Understanding Vertigo

Vertigo, a sensation of spinning or swaying, often disrupts balance and can significantly impact daily life. Unlike ordinary dizziness, vertigo can create a feeling that either the person or their surroundings are moving, making it challenging to stand, walk, or focus.

Episodes of vertigo vary in duration, from a few seconds to prolonged periods lasting hours or even days. Severe cases may persist over weeks, affecting quality of life and increasing the risk of falls or injuries.

Causes of Vertigo

The exact cause of vertigo is not always clear. However, common triggers typically involve issues within the inner ear, affecting balance. Common causes include:

• Migraines: For some individuals, migraines cause vertigo, referred to as vestibular migraines. Symptoms may include headache, visual disturbances, and sensitivity to light and sound.
• Benign Paroxysmal Positional Vertigo (BPPV): This occurs when small calcium particles (canaliths) accumulate in the inner ear canals, disrupting fluid movement. This can cause false signals to be sent to the brain, leading to sensations of spinning.
• Ménière’s Disease: Caused by fluid buildup in the inner ear, Ménière’s disease leads to vertigo episodes, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness in the affected ear.
• Vestibular Neuritis or Labyrinthitis: These conditions involve inflammation of either the vestibular nerve, which connects the inner ear to the brain, or the labyrinth, an inner ear structure. Inflammation, often caused by viral infections, can produce severe vertigo.

Other causes may include head injuries or certain medications that can trigger vertigo.

In many cases, vertigo improves over time without the need for extensive treatment. However, conditions like Ménière’s disease may cause recurring vertigo episodes over months or years.

Recognising the Symptoms of Vertigo

Vertigo symptoms vary by individual and may appear as:

• Sensations of spinning, tilting, or feeling off-balance.
• Worsening of symptoms with head movements, changing positions, coughing, or sneezing.

Additional symptoms may occur based on the underlying cause of vertigo:

• Nausea and vomiting.
• Headaches, with sensitivity to light or noise.
• Double vision, speech difficulties, or weakness.
• Sweating, rapid heartbeat, or shortness of breath.

When to Seek Medical Attention

If you experience any of the following symptoms, it is advisable to consult a healthcare professional to identify the cause of vertigo:

• Severe or sudden headaches.
• High fever (above 38°C).
• Double vision.
• Inability to stand or walk unaided.
• Persistent vomiting.
• Having risk of stroke due to diabetes, high blood pressure, or smoking.

Diagnosing Vertigo

A thorough medical history, physical examination, and specific diagnostic tests are commonly used to assess vertigo causes:

1. Dix-Hallpike test:To helpdiagnose BPPV by positioning the patient to trigger vertigo symptoms and observing eye movements for nystagmus (involuntary eye movements).
2. Audiometry and other hearing tests: To help identify any hearing loss, which is often present in cases of Ménière’s disease.
3. Imaging testslike MRI or CT scans: May be ordered to rule out central causes of vertigo, such as stroke, tumours, or neurological conditions.
4. Orthostatic blood pressure testing: A sudden drop in blood pressure upon standing may indicate an underlying autonomic issue or dehydration.

Treatment Approaches for Vertigo

Treatment depends on the specific cause of vertigo. Antihistamines, such as meclizine or diphenhydramine, as well as antiemetics like ondansetron or promethazine, can help manage vertigo symptoms. In some cases, sedatives like diazepam may also provide relief.

Vestibular Rehabilitation Therapy (VRT)is an exercise-based treatment programme that encourages balance system adaptation and helps relieve vertigo.

Make an Appointment at Gleneagles Hospitals

If vertigo is affecting your daily life or you have concerns about your symptoms, book an appointment at your nearest Gleneagles Hospitals for consultation. The team of neurologists is dedicated to providing specialised care, tailored to individual needs.