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What is vertigo ?

The sense of balance can be understood as a state of equilibrium. The brain takes inputs from various sources such as the eyes, the ears and other position receptors present in the body, so that the body stays upright, moves about in a coordinated manner and also carry out fine motor activities such as holding a pencil.

When there is a breakdown in any part of this elaborate system, then it can result in vertigo. Individuals with vertigo may experience spinning sensations that can sometimes be accompanies by vomiting and nausea. Most of us tend to describe symptoms of vertigo as lightheadedness or dizziness. But vertigo is vastly different and your health care provider would be best suited to provide an appropriate diagnosis of the symptoms.

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Dizziness can either mean vertigo or lightheadedness. While lightheadedness may point to feelings of fainting, vertigo indicates a loss in the sense of balance along with sensations of spinning. Also, the causes vary as lightheadedness usually results from lack of oxygen or heart abnormalities, whereas vertigo has neurological an inner ear irregularities as the cause.

The inner ear is divided into two parts, the vestibule and the semicircular canals which helps the body to realize it relationship to the gravity. The semicircular canals are three in number and are present at right angles to each other. These canals act as a gyroscope for the body. The canals are full of fluid and lined with crystal embossed and nerve filled membrane that transfer data to the cerebellum, which overlooks coordination and balance. The cerebellum then integrates this information with other data from the eyes and other receptors. This is how the brain is able to gauge its relationship to the world and gravity.

Body movements along with the simultaneous movement of the head result in the movement of the fluids in the canals. This information is relayed to the brain and the brain adjusts the body and muscles accordingly. When the head stops moving, the fluid movement also stops. Sometimes, there is delay in the stopping of fluid movement, even though the head the stopped moving. This results in distorted information in the brain, which results in a person losing his/her sense of balance and have sensation of spinning, i.e. vertigo. Adults may experience vertigo, after a joy ride.

Individuals afflicted with vertigo may suffer from irritation of the canal fluids or inflammation the crystals embedded on the nerve membranes, which result in spinning sensations even without movement of the head.

Symptoms of vertigo

People usually associate vertigo with dizziness, but the description of vertigo points involves experiences such as the world constantly spinning around individuals or the spinning of the persons themselves.

The sensations of spinning are similar to those that we experience when we suddenly get off a joy ride, such as a merry-go-round or when we are twirling around and rapidly stop. These feelings of spinning related to a loss in the sense of balance, which may result in an unsteady walk or falling down.

The patient or any family member may elucidate the feeling as walking while under the influence of alcohol. Vertigo, however, is an indicator or a symptom of a larger problem either with the cerebellum or with the structures of the inner ear.

  • Issues with the cerebellum in the brain may lead to symptoms such as loss in balance and coordination
  • In case parts of the inner ear are associated with the condition, then there may be additional symptoms such as diminished hearing capabilities or ringing sensations in the ear
  • The most common symptoms associated with vertigo are vomiting and nausea. These symptoms tend to increase in degree, with an increase in the severity of the condition.
  • Sometimes constant bouts of vomiting and nausea can lead to increased weakness and dehydration.

Causes of vertigo

Some of the causes of vertigo are discussed below:

  • Benign paroxysmal positional vertigo or BPPV: The causes of the condition are not fully understood, but it may result due to the dislodging of the crystals in the inner ear which cause irritation of the semicircular canals. The condition is accompanied by unusual movement of the head or its positioning and can be found in older people.
  • Meniere’s disease: The symptoms of the condition are closely related to those of vertigo, such as loss of hearing or ringing in the ear
  • Inner ear trauma: This may be caused due to a number of reasons such as a concussion or a basilar skull fracture. Such trauma can result in direct damage to the inner ear structures or dislodge a few crystals leading to the many symptoms of vertigo.
  • Acoustic neuroma: It is a form of benign tumor that affects the ear and can be accompanied by vertigo
  • Barotrauma: This condition is caused due to pressure changes that affects the inner ear and damages it. When a person dives into water and there is compression of air in the external ear canal, then it can result in injury to the middle and inner ear as well as the ear drum. Such an injury can result in vertigo. Also, excessive air pressure in the middle ear during diving expeditions can result in rupture of the inner ear structures. In case of the tympanic membrane rupture there is hearing loss and when the inner ear round and oval windows are damaged, it can result in vertigo.
  • Labyrinthitis: An infection of the middle ear by viruses that causes inflammation may result in this condition.
  • Vestibular migraines: Migraine headaches are usually felt on one side of the head and may or may not appear along with vertigo.
  • There are very few causes of vertigo that result from damage to the central nervous system. Multiple sclerosis, strokes, seizures and tumors may lead to symptoms of vertigo.

Treatment for vertigo

  • Vertigo caused due to labyrinthitis or BPPV requires physical therapy, wherein the dislodged crystals are removed from the ear through a variety of maneuvers which reduces the inner ear inflammation.
  • A soft collar is suggested for some patients to limit their head movement till vertigo resolves.
  • Surgery may be required to treat structural abnormalities of the inner ear and conditions like acoustic neuroma.
  • Antiviral medications can be used to treat viral infections of the ear
  • Inflammations of the vestibular system can also be reduced with medications such as antivert or valium.
  • Individuals who have vertigo as a result of central nervous system abnormalities require further investigation and relevant diagnosis.
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