • headache,
  • ringing in the ears,
  • minor hearing loss and
  • jerking of the eye.

Causes Of Vertigo

The major cause of vertigo is inner ear problems. Apart from this, the other causes of the condition are mentioned below [4] [5] :

Meniere's disease: An inner ear disorder, Meniere's disease is possibly caused due to a build-up of fluid and changing the pressure in the ear. The condition can cause vertigo which will be accompanied with a ringing in your ears as well as minor hearing loss.

Benign Paroxysmal Positional Vertigo (BPPV): This condition develops when tiny calcium particles clump up in the canals of the inner ear.

Vestibular neuritis or labyrinthitis: This condition affects your inner ear and is caused due to viral infections which result in the development of inflammation in the inner ear around nerves that help the body sense balance.

Some of the other factors that cause vertigo are as follows [6] :

  • Head or neck injury
  • Certain medications that cause ear damage
  • Brain problems such as stroke or tumour
  • Migraine headaches

Diagnosis Of Vertigo

The doctor will carry out a physical examination and ask about the impact of dizziness, that is, how it is making you feel. This helps the doctor in understanding the type of dizziness experienced by the patient.

The doctor will also ask about the patient's medical history. It will include a history of migraine headache or a recent head injury or ear infection [7] .

For further understanding, an MRI or CT scan will be advised.

Some of the other extensive tests involved in the diagnosis of vertigo are as follows:

  • Nystagmus testing
  • Electronystagmography (ENG)
  • Videonystagmography (VNG)
  • The head impulse test
  • Romberg's test
  • Unterberger's test

Treatment for Vertigo

This will be dependent on the cause of vertigo. In most cases, the condition disappears without the intervention of any medicines as the brain can adapt to the changes occurring in the inner ear.

For some individuals, treatment is required and the options are as follows [8] [9] :

Vestibular rehabilitation: A type of physical therapy aimed at strengthening the vestibular system, this treatment is prescribed for individuals with recurrent bouts of vertigo.

Canalith repositioning manoeuvres: This is recommended for vertigo caused by BPPV, where the treatment is carried out to move the calcium deposits out of the canal into an inner ear chamber so that it will be absorbed by the body.

Medicines: In most cases, a medication that helps manage the symptoms are prescribed. These medicines help relieve symptoms such as nausea or motion sickness associated with vertigo. And, if vertigo is caused by an infection or inflammation, using antibiotics or steroids may help reduce swelling and cure the infection.

In rare cases, surgery may be needed for vertigo.

Home Remedies For Vertigo

There are certain steps you can take at home to help resolve vertigo and limit its impact on your daily life [10] .

  • Use good lighting when getting up at night.
  • Sit down as soon as you feel dizzy.
  • If vertigo impacts your ability to walk or sense of balance, use a cane.
  • If certain movements make you feel dizzy, do it slowly.
View Article References
  1. [1] Murdin, L., Hussain, K., & Schilder, A. G. (2016). Betahistine for symptoms of vertigo. Cochrane Database of Systematic Reviews, (6).
  2. [2] Radziej, K., Probst, T., Limburg, K., Dinkel, A., Dieterich, M., & Lahmann, C. (2018). The longitudinal effect of vertigo and dizziness symptoms on psychological distress: symptom-related fears and beliefs as mediators. The Journal of nervous and mental disease, 206(4), 277-285.
  3. [3] Alarcón, A. V., Hidalgo, L. O. V., Arévalo, R. J., & Diaz, M. P. (2017). Labyrinthectomy and vestibular neurectomy for intractable vertiginous symptoms. International archives of otorhinolaryngology, 21(02), 184-190.
  4. [4] Thompson‐Harvey, A., & Hain, T. C. (2019). Symptoms in cervical vertigo. Laryngoscope Investigative Otolaryngology, 4(1), 109-115.
  5. [5] Hain, T. C. (2015). Cervicogenic causes of vertigo. Current opinion in neurology, 28(1), 69-73.
  6. [6] Bisdorff, A. (2016). Vestibular symptoms and history taking. In Handbook of clinical neurology (Vol. 137, pp. 83-90). Elsevier.
  7. [7] Roland, L. T., Kallogjeri, D., Sinks, B. C., Rauch, S. D., Shepard, N. T., White, J. A., & Goebel, J. A. (2015). Utility of an abbreviated dizziness questionnaire to differentiate between causes of vertigo and guide appropriate referral: a multicenter prospective blinded study. Otology & neurotology: official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 36(10), 1687.
  8. [8] Bhattacharyya, N., Hollingsworth, D. B., Mahoney, K., & O’connor, S. (2017). Plain Language Summary: Benign Paroxysmal Positional Vertigo. Otolaryngology–Head and Neck Surgery, 156(3), 417-425.
  9. [9] Kim, H. A., Bisdorff, A., Bronstein, A. M., Lempert, T., Rossi-Izquierdo, M., Staab, J. P., ... & Kim, J. S. (2019). Hemodynamic orthostatic dizziness/vertigo: Diagnostic criteria. Journal of Vestibular Research, (Preprint), 1-12.
  10. [10] Hart, R., & Stapleton, C. (2019). Dizziness: differential characteristics for patients with vertebral artery dissection, vertebrobasilar insufficiency and benign paroxysmal positional vertigo. Physiotherapy, 105, e207.
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