Are you an intense video gamer? Then, you might feel some sort of motion sickness— medically called vertigo.
And in this post, we try to conclude all the important findings of the term vertigo along with its types, causes, symptoms, diagnosis, and general FAQ.
So, let’s start.
What is Vertigo?
The word vertigo is derived from the Latin words “Verto” which means “to roam”. For instance, vertigo is nothing but a feeling of imbalance. The patient may experiences symptoms such as dizziness, imbalance, and spinning (a feeling of the whirling world).
Generally, vertigo can sometimes call to be dizziness, mental disorder, and confusion. So, vertigo is a symptom of a disorder, it is not a disease.
Along with dizziness, people also experience nausea, vomiting, double vision, racing heartbeat, excessive sweating, or instability in walking during an imbalance.
What are the Types of Vertigo?
Vertigo can be categorized into two broad categories, listed below:
- Peripheral Vertigo
- Central Vertigo
As you know, ear serves two main functions, one that all knows— hearing; and second, that most of you don’t know is balancing the body. So, where there is a disorder in balancing due to some problem in the inner ear— Peripheral Vertigo.
There are the following causes (sub-types) that lead to peripheral vertigo:
Benign Paroxysmal Positional Vertigo (BPPV)
It is the most common cause of peripheral vertigo. They occur due to sudden movement or head such as tipping the head up-down.
Mechanism of Causing BPPV
The structures called the otolith organs in the inner ear, which contain fluid and small crystals of calcium carbonate. When these particles of crystals become displaced or fall into the semicircular canals it causes irritation.
This causes irritation to small sensory hair cells within the cupula of the semicircular canals during movement. As a result, the brain receives inaccurate information about a person’s position, leading to vertigo.
Signs and Symptoms
Following are the symptoms of BPPV:
- Spinning or moving sensation
- Balance disorder or unsteadiness
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Firstly, understand what is the vestibular nerve? It is the eighth cranial nerve— a nerve in the inner ear that transmits sound and information to the brain about balance.
So, vestibular neuritis is a condition that causes vertigo and dizziness because of the inflammation or disorder in the vestibular nerve. When the nerves are inflamed, the information isn’t properly communicated, leading to feeling disoriented.
Most importantly, it is similar to labyrinthitis (discuss later in this post), but it does not affect hearing.
Causes of Vestibular Neuritis
To be true, there is no definite research that underlines why vestibular neuritis happens. But in most cases, it is caused by a viral infection or bacterial infection, but again they are rare.
While some common viral infections that could cause vestibular neuritis are:
Signs and Symptoms of Vestibular Neuritis
These are the following common symptoms that people experiences:
- Nausea and vomiting
- Dizziness and imbalance
- Severe Head spinning
- Hearing loss— in some cases
- Rapid involuntary eye movement
- Difficulty in concentration
Labyrinthitis— an inner ear disorder that happens due to inflammation in either of the two vestibular nerves. For instance, there are two vestibular nerves that connect the inner ear to the brain. And when either of these two nerves has inflammation, then it is a case of labyrinthitis
Causes of Labyrinthitis
Labyrinthitis can occur at any age and some factors that can cause labyrinthitis, including:
- Viral infections in the inner ear
- Respiratory illnesses, such as bronchitis
- Herpes virus
- Stomach virus
- Bacterial infections, including bacterial middle ear infections
- Infectious organisms, such as the organism that causes Lyme disease
However, if you have (or you do) following there is a higher chance of getting labyrinthitis, includes:
- Drinking too much alcohol
- Habitually fatigue
- Extreme stress
- Prescription medications
- Frequent dosage of OTC medications, especially aspirin
Signs and Symptoms of Labyrinthitis
Following are the symptoms that include:
- Dizziness with vertigo
- Nausea and vomiting
- Loss of balance
- Ear pain and some times loss of hearing
- Blur Vision with spinning feeling
- Tinnitus, which is characterized by a ringing or buzzing in the ear
- Difficulty in focusing
- In very rare cases, permanent hearing loss.
An inner ear disorder that causes episodes of spinning. It was first reported in the 1800s by a french doctor, Prosper Ménière.
People also might experience dizziness along with ringing in the ears that sometimes leads to permanent hearing loss. The permanent hearing loss, in general, occurs in one ear and after some time another ear has developed the same ringing sensation.
Causes of Ménière’s Disease
Meniere’s disease is caused by the obstruction by fluid and pressure in the labyrinth of the inner ear or the endolymphatic system. But, until now, no research states why these fluids accumulate in the endolymphatic system.
However, some factors that might be responsible for ménière’s disease are:
- Improper fluid drainage— perhaps because of a blockage or anatomic abnormality.
- Abnormal immune response
- Viral infection
- Genetic predisposition
Other factors like smoking, infections, or a high-salt diet may worsen the condition.
Signs and Symptoms of Ménière’s Disease
These are the following symptoms of ménière’s disease:
- Spinning sensation and imbalance
- Dizziness and motion sickness
- Hearing loss
- Ear ringing (tinnitus) or pressure
- Rapid involuntary eye movement
- Aural fullness
- Feeling of fullness in the ear or plugged
Acoustic neuromas — also named as Vestibular schwannoma. It is a non-cancerous tumor on the main nerve (vestibular) that connects the inner ear to the brain. In the majority of cases, a person loss his ability to hear along with the problem in balancing.
Causes of Acoustic Neuromas
The exact cause of acoustic neuromas is not known. However, it appears to be a malfunctioning gene on chromosome 22. Normally, this gene produces a tumor suppressor protein that helps control the growth of Schwann cells covering the nerves.
Although, in some cases, there is an inheritable condition that leads to acoustic neuroma formation called Neurofibromatosis Type 2 (NF2).
Signs and Symptoms of Acoustic Neuromas
- Hearing loss or ringing in the ear and unsteadiness.
- Balance disorder or dizziness (vertigo)
- Sensory loss: pins and needles or reduced sensation of touch
- Rapid involuntary eye movement
- Facial numbness and tingling
- Difficulty swallowing and hoarseness
- Facial weakness
- Taste changes
Vestibular migraine also named Migraine-associated vertigo, Migrainous vertigo, Migraine-related vestibulopathy. A vestibular migraine refers to a nervous system disorder or an episode of vertigo in someone who has a history of migraine symptoms.
Causes of Vestibular Migraine
Like many others, the doctor isn’t sure about its causes. However, some theory suggests the cause is the abnormal release of chemicals or miscommunication between nerve cells of the brain.
Some of the factors that can trigger a vestibular migraine include weather changes, stress, dehydration, lack of sleep, menstruation, or changes in barometric pressure.
While certain foods and drinks can also trigger a vestibular migraine. These are red wine, chocolate, coffee, aged cheeses, sodas with caffeine, and monosodium glutamate (MSG).
Signs and Symptoms Vestibular Migraine
These are the following symptoms of vestibular migraine:
- Feeling imbalanced
- Motion sickness
Perilymph Fistula (PLF)
Perilymph fistula (PLF), may occur due to a head injury or sudden pressure change, activities such as scuba diving.
When the inner ear is filled with a fluid called perilymph, it leaks into the middle ear due to a tear in either of the two membranes between the middle ear and inner ear. And, this leads to a change in pressure that affects your balance and hearing.
Causes of Perilymph Fistula
The primary cause of perilymph fistula is head trauma or barotrauma or even some extreme pressure changes occur while air travel, scuba diving, and heavyweight lifting. Other causes include:
- Experiencing whiplash
- Serious or frequent ear infections
- Blowing your nose very hard
- Puncturing your eardrum
- Being exposed to very loud sounds, including gunfire or sirens, close to your ear.
Signs and Symptoms of Perilymph Fistula
Symptoms of a perilymph fistula can include:
- A feeling of fullness in the ear
- Hearing loss
- Dizziness or vertigo
- Mild nausea or vomiting
- Memory loss
- Motion sickness
- Ringing in the ears
- Experience altitude changes
- Sneeze and cough
- Pressure in the ear
Superior Canal Dehiscence Syndrome (SCDS)
SCDS is a rare condition that may be due to abnormal thinness or a breakdown or even incomplete closure of a bony part of a canal that carries fluids in your inner ear.
Causes of SCDS
For Instance, inside our inner ear, there are three delicate, fluid-filled loops called semicircular canals. And these canal acts as a level measurer tool. So, with the movement these canal moves which dictate the positioning of the body which sensor the brain to keep balance.
And these are the following causes that can cause SCDS:
- Genetic problem
- Some infectious disease
- Some sort of trauma— generally blunt trauma.
Signs and Symptoms of SCDS
These are the following sign and symptoms of SCDS:
- Autophony (Echoes of sounds in your ear, like when you eat or talk)
- Sensitivity to loud sounds
- Hearing loss
- Internal noises, like your heartbeat, that are louder than normal.
- Nystagmus (uncontrollable movement of eyes)
- Vertigo and dizziness
- Fullness/pressure in the ears
- Ringing in ears
- Oscillopsia— abnormal sensation of the surrounding environment
These symptoms could be triggered when you:
- Cough or sneeze
- Feel pressure changes
- Hear loud sounds/ noises
- Lift heavy objects
Central vertigo is a clinical condition, where people generally undergo hallucinations or a sensation of spinning. Actually, the central causes of vertigo arise due to the abnormality in the brain, or brainstem, or spinal cord. Moreover, it occurs due to dysfunction of the vestibular structures in the central nervous system.
Central vertigo is caused by a disease or injury to the brain, such as:
- Concussion or traumatic brain injury
- Head injuries
- Illness or infection
- Multiple sclerosis
- Psychogenic disorder
- Brain tumors
- Strokes/ mini-stroke
- Cerebellar/brainstem disease
- Tumors of the brain and spinal cord
- Ear surgery
- Herpes zoster oticus- shingles in or around the ear
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Diagnosis for Vertigo
Vertigo can be diagnosed by several tests. But all the above types of vertigo diseases have different presentation and treatment methods. So, only after proper diagnosis, the doctor will learn more about your underlying condition.
It is the common test for benign paroxysmal positional vertigo (BPPV) which is also, in general, the common cause of vertigo. The test gives a distinctive difference between the cause of vertigo i.e. either by ear disease or some brain disorder/ disease.
Head Impulse Test
This is a general test for checking the conjoin functioning of eyes and inner ears. This test commonly helps in evaluates vertigo conditions such as vestibular neuritis. Moreover, the procedure is simple, a physician assists your head in a certain direction and at the same time check the eye movement and reflexes.
For the Romberg test, you have to stand on your feet. And, close your eyes. And the body’s sense of positioning is determined. This test helps doctors to check the normal functioning of the dorsal columns of the spinal cord.
A special test to differentiate between the affected and normal side of the brain or ear due to vertigo. In general, the doctor instructs the patient to walk straight or stray midline.
Electronystagmography (ENG) or Videonystagmography (VNG)
ENG (or VNG) detects the abnormality in the eye reflexes. They are usually done in the case when a doctor has a doubt of vertigo due to inner ear problems.
It is also termed as rotary chair testing which involves slow movement of the head from side to side. Meanwhile, eye reflexes are analyzed. With this test, a doctor can states how well eyes and inner ear work in body positioning.
This test analyzes your balance and posture. For this, the patient has to stand on a platform with barefoot under various circumstances and angle of slopes.
Vestibular Evoked Myogenic Potential (VEMP)
In this test, sounds are played and whose response is measured by special electrodes. By evaluating the result, the doctor can dictate whether your nerves and other parts are working properly.
Hearing Tests/ Audiometric Tests
In general, this test measures the hearing functionality and can detect the problem with the nerve that connects the inner ear to the brain.
Other Common tests for Vertigo
1. Electrocochleography: These tests help to determine whether there is fluid buildup or not which causing excessive pressure in your inner ear.
2. Magnetic Resonance Imaging (MRI): MRI scan may also show fluid buildup, inflammation in the inner ear, or any abnormality in nerves.
3. Computerized Tomography (CT) Scan: Through, CT scan— the physicians see abnormalities around the inner ear, such as fractures or thinning bone.
4. Vision Tests: To find out the cause for vertigo symptoms. The doctor may recommend a vision test which is generally done by the ophthalmologist.
5. Blood Test: In the case of viral and bacterial infection, a blood test might be helpful to reveal vertigo causing agents. However, other conditions such as blood cell count, thyroid function, blood sugar levels, electrolytes, etc. might point to the cause of vertigo.
6. Allergy Tests: Some allergies can also trigger the vertigo symptoms, so to check on it, a doctor might prescribe some allergy tests.
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When to see a Doctor on Vertigo?
See a doctor if you have the following situations:
- Feel your vertigo is getting worse
- Can’t perform daily tasks
- Impaired hands and feet movements.
See a doctor immediately if you:
- Develop a fever
- Have vision problems, hearing loss, or difficulty in speaking.
- Feel weakness or numbness in your arm or leg.
- Fall or have difficulty in walking
Treatment for Vertigo
In general, vertigo treatment depends on its causes and occurrence. In spite, most of the cases, vertigo goes away without any treatment. Because the brain is able to adopt or can compensate for changes to the inner ear to restore other mechanisms to maintain balance.
However, in some case, medication and other help are need, and these are the several treatments available for vertigo:
Sitting down for a moment and rising slowly while standing from a sitting position, might help in relieving vertigo. In the early phase, you can even use a cane to improve your balance.
Medications For Vertigo
Some medications used to treat vertigo are:
- Steroids— reduce inner ear inflammation
- Water pills— reduce fluid buildup.
Other medicines such as prochlorperazine, metoclopramide, zofran, diazepam, lorazepam (ativan), and antihistamines.
Physical Therapy Maneuvers
Physical therapy is quite useful in developing a balance. Vestibular rehabilitation training (VRT), actually helps a lot. In this, a series of exercises are insured for people with dizziness and balance problems.
In very few cases, surgery is needed for vertigo treatment. Surgery is might needed in those cases such as tumors, injury to the brain or neck, or even more serious underlying brain and inner ear problems.
Prevention from Vertigo
Full-proof prevention may not be possible, however, maintaining a healthy lifestyle will help to decrease the risks of vertigo condition.
While controlling the following risk factors that eventually decrease the risk of developing vertigo, especially central vertigo. This includes:
- High blood pressure
- Avoiding tobacco products
However, to decrease symptoms of vertigo in cases of Ménière’s disease, you should control your salt intake.
Home-Remedies for Vertigo
These are the following home remedies that you can use to suppress the symptoms of vertigo:
- Epley maneuver
- Vitamin D supplementation
- Herbal Remedies
- Ginger root
- Ginkgo biloba
- Avoiding tobacco, alcohol, and caffeine
- Be hydrated or drink plenty of fluids.
Note: If you have severe vertigo, please consult your doctor before using any home remedies for controlling the symptoms.
Hence, at last, here are some frequently asked questions that people usually search for.
How can I get BPPV?
Ans. Most of the time, BPPV occurs without any definite cause. It can emerge from a number of factors such as cold weather, otoliths, or extreme response to a situation.
Can vertigo be treated?
Ans. Yes, vertigo can be treated through self-care, physical therapy, medication, or sometimes with some surgical operations.
Whom should I see for vertigo treatment?
Ans. There are two types of physicians whom you should consult for vertigo treatment.
- Neurologists: deal in treating chronic forms of vertigo.
- Otolaryngologists: a neurologist specializing in ear disease.
Are there any surgical procedures to correct vertigo?
Ans. Yes, there are often surgical procedures to correct certain types of vertigo or it is caused by Meniere’s disease or by some tumors.
What triggers vertigo attacks?
Ans. The most common causes of vertigo are inner ear infections or diseases of the ear such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and Meniere’s disease.