Vertigo is a common issue. In many cases vertigo gets better without treatment, but if it recurs, or it is affecting your daily life, it is time to seek medical assistance. There are many causes of this puzzling condition, but it is often associated with problems in the inner ear.
What is vertigo?
Vertigo is a miserable condition. It can cause nausea and vomiting, and it can certainly cause people to miss work. Vertigo is a sensation that the environment around you is spinning in circles. It can make you feel dizzy and off-balance. Vertigo feels like you or everything around you is spinning – enough to affect your balance. It is more than just feeling dizzy. A common misconception is that dizziness is the same as vertigo. For example, lightheadedness is not vertigo because there is no side-to-side movement or sense of spinning.
A vertigo attack can last from a few seconds to hours. If you have severe vertigo, it can last for many days or months. Vertigo is not a disease. It is a symptom of varying conditions. There are two main types of vertigo; peripheral vertigo and central vertigo.
What causes vertigo
The cause of a person’s vertigo can vary greatly, from innocent causes such as an inner ear infection – or migraine-related dizziness to more severe origins, such as a stroke in the back of the brain.
Most cases of vertigo are associated with inner ear problems which affect balance. These include the following:
• benign paroxysmal positional vertigo (BPPV) – where specific head movements cause vertigo
• labyrinthitis – an inner ear infection caused by a cold or flu virus
• vestibular neuronitis – inflammation of the vestibular nerve
• Ménière’s disease – a rare inner ear condition which sometimes involves ringing in the ear (tinnitus) or loss of hearing.
Other things can cause vertigo such as:
• migraine
• some types of medicine
Sometimes the cause is unknown.
Is vertigo a serious condition?
Vertigo can be scary but the condition itself is not considered serious. However, vertigo can be linked to other potentially serious health conditions – that is why you should inform your doctor if you experience recurrent or prolonged vertigo attacks.
Who does vertigo affect?
Vertigo attacks can happen at any age, but they are more common in people over 65. Women are somewhat more likely to experience vertigo than men. Some people experience vertigo as a side effect of pregnancy.
How is vertigo diagnosed?
Your doctor will perform a physical examination and ask questions about your symptoms. They may also recommend one or more tests to confirm your diagnosis. Your doctor might also refer you to a specialist doctor such as a neurologist for further evaluation.
Treatment
The specific diagnosis dictates which of these treatment options is the best for each patient:
• Migraine-related vertigo typically responds to medications that can prevent migraines.
• Acute vertigo is best treated with nonspecific medication such as dimenhydrinate (Dramamine®) and meclizine (Bonine®).
• Vertigo that only occurs within the first five minutes of standing is typically due to blood pressure dropping (orthostatic hypotension). There are medications that can be used in this situation.
• Intermittent vertigo provoked by movement of the head or neck typically responds to a special type of physical therapy called vestibular rehabilitation.
• Intermittent vertigo provoked by very specific movements, such as lying down in bed or rolling over in bed, may be Benign Paroxysmal Positional Vertigo – which typically responds very well to a specific sequence of movements known as the Epley maneuver.
The vertigo treatment that is right for you depends on several factors, including the root cause.
Conclusion
An important point is that vertigo is not a diagnosis but the medical term for dizziness with the quality of movement such as spinning. Arriving at a specific diagnosis, and treating the cause, are very important. Many causes of vertigo are innocent. In a few cases, vertigo is a symptom of a serious disorder. If you have vertigo that is frequent and interfering with your life, please see a doctor. Vertigo goes away on its own in many cases. However, there are several treatments that can successfully manage vertigo.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field is ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
