Vertigo & Dizziness

What is vertigo?

Vertigo is the feeling that you or your environment is moving , tilting, spinning or falling. It differs from dizziness in that vertigo describes an illusion of movement. When you feel as if you yourself are moving, it's called subjective vertigo, and the perception that your surroundings are moving is called objective vertigo. 

During severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall
Unlike nonspecific lightheadedness or dizziness, vertigo has relatively few causes.

What causes vertigo? 

Vertigo occurs when there is conflict between the signals sent to the brain by various balance- and position-sensing systems of the body. Your brain uses input from four sensory systems to maintain your sense of balance and orientation to your surroundings.

Vision gives you information about your position and motion in relationship to the rest of the world. This is an important part of the balance mechanism and often overrides information from the other balance-sensing systems.
Sensory nerves in your joints allow your brain to keep track of the position of your legs, arms, and torso. Your body is then automatically able to make tiny changes in posture that help you maintain your balance (proprioception).
A portion of the inner ear , called the labyrinth, which includes the semicircular canals, contains specialized cells that detect motion and changes in position. Injury to or diseases of the inner ear can send false signals to the brain indicating that the balance mechanism of the inner ear (labyrinth) detects motion. If these false signals conflict with signals from the other balance and positioning centers of the body, vertigo may occur.

Common causes of vertigo include

• Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction. This type of vertigo is rarely serious and can be treated. 
• Vertigo may also be caused by inflammation within the inner ear (labyrinthitis or vestibular neuritis), which is characterized by the sudden onset of vertigo and may be associated with hearing loss. The most common cause of labyrinthitis is a viral or bacterial inner ear infection. 
• Meniere's disease is composed of a triad of symptoms including: episodes of vertigo, ringing in the ears (tinnitis), and hearing loss. People with this condition have the abrupt onset of severe vertigo, fluctuating hearing loss, as well as periods in which they are symptom-free. 
• Acoustic neuroma is a type of tumor of the nerve tissue that can cause vertigo. Symptoms include vertigo with one-sided ringing in the ear and hearing loss. 
• Vertigo can be caused by decreased blood flow to the base of the brain. Bleeding into the back of the brain (cerebellar hemorrhage) is characterized by vertigo, headache, difficulty walking, and inability to look toward the side of the bleed.
• Vertigo is often the presenting symptom in multiple sclerosis. The onset is usually abrupt, and examination of the eyes may reveal the inability of the eyes to move past the midline toward the nose. 
• Head trauma and neck injury may also result in vertigo, which usually goes away on its own. 
• Migraine, a severe form of headache, may also cause vertigo. The vertigo is usually followed by a headache. There is often a prior history of similar episodes but no lasting problems.
• Complications from diabetes can cause arteriosclerosis (hardening of the arteries) which can lead to lowered blood flow to the brain, causing vertigo symptoms. 

Vertigo prevention

• People whose balance is affected by vertigo should take precautions to prevent injuries from falls. 
• Those with risk factors for stroke should control their high blood pressure and high cholesterol and stop smoking.
• Individuals with Meniere's disease should limit salt in their diet. Christina ENT surgeon 

Treatment

Vertigo Medical Treatment 

The choice of treatment will depend on the diagnosis.
Vertigo can be treated with medicine taken by mouth, or drugs given through an IV, to alleviate the symptoms.
In addition to the drugs used for benign paroxysmal positional vertigo, several physical maneuvers can be used to treat the condition.
Vestibular rehabilitation exercises, also referred to as Epley maneuvers, consist of having the patient sit on the edge of a table and lie down to one side until the vertigo resolves followed by sitting up and lying down on the other side, again until the vertigo ceases.

Other vertigo exercises:

1. Eye exercises, can help people with vertigo overcome this uncomfortable sensation, by turning the eyes upward and then downward for 20.repetitions
2. One head exercise to treat vertigo is the side-to-side turning exercise (Hamid's Exercise). This exercise is exactly as simple as it sounds, but will likely produce feelings of dizziness.
3. Brandt-Daroff Exercise can help with vertigo. This exercise is much simpler than the vestibular rehabilitation exercise. It only entails leaning to whichever side of the body that elicits the most severe sensation of vertigo. In a seated position, quickly lean to one side until your ear rests on the bed or sofa on which you're sitting. Allow the dizziness to subside before returning to an upright position. Repeat 20 times twice a day. If you also experience dizziness while returning to an upright position, allow the sensation to subside before leaning again.