Your complete guide to Vertigo management

Vertigo

What is Vertigo?

Vertigo, is a condition when one feels that the world around is spinning or you are spinning around. One can feel this spinning even though the environment is around is still.  Causes of vertigo could be related usually to the inner ear, vision, and spinal cord at the neck level.  The ear is the organ of hearing and balance. The outer ear is made up of a flap called the pinna and the auditory canal. The main functional parts of the middle and the inner ear are contained within the skull. The middle ear is made up of three tiny bones called the auditory ossicles and the Eustachian tube. The Eustachian tube connects the ear to the throat. The inner ear is made up of a spiral cochlea, semicircular canals and vestibule. These components of the ear together work and are responsible for maintaining balance in the human body. The inner ear sends signals to the brain, to coordinate the head and body movements relative to gravity and in the process help maintain balance. Sound waves entering the ear travel through the auditory canal to the eardrum (tympanic membrane). Here they are converted to vibrations and are sent to the cochlea through the ossicles. The millions of microscopic hairs here convert these vibrations into electrical signals and pass it on to the brain to be interpreted. When there is a disturbance to this system created by some kind of an inflammation, injury or any other reason, it results in vertigo.  For example: if one drops cold water into the ear, the equilibrium is disturbed and causes vertigo temporarily.

Common causes associated with Vertigo:

  • Benign paroxysmal positional vertigo (BPPV): This happens when the inner ear canal gets clogged with tiny Calcium particles (Canaliths).  These particles are normally found in the ears, but can become displaced and cause irritation to the small hair cells. BPPV may occur either due to age or without a specific reason.
  • Meniere’s disease: the accumulation of fluid and pressure changes in the inner ear, seem to be the triggers for this form of vertigo. This is episodic and accompanied by ringing in the ears (tinnitus) and hearing loss.
  • Vestibular neuritis or labyrinthitis is again an inner ear viral infection which causes inflammation around the nerves which help in maintaining balance.
  • Vertigo can also be triggered in patients suffering with multiple sclerosis, tumors, or if there is a stroke in certain areas of the brain.
  • Patients with a type of Migraine called basilar artery migraine may also experience symptoms of vertigo.
  • In many cases injuries to the head or the brain can damage the inner ear which increases the risk of developing vertigo.
  • Medications causing ear damage could also trigger vertigo. Many medications including blood pressure regulators, antidepressants, antiseizure medications and in some instances even aspirin could increase the risk of developing vertigo.
  • Excess consumption of alcohol could also result in vertigo.

Symptoms of Vertigo

The symptoms of Vertigo include sense of spinning even when things are perfectly still. The symptoms include spinning, imbalance, body being pulled to one direction, nausea, abnormal eye jerking, headaches, sweating, ringing in the ears, hearing loss. The symptoms can be worsened by motion, in particular movements of the head or body.

 Diagnosis

Diagnosis includes taking a medical history and a physical examination which often shows abnormal eye movements (nystagmus).  Physical examination also includes positional testing and a blood pressure check. Many cases also require CT or MRI scans of the inner ear or brain. If the symptoms continue for more than a few days accompanied by in-coordination on one side of the body, stroke is also suspected, and immediate medical evaluation is necessary.

Treatment

Vertigo generally lasts for a few minutes to a few hours or more and may come and go. The treatment for vertigo depends on the underlying cause. Many times it is resolved on its own, due to the adaptability of the brain to the changes and thereby relying on other mechanisms to maintain balance. Repositioning of the displaced canaliths under an experienced medical professional can help resolve the problem. They basically move the head in such a way that the displaced Calcium particles are moved out of the inner ear and are subsequently absorbed by the body.

Cawthorne head exercises or also known as vestibular rehabilitation exercises are a series of head and eye movements that can help in decreasing the sensitivity of the nerves in the inner ear and in the process, ease the symptoms of vertigo. These exercises also help in strengthening the vestibular system. Generally betahistine, cinnarizine are effective. All the medications given do not provide a cure for the problem but only provide symptomatic relief.

Preventing Vertigo

As vertigo is spontaneous it is difficult to predict who is at risk. But listed below are a few steps one could take to reduce the risks of developing the problem:

  • Maintaining a healthy lifestyle goes a long way in keeping the body functioning in order, thereby preventing occurrences of symptoms like Vertigo.
  • Maintaining good sleeping patterns and healthy body postures can really help in preventing vertigo.
  • Moving the head carefully and slowly avoiding jerky movements during daily chores helps in preventing any form of injury that could eventually lead to vertigo.
  • Increase the intake of healthy dietary choices including drinking adequate fluids, avoiding foods and beverages with high salt and sugar content.
  • Exercises like Tai Chi and yoga are recommended to combat peripheral vertigo.
  • Avoiding certain migraine triggers like smoking, anxiety, stress and certain foods can help in the prevention of vertigo. Avoid reading or working while on the move to prevent vertigo episodes. One should avoid flying in case of a sinus or ear infection.
  • Central factors of vertigo arise in the brain or spinal cord. Central vertigo risks can be controlled by controlling stroke risks; which include taking care of blood pressure, cholesterol, weight, blood sugar. Maintaining a low salt diet minimizes the risks of developing Meniere’s disease.
  • Peripheral factors of vertigo are due to problems within the inner ear. Peripheral vertigo risks can be reduced by undertaking regular vestibular rehabilitation exercises.
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