What is Vertigo?
Vertigo is a sensation of spinning or movement, often described as feeling as though you or your surroundings are moving or spinning. It can be caused by a problem in the inner ear or brain and is commonly accompanied by nausea and balance problems. Vertigo can also be associated with other symptoms such as hearing loss, tinnitus, and fullness in the ear.
Vertigo can be caused by a number of conditions, including:
- Benign paroxysmal positional vertigo (BPPV) : a common cause of vertigo, which occurs when small crystals in the ear become dislodged and move into the semicircular canals of the inner ear, where they interfere with the normal function of the inner ear.
- Meniere’s disease: a disorder of the inner ear that can cause vertigo, hearing loss, and tinnitus.
- Vestibular neuritis: an inflammation of the vestibular nerve that can cause vertigo, hearing loss, and tinnitus.
- Acoustic neuroma: a noncancerous tumor that can form on the vestibular nerve, which connects the inner ear to the brain, can cause vertigo and imbalance.
- Migraine-associated vertigo (MAV) : Some people experience vertigo as a symptom of a migraine, usually lasting hours or days.
- Other causes: Less common causes of vertigo can include head injury, stroke, brain tumors, and certain neurological disorders.
It’s important to see a medical professional, such as an ear nose and throat doctor or neurologist, for an accurate diagnosis and appropriate treatment.
Common symptoms of Vertigo
Vertigo can cause a range of symptoms, some common symptoms include:
- Dizziness: The most common symptom of vertigo is a sensation of dizziness or spinning, which can be mild or severe.
- Nausea: Vertigo can cause nausea and a feeling of unsteadiness or loss of balance.
- Loss of balance: Vertigo can make it difficult to maintain balance, and you may feel as though you are swaying or that the room is moving around you.
- Hearing loss or tinnitus: Some people with vertigo may experience temporary or permanent hearing loss, or ringing in the ears (tinnitus).
- Headaches: Vertigo can be accompanied by headaches.
- Sweating, or increase in heart rate : Vertigo can cause a feeling of anxiousness or stress which can increase heart rate and sweating.
- Visual disturbances: Some people experience visual disturbances like double vision, difficulty focusing or blurred vision.
- Fatigue: Vertigo can cause fatigue, which can make it difficult to perform everyday activities.
Symptoms can vary depending on the underlying cause of the vertigo and can come and go, last for minutes or hours and can be accompanied by other symptoms like nausea, vomiting, and sweating.
Causes of Vertigo
Vertigo can be caused by a variety of conditions affecting the inner ear, brain, or sensory nerve pathways. Here are some common causes of vertigo:
- Benign paroxysmal positional vertigo (BPPV): caused by small crystals that become dislodged and float around in the inner ear, triggering sudden, intense episodes of vertigo.
- Meniere’s disease: a disorder of the inner ear that can cause vertigo, hearing loss, and tinnitus.
- Vestibular neuritis: an inflammation of the vestibular nerve, which connects the inner ear to the brain, can cause vertigo and imbalance.
- Acoustic neuroma: a noncancerous tumor that can form on the vestibular nerve, which can cause vertigo and imbalance.
- Migraine-associated vertigo (MAV): Some people experience vertigo as a symptom of a migraine, usually lasting hours or days.
- Inner ear infections: infections in the inner ear can cause inflammation and fluid buildup, leading to vertigo and other symptoms.
- Head injury or trauma: injuries to the head or neck can cause damage to the inner ear or nerve pathways, leading to vertigo.
- Stroke: a stroke that affects the cerebellum, the part of the brain that controls balance, can cause vertigo.
- Other medical conditions: certain medical conditions such as multiple sclerosis, Parkinson’s disease, and brain tumors, can cause vertigo.
It’s important to see a medical professional, such as an ear nose and throat doctor or neurologist, for an accurate diagnosis and appropriate treatment.
How is Vertigo assessed by a Physiotherapist?
A physiotherapist may assess vertigo using a variety of methods. One commonly used method is the Dix-Hallpike test, which involves the patient sitting on the examination table and then quickly lying down while the therapist observes the patient’s eye movements. The therapist may also perform a series of other maneuvers such as the Epley Maneuver or the Brandt-Daroff Exercises to further assess the cause and intensity of vertigo, and the presence of nystagmus (involuntary eye movements).
Additionally, the therapist may also assess the patient’s posture, balance and gait, as well as question the patient about their symptoms, medical history, and any triggers or exacerbating factors. Based on the assessment, the therapist will develop an appropriate treatment plan.
Treatment for Vertigo
Treatment for vertigo can vary depending on the underlying cause, but some common approaches include:
- Vestibular Rehabilitation Therapy (VRT): This is a form of physiotherapy that is specifically aimed at improving the symptoms of vertigo by retraining the brain to process and compensate for signals from the vestibular system. It may include specific exercises such as the Epley Maneuver, the Brandt-Daroff Exercises or the Cawthorne-Cooksey Exercises.
- Medications: Depending on the cause of vertigo, a healthcare provider may prescribe medication to help alleviate symptoms. For example, in cases of benign paroxysmal positional vertigo (BPPV), a type of vertigo caused by small crystals in the inner ear, a medication such as meclizine or cinnarizine may be prescribed to help reduce the symptoms of vertigo.
- Surgery: In some cases, surgery may be needed to correct a structural problem that is causing vertigo. For example, if a person has a vestibular neuritis, a condition in which the vestibular nerve is inflamed, surgery may be done to repair or remove the damaged portion of the nerve.
- Lifestyle changes: Making some simple changes to your lifestyle such as reducing stress, avoiding triggers such as certain foods, and getting enough sleep can help alleviate vertigo symptoms.
It’s important to note that most cases of vertigo are benign and self-limiting, meaning that they will go away on their own. However, if the vertigo persists or is associated with other symptoms, it is important to seek professional help.
Dangers if left untreated
If vertigo is left untreated, it can lead to a number of complications, including:
- Falling: Vertigo can cause balance problems, making it difficult to walk and increasing the risk of falling. This is especially dangerous for older adults, who are at a higher risk of serious injury from a fall.
- Dehydration: Vertigo can cause nausea and vomiting, which can lead to dehydration if fluids are not replenished. Dehydration can lead to a range of health problems, such as kidney damage and low blood pressure.
- Social isolation: Vertigo can be a debilitating condition that can interfere with daily activities and make it difficult for a person to leave their home. This can lead to social isolation, which can have a negative impact on mental health.
- Anxiety and depression: Vertigo can be a distressing condition, which can trigger feelings of anxiety and depression. Persistent vertigo can also lead to a chronic state of anxiety and depression.
- Chronic dizziness: In some cases, vertigo can become a chronic condition, with symptoms that persist over time. This can lead to a reduced quality of life, and make it difficult for a person to participate in daily activities.
If vertigo is caused by an underlying condition, untreated it can lead to further complications and progression of the disease. It is important to seek medical attention and undergo proper evaluation, treatment and management to prevent these complications and to improve the quality of life.
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