What is vertigo?
Vertigo is a symptom where a person has the feeling of a spinning motion without any actual motion in the envirobment. It is a form of dizziness but the difference between vertigo and classical dizziness is that in dizziness there is lightheadedness and even fainting. Often dizziness and vertigo occurs simultaneously and affects about 20 to 30% of the population. There are number of causes that can lead to vertigo like benign positional vertigo, Meniere’s disease and labyrinthitis but in many cases the cause is never identified. Treatment depends on the underlying cause.
Types of Vertigo
There are two types of vertigo – subjective and objective.
- In the subjective variety of vertigo, patients feel that they is moving or spinning around.
- In objective vertigo the patient suffers from the illusion that the surroundings are moving or spinning.
- A third variety of vertigo is also there known as pseudovertigo where the patient the intense feeling of spinning inside the head.
Vertigo is not a medical condition but rather a symptom that indicates presence of underlying disease. The patient complains of spinning of head or surroundings without any external stimulus.
- Classically symptoms of vertigo co-exist with the feeling of disorientation, intense feeling of nausea, vomiting, profuse sweating during vertigo attacks and abnormal movement of the eyes.
- Duration of vertigo attacks may last for minutes to hours. The feeling may occur in episodes or is constant. Usually the symptoms occur due to a change in position or during motion.
- Sometimes there may be associated hearing loss and ringing sensation in the ears (tinnitus), ear pain and a feeling of fullness or throbbing sensation in the ear.
- Patients suffering from intense vertigo may complain of impaired vision, difficulty in speech, altered consciousness, difficulty maintaining balance and abnormal gait.
- Attacks of vertigo can be so severe that it can affect the quality of life and impair professional, personal or social life.
Causes of Vertigo
There are a number of medical conditions responsible for vertigo but the cause of vertigo cannot always be identified.
- Benign paroxysmal positional vertigo (BPPV) is the most common disease causing vertigo. The symptoms are triggered following sudden head movement especially in a particular direction.
- Inflammation of the inner ear structure known as labyrinthitis may also lead to symptoms of vertigo due to a viral or bacterial infection. Labyrinthitis may often be associated with hearing loss.
- Menieres’s disease where the pressure inside the inner ear increases due to accumulation of endolymphatic fluid. In this disease there are repeated attacks of severe episodes of vertigo, the sensation of fullness in the ear, ringing in the ears, nausea and vomiting.
- Acoustic neuroma is a type of tumor of the 8th nerve that may also lead to vertigo.
- Decreased blood supply in the brain tissue especially due to cerebellar hemorrhage may lead to vertigo.
- Head trauma, neck injury and severe attacks of migraines may also be the underlying causes of vertigo.
- Long-standing diabetes patients may suffer from atherosclerosis where there is narrowing of the blood vessels due to fatty deposits on the inner walls of the vessels. Atherosclerosis may lead to poor blood supply to the brain and subsequent symptoms of vertigo.
Treatment options for vertigo depend upon the underlying cause. For example, labyrinthitis is treated with antibiotics or antivirals while Meniere’s disease is managed by low salt diet and the use of diuretics (“water pills”). There number of physical measures such as Epley’s maneuver and particle repositioning maneuvers which helps to relieve the symptoms of vertigo. Drugs like meclizine, scopolamine skin patch and diazepam are also used to relieve vertigo and associated symptoms.