Vertigo is defined as a sensation of spinning and being unsteady, as though the world is tilting or swaying despite being in the same place at the same time. It's almost always used interchangeably with dizziness, as patients who manifest vertigo may also feel lightheaded and off-balance. In a worst-case scenario, patients may also experience nausea and vomiting, eventually leading to toppling, fainting, or blacking out.
Vertigo and Dizziness
Most people have experienced vertigo at some point in their lives without them realizing it. Patients may manifest feeling giddy and having a slight sensation of head reeling for a short period of time. It could sometimes be triggered by simple case scenarios such as the act of waking up or a sudden change in position. For worst-case scenarios, where it often occurs during an episode of anxiety, panic disorder, or stress-related episodes, a patient may verbalize episodes of lurching, tottering, and teetering that impose a safety risk. There are several other causes of vertigo, including inner ear infections, migraines, and certain classifications of medications.
What Causes Vertigo?
As we are now aware that vertigo is a condition associated with several symptoms, such as feeling dizzy, giddy, and nauseous, with patients clearly seen to be experiencing lurching and tottering, it is vital to be aware of the causes to prevent such debilitating reeling sensations. The most common causes of vertigo are the following:
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Benign paroxysmal positional vertigo (BPPV) is a common problem that could affect anyone of all ages, including children and older adults. However, it is also known as "dizziness of aging" as it is more common for older adults who had such experience of head trauma. BPPV is a disorder that mainly affects the inner ear that causes disequilibrium that is prompted by eye movements, which is commonly described by patients as a spinning sensation. It usually lasts for several seconds and then subsides, but its exact cause has been debated for decades. It has been suggested that it may be caused by a displacement of otoconia, small crystals inside the utricle of the inner ear, or from calcium carbonate crystals located in the semicircular canal of the inner ear that is responsible for sensing head movements through the detection of angular accelerations and decelerations.
BPPV disease is found to be most commonly associated with head trauma or changes in head position. The most common origin of BPPV disease is post-traumatic, when the excessive movement of the head can cause displaced otoconia to fall into one of three main semicircular canals, resulting in vertigo that lasts ten to thirty seconds. When this occurs, physical maneuvers such as Epley's maneuver or Semont's Canalith Repositioning are usually effective in eliminating vertigo, but such treatments can only be performed by trained professionals.
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Meniere's disease is manifested with vertigo, tinnitus, hearing loss, and a feeling of pressure in the ear. The exact cause is unknown, but it is often associated with a pressure build-up that is caused by fluid inside the inner ear, which leads to swelling and subsequent malfunctioning of the balance system. The cause is believed to be genetic and triggered by environmental factors. Normally, fluid in the inner ear moves in response to sound waves and other stimuli, but in Meniere's patients, this fluid becomes less free-flowing—, and when it does move around, it can cause uncomfortable signs and symptoms. Although Meniere’s disease has similar clinical manifestations to that of vestibular migraine, its cause is not originated with vascular diseases or structural damage to the inner ear like that of migraine sensitivity. Additionally, symptoms of Meniere’s disease are not only limited to those imbalance manifestations such as teetering and toppling, but its dizziness is almost always accompanied by nausea and vomiting. An episode typically lasts for about 20 minutes and is commonly experienced when one’s sleeping or after meals. Apart from its signs and symptoms, Physicians usually have to test the functions of the inner ear to be able to confirm its diagnosis.
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Vestibular neuritis (VN) or labyrinthitis is an inflammation of the vestibular nerve, which is a cranial nerve in the inner ear. It can cause vertigo, spinning or swaying sensation, fluctuating hearing loss, tinnitus (ringing in the ears), hearing distortion, and feeling off balance. The most common cause of Vestibular neuritis is a viral infection that causes inflammation of the vestibular nerve. There is no standard cure for Vestibular Neuritis, but physicians utilize symptomatic treatments for its clinical manifestations. Examples are:
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Physical therapy to help improve balance and coordination
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Treatments for depression and anxiety that can result from having VN
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Medications for nausea and vomiting
The symptoms of Vestibular Neuritis can be managed with therapy and medications but time is essential and seeking consultation promptly is important because VN can lead to permanent damage if it goes undiagnosed and untreated.
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What Are the Treatments for Vertigo?
There are many treatments available for vertigo, depending on the underlying cause. For instance, if the cause is an inner ear infection, antibiotics may be prescribed. If the cause is Meniere's disease, diuretics may be prescribed to help reduce fluid buildup in the inner ear. Surgery may also be recommended to repair a damaged eardrum or to remove excess fluid from the inner ear.
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Medication is commonly used for the treatment of vertigo and dizziness as it easily reduces accompanying symptoms such as nausea and vomiting. The most common type of medication used to treat vertigo is a vestibular suppressant. This type of medication works by reducing the activity of the vestibular system, which is responsible for the sensation of movement. One medication in particular called meclizine (available under brand names like Dramamine) has been shown in multiple studies to be very effective at treating motion sickness, which is one type of vertigo. But please be reminded to consult with your physician first and not to take over-the-counter medications without any professional advice. There are certain kinds of medications that could worsen the symptoms and are not advisable for pregnant women, stroke patients, etc.
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Some people also use exercise to help reduce the symptoms of vertigo. Patients engaged in different maneuvers to reduce falling sensations and other balance-related symptoms. The theory behind this is that physical activity can stimulate your vestibular system, which may help you get a clearer vision of where you are in space and stop feeling so disoriented.
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In some cases, surgery might be necessary to treat a blockage in one of your semicircular canals or remove excess fluid from behind your eardrum. Surgery for vertigo may be necessary when all other types of therapy fail and most especially when there’s a possibility of hearing loss. It’s also important to note that vertigo is often a symptom of other medical conditions.
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The most common treatment for vertigo is vestibular rehabilitation (VR). VR is used to re-train your brain and body. It teaches you how to move and react in a more efficient manner when you feel dizzy or experience sensations of becoming off-balance so that you can feel better as a result. In VR, you will be led through a series of different exercises by a qualified therapist. These exercises are designed to improve your balance and walking ability as well as your reaction time. If you have already been diagnosed with the condition that triggers vertigo (such as Meniere's disease), Vestibular Rehabilitation can be prescribed by your attending physician together with oral medications to help reduce the severity and frequency of your symptoms. However, it’s more important to consult with a specialist first if there are any age restrictions or contraindications, such as for cases of pregnant and lactating women.
Balance Rehabilitation to Help You with Vertigo
Balance Rehabilitation can help you with your problems of vertigo with our several treatment options available. Our professional staff can help with healthy lifestyle habits, perform laboratory tests, formulate and diagnose based on your given information and we can help you receive the care you need for your vertigo-related disorders. Patients may come in with complaints of dizziness, spinning or sensations of swaying and/or nausea and vomiting. They report feelings of fainting and blacking out. We will work with you to provide multiple treatment options and professional advice from our therapists to give you the information and treatment you need. We encourage you to call or fill out our online form so we can initially assess your condition. We are always ready to answer any questions or concerns you might have. We look forward to giving you the best course of treatment available as we aim to treat your balance problems and achieve back your quality of life.