Vertigo

Vertigo is a type of dizziness. It is described as a ‘spinning’ sensation in the head and is usually brought on by sudden changes in position.

Some people say it feels like standing still in a spinning room. You may feel like you are going to fall over. While there are some serious causes of vertigo, in most cases it is not a serious condition and usually gets better with time.

Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making normal life very difficult. Other symptoms associated with vertigo may include –

• Loss of balance – which can make it difficult to stand or walk
• Feeling sick or being sick
• Dizziness

Types and Causes of Vertigo

• Peripheral vertigo – Peripheral vertigo is a term that collects together the inner ear causes. The labyrinth of the inner ear has tiny organs that enable messages to be sent to the brain in response to gravity. By telling our brains when there is movement from the vertical position, we are able to keep our balance, maintain equilibrium. Viral infection is behind the inflammation seen in the following two conditions.
  • Labyrinthitis – this is inflammation of the inner ear labyrinth and vestibular nerve (the nerve responsible for encoding the body’s motion and position7)
  • Vestibular neuronitis – this is thought to be due to inflammation of the vestibular nerve.
  • Ménière’s disease can also be caused by inflammation, but this can be due to bacterial as well as viral infection.

 

• Benign paroxysmal positional vertigo (BPPV) is thought to be caused by a disturbance in the otolith particles. These are the crystals of calcium carbonate within inner ear fluid that pull on sensory hair cells during movement and so stimulate the vestibular nerve to send positional information to the brain.

Benign paroxysmal positional vertigo is twice as common in women as men, usually affects older people and most often arises without a known cause (idiopathic). While most cases are spontaneous, BPPV vertigo can also follow –

• A head injury
• Reduced blood flow in a certain area of the brain (vertebrobasilar ischemia)
• An episode of labyrinthitis
• Ear surgery
• Prolonged bed rest.

 

• Central vertigo is a term that collects together the central nervous system causes – involving a disturbance to one of the following two areas –

The parts of the brain (brainstem and cerebellum) that deal with interaction between the senses of vision and balance, or

• Sensory messages to and from the thalamus part of the brain.
• Migraine headache is the most common cause of central vertigo.

Uncommon causes are stroke and transient ischemic attack, cerebellar brain tumor, acoustic neuroma (a non-cancerous growth on the acoustic nerve in the brain) and multiple sclerosis.

Activities that bring on a dizzy spell can vary. They often involve moving your head into a certain position suddenly, such as:

• looking up
• lying on one ear
• rolling over in bed
• getting out of bed
• bending over.

Symptoms

• Dizziness – this begins seconds after a certain head movement and lasts less than a minute.
• Feeling light-headed.
• Balance problems.
• Nausea – feeling like you are going to vomit.

These symptoms usually get better once you are in a different position. Pain, ringing in the ears (tinnitus) or deafness is not common.

If you have more serious symptoms – speech difficulty, double vision, unsteady walking, difficulty swallowing, altered strength or feeling in your legs or arms, ringing in your ears or deafness – you should seek medical help.

Treatment

Treatment of vertigo depends on its cause. If a specific causative disease is identified, therapy can be tailored for that disorder. Frequently there can be multiple, coincident causes of vertigo, and each needs to be treated individually. Surgery can be helpful and even curative for many causes of vertigo. There are a number of different operations that can eliminate vertigo from various inner ear diseases. In general, surgery is reserved for patients in whom more conservative treatments have failed to control the symptoms. Medications are often helpful in controlling the acute symptoms of vertigo, but can frequently be counter-productive for people with more chronic problems.

In certain cases, one specific cause of vertigo cannot be identified, but, depending on the nature of the vertigo treatment may still be provided with good hope for improvement. In many such instances, vestibular rehabilitation therapy (VRT) is the recommended approach.

Alternative Treatment

Vitamin B6 – This vitamin is essential for the brain and the nervous system to function normally; getting enough is vital for avoiding migraine attacks.

Vitamin D – The inner ear is partly responsible for your sense of balance, so any ear problems may cause migranes. Getting enough vitamin D is vital for your ear health.

Vitamin B12 – This is the usual vitamin deficiency suspect if you’re experiencing dizziness. Vitamin B-12’s primary functions are in the formation of red blood cells and the maintenance of a healthy nervous system.

Antioxidants—Antioxidants mitigate the damaging effects of free radicals on tissues, cell membranes, and DNA. Vitamin C, vitamin E, lipoic acid, and glutathione are among the most important antioxidants. Vitamin C has been shown to have a beneficial effect on patients with Ménière’s disease when given in combination with glutathione.

Ginkgo biloba—Researchers have found that dizziness induced by vestibular receptor impairment can be reduced by Ginkgo biloba extract.

Ginger – Ginger, or Zingiber officinale, is a perennial used in cooking and herbal medicine. It’s a traditional remedy for stomach problems, nausea, fever, coughs and diarrhea. The rhizomes are rich in volatile oil, and have antibacterial, cholesterol-lowering, hypoglycemic and anti-ulcer action.

Vertigoheel – A randomized, double-blind trial was performed in 2005 of 170 elderly patients with atherosclerosis-related vertigo to assess the noninferiority of Vertigoheel versus ginkgo biloba

Acupuncture has been used for patients with Menie`re disease and for relief of vertigo.

Osteopathic manipulative therapy (OMT) has been described for disorders of dizziness and balance. OMT is taught in schools of osteopathic medicine and is also practiced by physical therapists and physiatrists.

 

Reference –