Types of Vertigo

• Peripheral Vertigo: This may be caused by a problem with the inner ear’s semicircular canals or vestibular labyrinth that controls balance.
• Benign paroxysmal positional vertigo (BPPV): This is an inner ear disorder that makes you experience a sudden spinning sensation whenever you move your head.
• Central vertigo: This occurs due to an issue in the brain stem or a problem in the cerebellum (back of the head). This can be caused by various conditions such as diseases in the blood vessels, stroke, brain tumor, migraine, multiple sclerosis, infections, and drugs such as aspirin, anticonvulsants, and alcohol.

Causes of Vertigo

An inner ear problem commonly causes vertigo, issues in certain parts of the brain, and other health conditions or syndromes, including:

• Benign paroxysmal positional vertigo (BPPV): This is the most common cause of vertigo triggered by changes in your head position. If you have BPPV, you may experience vertigo when sitting up, lying down, or turning over in bed. It occurs when tiny calcium particles collect in the inner ear.
• Labyrinthitis: This occurs when the inner ear labyrinth becomes infected, leading to inflammation. If you have labyrinthitis, you may experience ear pain, vision changes, headaches, or hearing loss.
• Meniere’s disease (idiopathic endolymphatic hydrops): is a rare inner ear disorder that affects your hearing and sense of balance.
• Cholesteatoma: Recurrent ear infections may lead to noncancerous abnormal growth that forms behind your ear drum, which causes severe conditions and affects your hearing.
• Vestibular neuritis: This is caused by infection or inflammation of the vestibular nerve between the inner ear and the brain stem. It is similar to labyrinthitis but does not alter your hearing. Nausea and blurred vision are commonly experienced.
• Acoustic neuroma or Vestibular schwannomas: They are caused by hearing and balance nerves. Symptoms are hearing trouble, weakness, facial numbness, and vertigo.
• Otosclerosis: This is an abnormal growth of the bone which affects the middle ear.
• Perilymphatic fistula: This occurs when the fluids leak in the middle ear.
• Vestibular Migraine: It causes continuous dizziness and is a nervous system condition.

Other conditions that cause vertigo include:

• Neurological conditions such as multiple sclerosis and Parkinson’s may lead to progressive loss of balance.
• Ataxia which results from muscle weakness
• Head or neck injury, especially traumatic vestibular system damage.
• Certain medications can cause symptoms such as hearing loss, tinnitus, vertigo, and dizziness.
• Low blood pressure (orthostatic hypotension) decreases your blood pressure when standing up.
• Shingles, like any viral infection, may lead to symptoms of weakness and lightheadedness. They are caused by the reactivation of varicella-zoster virus (VZV)
• An arrhythmia occurs when your heart doesn’t circulate your blood efficiently due to conditions such as cardiomyopathy, carotid artery disease, or heart arrhythmia. When that happens, you may experience dizziness and vertigo
• Ear surgery may cause vertigo due to contact between the surgical tool or prosthesis.
• Stroke symptoms come with headache, numbness, vertigo, and nausea.
• Diabetes patients may experience dizziness caused mainly by certain medications or dehydration.

Symptoms of Vertigo

Many different conditions combine their symptoms with vertigo, and it can occur with other symptoms, which include:

• A sense of motion sickness
• Faint and lightheadedness
• Unsteadiness
• Nystagmus (a condition where the eyes move side to side)
• Headaches and sensitivity to light and noise
• Nausea and vomiting leading to body fluids loss
• Balancing difficulties
• Tinnitus (high-pitched ringing in the ears)
• Double vision or see double
• Difficulty speaking or swallowing
• Shortness of breath or racing heart

These symptoms may last for a few seconds, minutes, or days; they are also worsened by standing, walking, rolling over, coughing, sneezing, or moving your head.

When to Seek Emergency Care

If you experience the following symptoms, contact your doctor or seek immediate medical care.

• Fever (Temperature greater than (38ºC)
• Hearing loss
• Coordination loss
• New, different, or severe headache
• Limb weakness
• Difficulty walking
• Double vision or loss of vision
• Loss of consciousness
• Slurred speech or trouble speaking or hearing
• An inability to walk without assistance
• Weakness in an arm or leg
• Numbness or tingling
• Inability to keep food down, or continuous vomiting
• Passing out
• Chest pain

Seek help immediately if you have vertigo that lasts for several minutes or more if you:

• Have had a stroke in the past
• Have stroke risk factors (high blood pressure, diabetes, smoking)
• Are elderly

Treatment for Vertigo

Most cases of vertigo resolve independently without treatment because the brain can adapt and create other mechanisms for balance control. Vertigo treatment depends on the underlying cause and aims to relieve the symptoms and help with recovery. Treatment options include:

Medication
Medication may be given to relieve symptoms associated with vertigo, such as antibiotics to treat an infection or steroids to reduce inflammation. Diuretics (water pills) may be prescribed for Meniere’s disease to reduce pressure from fluid buildup. You may also be given medications to relieve nausea and motion sickness.

Canalith Repositioning Procedure (CRP)
This is used for BPPV to help move calcium deposits out of the canal into an inner ear chamber for absorption by the body. The procedure uses a series of specific safe and effective head and body movements, and you might have vertigo symptoms during the procedure.

Vestibular Rehabilitation
This type of physical therapy helps reduce symptoms and strengthen the vestibular system (its work is to send signals to the brain about head and body movements). Vestibular rehabilitation also helps to improve other senses to compensate if you have recurrent bouts of vertigo.

Surgery
Surgery is recommended when a severe underlying issue needs to be corrected, such as a brain tumor, neck injury, or microvascular decompression.

How to Prevent Vertigo Attacks

You can prevent symptoms from worsening and reduce the risk of vertigo by trying the following:

• Sit or lie down as soon as you feel dizzy.
• Elevate your head on two pillows when sleeping.
• Squat when picking something instead of bending.
• Resume activity gradually.
• Slowly stand up and don’t do trigger movements.
• Avoid bright lights and reading when symptoms occur
• Avoid hazardous activities such as operating heavy machinery or driving until several days after symptoms disappear.

At Axon Health Associates, we understand that living with vertigo can affect your quality of life and keep you from doing your day-to-day activities. We customize treatment plans tailored for your unique needs. Contact us today for more information or schedule an appointment online.