Vertigo

What is vertigo?

Vertigo is the false sensation of movement, most commonly described as a feeling that you or your surroundings are spinning or rotating, even when you’re not moving. It is a symptom and not a diagnosis

What are some of the symptoms often associated with vertigo?

• Feeling of fullness in the ear
• Tinnitus (ringing in the ear)
• Hearing loss
• Nausea and vomiting
• Headache
• Visual disturbance such as nystagmus (involuntary jerky eye movements)
• Imbalance or feeling of falling to one side
• Motion sickness

Are there different types of vertigo?

There are two main types of vertigo:

Peripheral vertigo: The most common type of vertigo which happens when there is an issue with the inner ear or vestibular nerve, both of which are involved in balance. There are several sub-types of peripheral vertigo:

• Benign paroxysmal positional vertigo (BPPV)
• Labyrinthitis
• Ménière’s disease
• Vestibular neuritis

Central vertigo: This is not as common and happens when a condition affecting the brain, such as stroke, infection or trauma, is present. The symptoms of central vertigo are usually more severe, leading to instability or difficulty walking.

What causes vertigo?

The cause of vertigo varies from person to person and may include:

• Acoustic neuroma
• Arrhythmia
• Ataxia (lack of muscle coordination)
• Brain diseases
• Certain medications (such as some cardiovascular drugs, antibiotics and anti-inflammatories)
• Diabetes
• Ear surgery
• Head injuries
• Hyperventilation
• Low blood pressure
• Migraine headaches
• Multiple sclerosis
• Perilymphatic fistula
• Otosclerosis
• Prolonged bed rest
• Shingles in or near your ear
• Stroke
• Syphilis.

How is vertigo diagnosed?

Your doctor will perform a physical examination and discuss your symptoms with you in detail. Further diagnostic tests may be needed, which may include:

• Fukuda-Unterberger test: You will be asked to walk/march on the spot and assessed for signs of imbalance.
• Head impulse test: Your doctor will move your head while you focus on a stationary point, assessing your eye’s movements as they do so. This can indicate problems with the inner ear’s balance system.
• Imaging tests: A CT scan or MRI scan may be ordered.
• Romberg’s test: You will be asked to close your eyes and stand with your feet together. You will be assessed for signs of imbalance or unsteadiness, which may be a sign of a problem with your central nervous system.
• Vestibular test battery: These are a range of tests which check the vestibular portion of the inner ear system and can determine if vertigo symptoms are caused by a problem in the inner ear or brain.

How is vertigo treated?

The treatment of vertigo will depend on the underlying cause. Treatments may include:

• Repositioning maneuvers: In people with Benign paroxysmal positional vertigo (BPPV), very small calcium carbonate crystals have moved from the inner ear to the ear canal, causing vertigo symptoms. Repositioning procedures, which involve a series of head movements, can help to move the crystals back into the inner ear and alleviate symptoms.
• Vertigo medication: Motion sickness medication and antihistamines can help ease symptoms of acute vertigo.
• Vestibular rehabilitation therapy: This involves a range of exercises to help the symptoms of vertigo. Therapy is tailored to the individual but usually includes strengthening, stretching, marching and eye movement control.
• Surgery: Surgery is rare but may be needed if there is a serious underlying health problem that is causing the vertigo, such as a neck injury or brain tumor.

It is not always possible to treat vertigo permanently. For some, it happens once and never returns, but for others, it is a recurring problem.

If left untreated, vertigo can cause falls and other injuries. It can interfere with quality of life and impact your ability to carry out everyday tasks, such as driving or working.

If you experience any symptoms of vertigo, always talk to your doctor about ways to manage the symptoms and improve your quality of life.