Vertigo: Causes, Symptoms, and Treatment

People afraid of heights usually feel dizzy when they are in front of great heights. 

The world feels like spinning, and they start sweating while the heart rate increases. 

But what if you feel a similar sensation without any heights involved? 

You’re quiet in your room, and suddenly everything starts moving all around. 

Are you dizzy, or is it vertigo? Is there a difference between the terms?

In this article, we’re exploring the answer and reviewing the most critical aspects of vertigo.

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What is vertigo?

Vertigo is an abnormal sensation of balance problems caused by abnormalities in the inner ear. 

The world feels like spinning around the patient, and it is sometimes known as dizzy spells.

It is crucial to mark a difference between vertigo and dizziness. 

They both cause balance problems, but they feel pretty different. 

When you’re dizzy, it feels like your balance is completely off. 

It feels like your body is moving. 

On the other hand, vertigo feels like the world is spinning, even if you’re not moving at all (1).

Symptoms

Vertigo is by itself a symptom of various conditions. 

Similar to the sensation of pain, we can describe a variety of aspects of this spinning sensation.

The first thing a doctor would do if you feel something like this is evaluate the symptom. 

They would probably ask if you feel like everything is moving around you or like your body is moving out of balance.

They would also change the position of your head while you’re sitting or lying down. 

If you have vertigo, these position changes will probably trigger the symptoms of feeling unbalanced, spinning, swaying, or tilting.

Besides, the symptom of vertigo can be accompanied by others, including (1):

  • Nausea with or without vomiting
  • Sweating
  • Headache
  • Nystagmus, which are involuntary and abnormal eye movements the doctor evaluates during vertigo episodes
  • Tinnitus, defined as a constant ringing sound in your ears

Causes

The leading cause of vertigo is an inner ear problem. 

In this tiny organ, there’s a specialized receptor for balance. 

It uses fluids filling a series of compartments known as utricle, saccule, and semicircular canals. 

Gravity moves the fluids, and the receptors inside the inner ear detect the position of the liquid. 

That’s how your body knows if you’re standing, lying, or upside down.

A vestibular disorder causes vertigo in these inner ear receptors. 

They send false signals to the brain, and then everything around you feels like moving or spinning. 

Why does this happen? The most common causes include (1):

Benign Paroxysmal Positional Vertigo, or BPPV

In this case, there’s a misplacement of small calcium particles inside the inner ear compartments. 

They are a part of otoliths, a granule attached to the body position receptor. 

But when they move out of place, the signal to the brain becomes inaccurate and causes vertigo.

Meniere’s disease

In this case, the problem is not in the inner ear receptor. 

They are working fine, but the fluid moving around them is building up, and the pressure changes. 

That’s why it is also known as endolymphatic hydrops. 

Such a change leads to abnormal activation of the receptors and causes vertigo. 

Patients with Meniere’s disease usually have tinnitus as well. They may even experience hearing loss.

Infection and inflammation in the inner ear

When there’s an infection in the inner ear, this causes inflammation. 

It happens in cases of labyrinthitis and vestibular neuritis. 

The nerves become hyperresponsive, sending equivocal signals. The cause is usually a viral infection.

Other causes of vertigo include a vestibular migraine headache, a neck or head injury, a brain tumor such as vestibular schwannoma (also known as acoustic neuroma), a stroke, or a medication causing ear damage.

Risk factors

There are a few predisposing factors in patients with vertigo. 

If you have one or more, there’s a higher chance of having BPPV and other causes of vertigo. 

They include:

  • Women over 50 
  • Trauma
  • Ear infections
  • Hearing loss
  • CNS disease
  • Taking ototoxic drugs (particularly antipsychotics or antidepressants)
  • Heavy alcohol drinking

Diagnosis

The diagnosis of peripheral vertigo can be difficult because it sometimes relies on vague descriptions by the patient. 

It should be differentiated by other causes of dizziness, such as motion sickness or another type of balance disorder.

Thus, your doctor may need a more objective look at the problem by performing a series of maneuvers. 

These will trigger vertigo in the doctor’s office, but that’s the most reliable way to assess the situation.

The doctor will also analyze eye movements and look for nystagmus, and measure your balance. 

They may require imaging tests to find a possible cause of vertigo. 

You may also need to go through visual tests, hearing tests, and a series of blood tests.

An otolaryngologist should evaluate this condition, but a neurologist can also treat your vertigo symptoms. 

Treatment

Peripheral vertigo is not a life-threatening problem, but it will affect the patient’s daily life. 

Those with severe vertigo won’t be able to drive and may become susceptible to falls. 

This is particularly concerning for seniors, a group at a higher risk of vertigo. 

Thus, treatment is often established to prevent future complications.

Depending on the cause of vertigo, your doctor may consider different options

They include (2):

Canalith Repositioning

This is a treatment of BPPV.

Through different maneuvers, doctors reposition the calcium particles that cause vertigo. 

Vestibular rehabilitation

They include exercises and practices to retrain your vestibular system and minimize balance problems. 

Habituation exercises treat dizziness in stimulating environments, gaze stabilization improves eye movements to prevent moving your head, and balance training reduces the risk of falling (3).

Oral medications

There’s a wide range of vestibular suppressants to relieve the symptoms of vertigo. 

The most common is Dramamine, but doctors may also consider others, including Valium and Antivert. 

Lifestyle changes 

It is also essential to make a few adjustments to your routine. 

Salty foods are usually a trigger for a new vertigo episode. 

The same happens with high concentrations of caffeine

Doctors also recommend hydrating properly to ensure a healthy level of fluid in your inner ear.

Psychotherapy and relaxation techniques

They are complementary to medical therapy. 

They mainly work in patients who feel anxious during vertigo episodes and those who experience sleeping problems.

Conclusion

Vertigo is a specific type of dizziness caused by inner ear disease. 

It causes imbalance problems and increases the risk of falling in seniors. 

Thus, it is vital to diagnose and treat the condition before reaching its complications.

To diagnose vertigo, your doctor may need to rule out motion sickness and other causes of dizziness. 

They will perform maneuvers to recreate the symptoms in a controlled environment. 

There are different tests your doctor may require to assess your problem and reach a final diagnosis.

After knowing the cause of your symptom, there are different treatments available. 

They include oral medications, vestibular rehabilitation, and lifestyle recommendations you can follow to feel better.

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Sources

  1. Chang, R. (2008). Vertigo: Part 1-assessment in general practice. Australian Journal of General Practice, 37(5), 341. https://pubmed.ncbi.nlm.nih.gov/18464964/
  2. Chang, R. (2008). Vertigo: Part 2-management in general practice. Australian Journal of General Practice, 37(6), 409. https://pubmed.ncbi.nlm.nih.gov/18523693/
  3. Herdman, S. J., & Clendaniel, R. (2014). Vestibular rehabilitation. FA Davis. https://www.fadavis.com/product/physical-therapy-vestibular-rehabilitation-herdman-4

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