Vertigo is a feeling of spinning or whirling when you are not moving. It can also be an exaggerated feeling of motion without moving your body. It is the most common form of dizziness, but is different from light-headedness (the feeling of nearly passing out).
Vertigo is usually caused by problems in the nerves and structures of the inner ear, called the vestibular system. This system senses the position of your head and body in space as they move.
Vertigo can occur with the following conditions:
Tiny particles naturally present in the canals of the inner ear, dislodge, and move abnormally when the head is tilted, pushing ear fluid against hair-like sensors in the ear. BPPV may result from:
This condition results from fluid buildup in the part of the inner ear called the labyrinth. This vertigo usually occurs along with hearing loss and tinnitus .
This is a slow-growing, noncancerous tumor of the acoustic nerve. The tumor can press against the nerves of hearing which can lead to hearing loss and tinnitus (ringing in the ear).
This refers to diminished blood flow to the base of the brain often caused by atherosclerosis (deposits of fat in the arteries). It is usually accompanied by other neurological symptoms.
Examples include:
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
Most cases of vertigo occur with nystagmus , an abnormal, rhythmic, jerking eye movement. Other symptoms depend on the condition causing the vertigo.
Symptoms may last only a few seconds, but may come and go for weeks or even years.
Sudden, intense vertigo lasting for several days to one week and often occurring with nausea and vomiting.
Sudden vertigo attacks lasting between minutes and hours and typically occurring with prominent hearing loss and tinnitus.
The doctor will ask about your symptoms, medication intake, and medical history, and perform a physical exam. In addition, the following tests may be performed:
Vertigo due to BPPV, labyrinthitis, or vestibular neuritis may subside on its own, usually within six months of onset (but it may sometimes take longer).
Treatments include:
To treat vertigo and nausea:
To treat Meniere's disease:
Most often used to treat BPPV:
If you continue to experience vertigo, the maneuvers can be repeated, or more difficult maneuvers such as Brandt-Daroff exercises can be done.
Physical therapy can also be helpful.
If symptoms persist for a year or more and cannot be controlled by the maneuvers, several surgical procedures can be performed. A surgical procedure called "canal plugging" may be recommended.
Canal plugging completely stops the posterior semicircular canal's function without affecting the functions of the other canals or parts of the inner ear. This procedure poses a small risk to hearing. Other surgical procedures include removing parts of the vestibular nerve or semicircular canals in the inner ear. Gentamycin injections can also be done. Talk with your doctor to learn more about these injections.
Vertigo can be a symptom of another medical condition, such as a heart problem or a neurological problem. Once that condition is treated, vertigo should stop, or, in this case, the underlying medical problem should be treated to help relieve the vertigo.
If you are diagnosed as having vertigo, follow your doctor's instructions .
If you are prone to vertigo, the following precautions may help prevent an episode:
RESOURCES:
American Academy of Otolaryngology–Head and Neck Surgery
http://www.entnet.org
Vestibular Disorders Association
http://www.vestibular.org
CANADIAN RESOURCES:
Balance And Dizziness Disorders Society
http://www.balanceanddizziness.org/index.html
Canadian Academy of Audiology
http://www.canadianaudiology.ca/
References:
American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html .
Vestibular Disorders Association website. Available at: http://www.vestibular.org .
Updated Maneuvers section on 9/6/2007 according to the following study, as cited by DynaMed's Systematic Literature Surveillance : Oh HJ, Kim JS, Han BI, Lim JG. Predicting a successful treatment in posterior canal benign paroxysmal positional vertigo. Neurology. 2007;68:1219-1222.
Last reviewed November 2008 by Elie Edmond Rebeiz, MD, FACS
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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