365. What Is Vertigo?

What Is Vertigo?

What Causes Vertigo?

Vertigo is a feeling of dizziness, the patient feels that all around him is moving or spinning. Vertigo is usually caused by an inner ear problem, but may also be linked to some kind of eyesight problem.

Most of us have the occasional dizzy spell; vertigo is different. Vertigo is a persistent sense of motion, a feeling of tilting, swaying, spinning, when nothing is moving. The sensations are typically accompanied by sweating, vomiting and nausea.

People with vertigo often feel that things around them are moving when they are standing completely still.

Vertigo is medically different from dizziness, lightheadedness, and unsteadiness. Lay people commonly use the terms dizziness and vertigo indistinctly. If this happens, it is important for a doctor to determine exactly what the patient is trying to describe.

Doctors say that vertigo is more severe than dizziness, which commonly happens when a person stands up and feels light-headed. People with vertigo may find it harder to move around because the spinning sensation tends to affect balance.

"Vertigo" is often used, incorrectly, to describe the fear of heights, but the correct term for this is acrophobia. The medical term vertigo can occur at any time and may last for days, weeks, months, and even years, while acrophobia symptoms only occur only when the person is high up and looking down. However, vertigo is so commonly used 'incorrectly' by lay people that it would be naive today to say it only has one meaning.

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What are the symptoms of vertigo?

The patient may feel that his/her surroundings seem to be moving either vertically or horizontally. There may also be a sensation of spinning. Sometimes the feeling may be so slight that it is hardly noticeable. However, for some people the severity of symptoms makes it hard to keep balance and carry out everyday tasks.

A bout of vertigo can last from a few minutes to several days, and sometimes much longer. The following symptoms are possible:

• A sensation that everything around you is moving or spinning
• Loss of balance
• Nausea
• Vomiting
• Light-headedness
• Problems walking properly
• Problems standing still properly
• Blurred vision
• Earache

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What are the causes of vertigo?

Vertigo can be caused by a problem with the balance mechanisms of the inner ear, a problem with the brain, or a problem with the nerves that connect the brain to the middle ear.

Labyrinthitis

Inflammation of the labyrinth, a system of canals and cavities within the inner ear which gives us our sense of balance. The sudden onset of a feeling of vertigo caused by labirynthitis is triggered by head or body movement, and is usually accompanied by a feeling of nausea and malaise.

Labyrinthitis may be caused by a viral or bacterial infection. Viral infections, such as a common cold or flu can spread to the labyrinth - labyrinthitis. Bacterial infections are less common.

The patient may also have a painful ear and fever.

Vestibular neuritis

The vestibule is in the inner ear. It is like an internal carpenter's level. The vestibule and the semicircular canals work with the brain to control balance. Vestibular neuritis is inflammation of the vestibular nerve - the nerve running to the vestibule. Vestibular neuritis often follows an upper respiratory infection. Patients will experience vertigo, but will not usually have ringing in the ear (tinnitus) or hearing problems.

Benign paroxysmal positional vertigo (BPPV)

The vestibular labyrinth, inside the ear, includes semicircular canals (loop-shaped structures) that contain fluid and tiny hair-like sensors that monitor the rotation of the head. The otolith organs, also in the ear, monitor movements of the head and its position. There are crystals in the otolith organs that make us sensitive to movement. Sometimes, when the patient is lying down, these crystals can become dislodged and move into one of the semicircular canals, making it sensitive to head position changes - something it would not normally do. This unusual response to head movements by the semicircular canal can give patients vertigo symptoms.

BBPV most commonly occurs in elderly patients. A blow to the head can cause BBPV; even a minor blow. BBPV can also be caused by disorders that damage the inner ear, infection, ear surgery damage, or if the patient has been lying on his/her back for too long.

Most BBPV attacks clear up within a few days. The condition generally goes away within a few weeks or months, but can sometimes recur.

Meniere's disease

Dysfunction of the semi-circular canals (endolymphatic sac) in the inner ear. Patients experience recurrent vertigo, as well as tinnitus and loss of hearing in the affected ear, abnormal eye movements, nausea, and vomiting. People with Meniere's disease usually find that the tinnitus gets worse over time. Hearing loss may start off as intermittent, but gradually progresses until it becomes permanent.

Head injury

Some patients can develop vertigo after a head injury. If you have had a head injury and subsequently experience vertigo or dizziness you should tell your doctor straight away.

Migraine

Usually characterized by periodic headaches and some vision problems, such as seeing stars (as if someone had quickly flashed a strong light in your eyes). Some migraine patients also experience dizziness and vertigo. In fact, for some migraine patients, vertigo can eventually become the only symptom. Some studies have shown that migraine patients who experience vertigo during their attacks tend to show a higher lifetime prevalence of migraine.

Chronic otitis media

Long-term infection of the inner ear, or infection of the inner ear that recurs over a long period. Some patients with chronic otitis media have episodes of vertigo.

Acoustic neuroma

A benign (non-cancerous) tumor that develops on the acoustic nerve of the inner ear; this nerve is involved in helping us balance. Patients who do experience vertigo usually have mild symptoms.

Dehydration

Dehydration may lead to feelings of lightheadedness, dizziness, and/or vertigo, especially when changing positions. This symptom is due to a drop in blood pressure.

Some medications

Salicylates, quinine, and aminoglycosides may sometimes cause vertigo.

Boat, airplane, car travel (motion sickness)

Some people experience vertigo during and/or after a plane, boat, or even a car trip. This may last from a few minutes, hours to a couple of days.

Earthquakes

Some people who have been in a strong earthquake can suddenly feel that the firm ground around them moves long after the earthquake is over. This sudden sensation can occur on-and-off over a number of days, and sometimes weeks.

I was in the devastating Mexico City earthquake of 1985 (Richter 8.2). For a couple of weeks I would occasionally feel that the firm ground was wobbling - the sensation would last a couple of seconds and slightly affected my balance. I know a number of people who had to sit down when this happened to them.