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What is vertigo

It is a false sense of motion, spinning or feeling of imbalance Often the imbalance is associated with nausea, vomiting or unsteadiness on walking. It may worsen when you move your head. Vertigo should not be mixed up with acrophobia, which is an extreme fear of heights.

Vertigo and dizziness are common complaints presented by patients to doctors of all specialties, and they affect all age groups. It is a fact that 20-40% people are affected by dizziness at some point in time in their life; 15% people have dizziness; 5% have vertigo in any given year; 2.5% of all primary care visitors report dizziness, and 2-3% of emergency visits in the developed world is for vertigo.

But it must be noted that vertigo is not a disease. It is only a symptom of a disorder. Therefore, suppressing the symptom is not the solution. Proper diagnosis of what is causing vertigo/dizziness is possible only when the doctor makes a systematic evaluation. A neuro-otological workup alone will help to find out if a vertigo patient is suffering from disorders like BPPV, Meniere’s Disease, Vestibular Neuritis, Labyrinthitis, Acoustic Neuroma, Otolith Dysfunction, Vestibular Migraine, Central Vestibulopathy or psychogenic disorders.

Different disorders causing vertigo have different presentations and require diverse treatment protocols. A correct diagnosis will enable the doctor to offer the right treatment, which is the only way to give the patient lasting benefit.

Symptoms of Vertigo / Dizziness

Patients suffering from persistent or intermittent dizzy spells usually describe their symptoms as below:

  • Spinning
  • Swaying
  • Tilting
  • Feeling unsteady or imbalanced
  • Falling
  • Dizziness

Causes of vertigo

There are several possible causes of vertigo, including:

  • Inner ear problems: The most common cause of vertigo is a problem with the inner ear, such as benign paroxysmal positional vertigo (BPPV), which occurs when small crystals in the ear become dislodged and move into the ear canal, triggering a sensation of spinning.
  • Meniere's disease: This is a condition that affects the inner ear and can cause episodes of vertigo, as well as ringing in the ears, hearing loss, and a feeling of fullness in the ear.
  • Vestibular neuritis or labyrinthitis: These are conditions that can cause inflammation of the inner ear, resulting in vertigo, as well as nausea, vomiting, and difficulty with balance.
  • Head injuries: A head injury or concussion can damage the inner ear or the parts of the brain that control balance, resulting in vertigo.
  • Migraine: Migraine headaches can sometimes cause vertigo, particularly in people who experience aura symptoms before a migraine attack.
  • Certain medications: Some medications, such as certain antibiotics, can cause vertigo as a side effect.
  • Other medical conditions: Certain medical conditions, such as high blood pressure, multiple sclerosis, or tumors, can also cause vertigo.

Treatment for Vertigo/Dizziness

The treatment options for vertigo depend on the underlying cause of the condition. In many cases, vertigo can be managed with non-surgical treatments, including:

  • Medications: There are several medications that can be used to manage vertigo symptoms, including antihistamines, anti-nausea medications, and benzodiazepines. These medications can help relieve dizziness, nausea, and other symptoms.
  • Canalith repositioning maneuvers: This is a series of head movements that can help move displaced crystals in the inner ear back into their proper position, which can relieve symptoms of vertigo. Canalith repositioning maneuvers are often used to treat benign paroxysmal positional vertigo (BPPV).
  • Vestibular rehabilitation therapy: This is a type of physical therapy that can help improve balance and reduce symptoms of vertigo. Vestibular rehabilitation therapy may involve exercises that help strengthen the muscles and improve coordination.
  • Lifestyle modifications: Certain lifestyle changes, such as reducing salt intake, staying hydrated, and avoiding caffeine and alcohol, may help reduce vertigo symptoms.
  • Surgery: In some cases, surgical treatment may be necessary to manage vertigo symptoms. Surgery is typically only recommended if non-surgical treatments have not been effective, and the vertigo is caused by a specific structural problem in the inner ear or brain.

It's important to get consulted if you experience frequent or severe vertigo, as it can be a symptom of a more serious underlying condition

Surgical procedures for vertigo/Dizziness

Surgical treatments for vertigo are not typically considered a first-line treatment option, as there are usually less invasive treatments that can effectively manage symptoms. However, in some cases where vertigo is caused by a specific structural problem in the inner ear or brain, surgery may be recommended. Some surgical treatments for vertigo include:

  • Endolymphatic sac decompression: This is a surgical procedure in which a small piece of bone is removed from the inner ear to relieve pressure and improve fluid drainage. It is often used to treat Meniere's disease.
  • Labyrinthectomy: This is a procedure in which the inner ear is surgically removed to eliminate vertigo symptoms. It is typically only used in severe cases where other treatments have not been effective.
  • Vestibular nerve section: This is a procedure in which the vestibular nerve, which carries signals from the inner ear to the brain, is surgically cut to eliminate vertigo symptoms. It is typically only used in cases where other treatments have not been effective.
  • Brain surgery: In rare cases, vertigo may be caused by a tumor or other structural problem in the brain. In these cases, surgery to remove the tumor or repair the structural problem may be necessary.

What to expect after treatment for vertigo

Overall, the goal of treatment for vertigo is to manage symptoms and improve quality of life.What to expect after treatment for vertigo will depend on the specific treatment used and the underlying cause of the vertigo. Here are some general expectations for common treatments:

  • Medications: If medications are prescribed, it may take some time to determine the most effective medication and dosage for you. It's important to follow your healthcare provider's instructions for taking medication and report any side effects. You may need to have regular check-ups to monitor your symptoms and adjust your medication as needed.
  • Canalith repositioning maneuvers: After canalith repositioning maneuvers, you may experience some dizziness or vertigo for a short time. It's important to follow your healthcare provider's instructions for performing the maneuver correctly and avoid sudden head movements for a few days after the procedure.
  • Vestibular rehabilitation therapy: If you undergo vestibular rehabilitation therapy, you may need to attend several sessions over a period of several weeks or months. The exercises may initially cause some dizziness or vertigo, but should improve over time. It's important to follow your healthcare provider's instructions for performing the exercises correctly and report any difficulties or side effects.
  • Lifestyle modifications: Lifestyle modifications may take some time to have an effect on vertigo symptoms. It's important to be consistent with any changes you make and report any improvements or difficulties to your healthcare provider.
  • Surgery: If you undergo surgery for vertigo, you will likely need to stay in the hospital for a few days and may need some time to recover at home. It's important to follow your healthcare provider's instructions for post-operative care, including taking any prescribed medication and avoiding certain activities.
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