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‘Vertigo’ comes from the Latin word ‘verto’ which means
whirling or spinning movements. Vertigo is a sense of rotation
or of the world spinning, experienced even when someone is
perfectly still. A person feels as if he or the objects around him
are moving, when they are not.
Children attempt to create a sense of vertigo by spinning
around for a time.This type of induced vertigo lasts for a few
moments and disappears.
In comparison, when vertigo occurs spontaneously, it tends to
last for many hours or even days.
There are two kinds of vertigo – Peripheral and Central.
Peripheral vertigo is caused by problems in the inner ear while
Central vertigo arises in the brain or spinal cord.
Causes of Peripheral vertigo:
1) BPPV (Benign Paroxysmal Positional Vertigo)
2) Ménière's disease
3) Vestibular neuritis
Causes of Central vertigo (occurring less often):
1) Head injury
2) Stroke
3) Brain tumour in a certain area
4) Certain medications (Anti-seizure medication, Antidepressants,
even Aspirin)
5) Drinking alcohol
Studies show that 2% to 3% of the population is at risk of
developing BPPV, with older women being at slightly higher risk.
Symptoms:
Vertigo is often triggered by a change in the position of your
head. People usually describe it as a feeling of
Spinning
|
Tilting
|
Swaying
|
Imbalance
|
Being pulled
to one direction
Other symptoms that may accompany vertigo include:
Feeling nauseated
|
Jerking eye movements
|
Headache
|
Sweating
|
Ringing in the ear
|
Loss of hearing
Symptoms can last from a few minutes to a few hours or even more.
Treatment of vertigo:
Treatment depends on the cause. In many cases it goes away
without any treatment. In some cases treatment is needed.
Treatment includes - Vestibular rehabilitation with
Physiotherapy, Medicine and Surgery.
Vestibular rehabilitation (Epley Manoeuver):
If your left ear is suffering, sit on the edge of your bed, turn
your head 45 degrees to the left, place a pillow so that it rests
between your shoulders rather than under your head when you
lie down. Next, lie down quickly, face up, with your head on
the bed. (Your head should still be at a 45 degree angle.) Wait
for 30 seconds. Now turn your head 90 degrees to the right
without raising it. Wait for 30 seconds. Now turn your head
and body on its side to the right, so that you are looking at the
floor.Wait for another 30 seconds, sit up slowly but remain on
the bed for a few minutes. If the vertigo comes from the right
ear, reverse this manoeuver.
Do these movements 3 times before going to bed every night
until you have gone 24 hours without vertigo.
Medication:
Medication may provide some relief but it is not recommended
for long term use.Meclizine is prescribed for persistent vertigo.
Diazepam is also effective. Other medication may be used to
decrease nausea and vomitting. Medication can only provide
symptomatic relief but is not considered a cure for vertigo.
Surgical treatment:
Surgical treatment is helpful in curing Ménière's disease.
Can vertigo be prevented?
Controlling risk factors for strokes may decrease the risk of
Central vertigo. This includes making sure that cholesterol
and blood glucose levels remain within optimal ranges.
Decrease in salt intake helps in preventing vertigo from
Ménière's disease.
If Peripheral vertigo has been diagnosed, then performing
vestibular rehabilitation exercises routinely may help in
preventing episodes of vertigo.
As most cases of vertigo occur spontaneously, it is difficult to
predict who is at risk, so complete prevention may not be
possible. However, maintaining a healthy lifestyle will decrease
the risk of vertigo.
~ Dr Neelmonee Dutta
Phulbari Central Hospital
Phulbari T.E.
July 2016 49
Dr Neelmonee Dutta is an ENT Specialist
with many years’ experience in treating
various conditions, including Vertigo.