Vertigo is one of the most frequent complaints among the medical outpatients. The other common ailments for which patient visits the physician are headache, low backache and generalized weakness. Most of the time vertigo is harmless but there is always a possibility of an underlying disorder in the brain. So, proper cause for the vertigo must be found out and should be treated.
What is vertigo?
Most of the time, the terms vertigo and dizziness are used for describing the same condition. The patient will have a number of different complaints. He may have a feeling of rotation or whirling, weakness, faintness or unsteadiness. At times the patient will have the feeling that the whole world is rotating around him.
What are the causes of vertigo?
Vertigo is mainly caused by the disturbance in balancing system of the brain. Signals from the eyes, ear (labyrinth, vestibular part of the eight cranial nerve) and also our muscles and joints are responsible for our smooth normal day-to-day activities (equilibrium). This balancing activity is carried out continuously with our knowledge, by the brain. When there is in-coordination between these systems, vertigo results. Also, old age people lose their balance because their signals from the muscle and joints and from the ear (labyrinth) are impaired. One form of vertigo, called the benign positional vertigo of Barany, occurs only when the patient turns the head from a resting position. Meniere disease, vestibular neuronitis, tumours of the brain like acoustic neurinoma, head injury, bleeding in the cerebellum and some brain stem lesions can also cause vertigo.
What are the symptoms of vertigo?
The patient may feel that the objects surrounding him are rotating or he himself has a sensation of whirling. There may also be a feeling of to and fro or up and down movement of the head and the body. The floors and the walls of the room may sink or rise up. He may have a sensation of being pulled towards one side as though being drawn by a magnet. This is very characteristic of vertigo. Sudden stoppage after a rapid motion also causes vertigo in these patients. Making a sudden turning or keeping a foot in the car also induces vertigo. Severe vertigo may throw the patient to the ground. They also may have nausea, vomiting, sweating and some difficulty in walking.
What is pseudo-vertigo?
Before starting treatment, the physician must differentiate vertigo from pseudovertigo. The patients will complaint only of light-headedness, swimming sensation or only dizziness. They may also feel like walking on air. They have associated tremors and sweating. These symptoms are particularly common in anxiety disorder, hysteria or depression.
What are the diagnostic tests for vertigo?
Caloric testing is more frequently done. It is done by irrigating ice water and warm water into the ears and noting the response. In suspected cases of underlying neurological disorder like brain tumor, CT scan and MRI scan are indicated.
What are the treatments available for vertigo?
Vertigo can be treated by drugs if there is no underlying cause like brain tumour or infection in the brain. Drugs like cinnarizine, betahistine are useful. Other drugs used in the treatment of vertigo are Diphenhydramine, Scopolamine trans-dermal patch and Promethazine hydrochloride. Adaptation exercises (for the balancing system-vestibular system) are helpful in treating vertigo like benign paroxysmal positional vertigo. Usually vertigo is a self limiting disease and can be cured by drugs and rehabilitation exercises. Any underlying disease should be treated immediately. Patient with vertigo should take adequate precaution so that he can avoid fall and injuries.