Imagine a carnival ride spinning you around and the dizzy feeling that starts to take over. You enjoy the excitement of the ride and exit as you try to regain your balance. However, having a sudden internal or external spinning sensation trigger from just moving your head too quickly can become bothersome. A sense of spinning dizziness can be referred to as Vertigo. Keep all hands and feet inside the ride at all times as we dive into the understanding of what is Vertigo and how to treat dizziness. Will explain the science, symptoms, causes, diagnosis, and treatment options available to help you regain balance and control when faced with this condition.
What is Vertigo?
First, it’s important to note that Vertigo is a symptom where a person may feel as if they or the objects around them are moving. Furthermore, Vertigo is the most common type of dizziness and can have causes that aren’t exactly due to underlying diseases such as stepping off a spinning carnival ride. It is a symptom with a range of conditions and can happen when there is a problem with the inner ear, brain, or sensory nerve pathways. There are 2 major types of classification for Vertigo.
- Peripheral Vertigo
- Central Vertigo
We will go into more detail about these types of Vertigo further down the article.
If you’re reading this, you most likely experienced some form Vertigo or you are a student doing some research on the topic. Either way, we do the research so you don’t have to. We’re friends and that’s what friends do. Also, because we like science! According to the National Institute on Deafness and Other Communication Disorders, it is estimated that approximately 40% of the population in the United States will experience some form of dizziness or balance difficulty over the course of a lifetime. With almost half the population experiencing some type of dizziness, it’s safe to say it’s a common condition. With a little more research, we can narrow this scope down to a demographic by risk level.
- 35% of adults aged 40 years or older demonstrate some form of Vestibular Dysfunction (Balance and Eye Movement System)
- Dizziness and Vertigo in the pediatric population occurs in up to 18% of children
- Emerging data suggests that significant associations exist between those with balance disorders and reports of hearing loss, syncope (fainting / passing out), and headache
The average Vertigo victim would most likely be above the age of 40 and have some form of medical history with ear infections, headaches, or vestibular dysfunctions. However, due to a sizable percentage of pediatric cases, it is not uncommon to experience Vertigo at any stage in a person’s life.
As we stated before, Vertigo can be a symptom of other conditions. It is often triggered by a change in the position of your head. In addition, it can also have its own set of related symptoms. When the condition is triggered, people typically describe it as feeling like they are:
- Pulled to one direction
Other symptoms that may accompany Vertigo and it’s other types are:
- Balance problems and lightheadedness
- A sense of motion sickness
- Nausea and vomiting
- Tinnitus (Perception of noise or ringing in the ears)
- A feeling of fullness in the ear
In this case, the symptoms represent the feeling of being trapped on a (not so well maintained) spinning carnival ride. At this time we know the symptoms and statistics surrounding the condition. Clearly the next logical question would be…
What Causes Vertigo?
If we look back at the data from earlier, there are significant associations between balance disorders and reports of hearing loss, syncope (fainting / passing out), and headache. In addition to this, we have also seen that Vertigo can have causes that aren’t due to underlying disease such as spinning in circles or medication side effects. So now we can bring up the types of Vertigo we talked about earlier. Each type has its own set of underlying causes directly related to them.
This is the most common type of Vertigo. In most cases, the problem is caused by a problem in the inner ear. This structure makes up part of the vestibular system which is responsible for balance, and damage to it can bring on a feeling of dizziness. This form of Vertigo tends to pass quickly and the most common causes of peripheral vertigo are:
- In most cases, there is no known cause for BPPV. If a cause can be determined, it is usually due to a minor or severe blow to the head. This causes small crystals to get loose and start to float in the fluid of the inner ear and triggering the feeling of dizziness.
- This is a condition that associates symptoms of dizziness with the occasional loss of hearing. There is no exact cause for Meniere’s disease. Triggers for the disease are associated with eating salt, drinking caffeine, smoking cigarettes, or drinking alcohol. This disease comes in stages. The early stages include feelings of vertigo accompanied with hearing loss. Conversely the later stages experience less vertigo and hearing loss will gradually worsen.
- People who suffer Vestibular Neuritis will most likely experience a sudden and severe case of dizziness that lasts for 2 to 3 weeks. Most researchers believe the most likely cause is a viral infection of the inner ear. This infection causes swelling of a branch of the vestibulocochlear nerve and it affects the balance of the person infected.
- Otosclerosis is the abnormal growth of bone in the middle ear. This prevents the other structures connected to the middle ear from working properly together causing hearing loss, dizziness, and balance problems.
- This is usually caused by a viral or bacterial infection that causes inflammation of the part of the inner ear called the labyrinth. This inflammation affects the organs of balance in usually one ear. There is a difference of information being sent to the brain from the infected ear and the healthy ear. This causes the feeling of dizziness.
- There are several medications with side effects that can be associated with Peripheral Vertigo. These usually consist of drugs that affect blood and hormone levels including:
- Blood Pressure Drugs
- Muscle Relaxants
- Pain Relievers
- Sleeping Pills
Perilymph Fistula (PLF)
- This condition is caused by a physical tear or defect within a thin membrane between the middle ear and inner ear. This abnormal connection prevents the separation between the air filled middle ear and the perilymphatic space of the inner ear. The tear allows for changes in pressure within the ear and causes a feeling of Vertigo.
Superior Semicircular Canal Dehiscence Syndrome (SSCDS)
- SSCDS is when the normal bony covering of the superior semicircular canal of the ear is missing. Although the cause is unknown, head trauma and defects are believed to be possible causes. People suffering this condition may never actually have symptoms of Vertigo or dizziness.
This type is usually caused by some form of disease or injury to the brain. Therefore, Central Vertigo is less common than Peripheral Vertigo. This condition requires treating the root cause. For some ongoing conditions, treatment may be limited to managing the symptoms through medication, surgery, or mobility rehabilitation. Not only do these come without warning but also last long periods of time. Causes of Central Vertigo may consist of:
Illness or Infection
- Illnesses or infections that affect the brain or nervous system can cause problems for basic mobility and cause symptoms of Vertigo.
Head Injuries or Migraines
- A traumatic head injury or severe headache such as migraines can take a toll on the human body as well as mind, and balance.
- Multiple Sclerosis is a neurological disease that damages or distorts the nerves between the mind and body. This distortion between mind and body causes the feeling of dizziness accompanied with Central Vertigo.
- The cerebellum plays a major role in motor control for the human body. A brain tumor located on the cerebellum will cause problems in balance and basic mobility.
Transient Ischemic Attacks – Stroke
- This is when part of the blood supply is cut off from the brain. The lack of blood flow to the brain impairs proper mobility and creates a problem for balance in people who suffer from them.
How Do You Know If You Have Vertigo?
If you go to a doctor with symptoms of Vertigo, the first thing they might do is examine your ears. This will require a physical examination along with questions about any head injuries, ear infections, or how the dizziness makes you feel. Be sure to check your family’s medical history looking for any history of migraines or headaches. If a physical examination does not provide a diagnosis there are other tests you may undergo before a head CT or MRI scan.
- Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements. In order to check for nystagmus, the doctor rapidly moves the patient from a sitting position to a lying down position. The head is turned and held 45 degrees toward the affected side. Furthermore, the head is then moved 30 degrees downward over the end of the bench and below the horizontal position of the rest of the body. If the patient experiences Vertigo shortly after, and if the doctor observes specific eye movements, those of nystagmus, this can indicate that the patient is suffering from Vertigo. This can be achieved through a number of tests such as:
- This test can electronically record the nystagmus. The patient will wear a headset that places electrodes around the patient’s eyes. The device will then monitor the movements of the patient’s eyes.
- This newer technology can provide a video recording of the nystagmus. The person who is said to be suffering from vertigo puts on a pair of special glasses. These glasses contain recorders that focus on the eyes. The device records horizontal, vertical and torsional eye movements with the use of infrared light. Computer processing would then analyze the data to determine whether or not the patient has Vertigo
The Head Impulse Test
- This test will have your eyes fixed upon the tip of the examiner’s nose. Simultaneously, your head is moved quickly to one side. If you can keep your eyes on the nose of the examiner during this movement, then the test will be negative. Should you have vestibular dysfunction, the eyes would have trouble focusing during the head movement and help determine which side is experiencing an inner ear problem. Additionally, a positive test may be due to a problem with the central nervous system.
- Stand in place with arms and feet together at the sides. Keep your eyes closed and have a friend watch your balance. If you become unsteady, this could be a sign of an inner ear problem. The side you fall towards is typically the side on which the inner ear is affected.
- March in place for 30 seconds with your eyes closed. Have someone watch your movements. Peripheral Vertigo may be present if there is a sideways rotation while marching in place and the affected ear will be on the side the rotation occurs towards.
At this time, we have covered the data surrounding Vertigo. We went over diagnosis procedures, the symptoms, Central Vertigo, Peripheral Vertigo, as well as the underlying causes for all of these topics. Now that we know what is Vertigo, what causes Vertigo, and how do you know if you have Vertigo, last but not least is…
What Do You Do If You Have Vertigo?
Due to the many causes that are associated with Vertigo, treatment methods can vary. In many cases, dizziness and Vertigo will go away without any treatment whatsoever. Usually, this symptom recovery is due to the brain’s ability to adapt to the changes that have taken place in the inner ear and relies on other mechanisms to maintain balance. Alternatively for others, treatment will be necessary and may include:
- This is a type of physical therapy with the ultimate goal of strengthening the vestibular system (bodies balance system). This system is designed to send signals to the brain about head and body movement and its relation to gravity. Physical therapy is recommended if you have recurring experiences with Vertigo. Physical therapy helps train the other senses to compensate for it. A method of physical therapy used is Canalith Repositioning Maneuvers. These maneuvers were set by the American Academy of Neurology and are used to treat Benign Paroxysmal Positional Vertigo (BPPV). This treatment uses specific head and body movements to move calcium deposits out of the ear canal and into an inner ear chamber to be absorbed by the body. A doctor or physical therapist can guide a patient through the movement in a safe and effective way.
- Vertigo cases are also be treated with medication. These medications are used to relieve symptoms such as motion sickness or nausea. An example for cases that are caused by Meniere’s disease would be the use of diuretics (water pills) to reduce the pressure from fluid buildup.
Surgery For Vertigo
- Nevertheless, surgery has to be considered if these treatments fail. Surgery for Vertigo is usually associated with the Central Vertigo type. This involves causes such as a tumors, and extreme brain or neck injury. Fixing the root cause to the specific condition will relieve or terminate the symptoms of Vertigo.
Stepping off the carnival ride, the dizziness you were feeling began to vanish and things become clear again. With a strong base knowledge of Vertigo and dizziness to stand on, you are now too tall to ride this ride.
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