Vertigo refers to a very distinct sensation that is similar to the feeling of spinning or motion that leads to dizziness. Vertigo is not lightheadedness or the dizziness associated with low blood pressure. Vertigo is more about the sensation of moving while the body is standing still. People with vertigo may feel as though they are moving or spinning, or that the environment is actually moving or spinning, and this sensation leads to dizziness. There are two variations of vertigo. When there is a problem within the inner ear, or the vestibular which connects the part of the inner ear that controls balance to the brainstem, it is called peripheral vertigo. Central vertigo is diagnosed when there is a problem within the brain itself, typically the back of the brain or the brain stem.
The basic symptom of vertigo is sensation oriented, often the sensation of the individual is moving through or around a room or the sensation of the room moving around an individual. Subsequent symptoms may include difficulty swallowing, facial paralysis, double vision, blurry vision, slurred speech, or weakness or immobility of the extremities.
Vertigo that stems from inner ear problems may be caused by benign positional vertigo, which means that vertigo attacks only happen when the individual is in a specific position. It also may stem from medication known as aminoglycoside antibiotics, injury, labyrinthitis, or Meniere’s disease. Vertigo which stems from the vestibular nerve may be caused by typically either inflammation or nerve compression. Vertigo which originates in the brain stem may be caused by blood vessel diseases, migraine headaches, multiple sclerosis, or drugs such as aspirin, anticonvulsants, or alcohol.
There is no evidence to support that there is a genetic link for determining risk factors for vertigo. In fact, only those diseases which may be a cause of vertigo are considered risk factors. Vertigo strikes randomly, however the cause is typically fairly quickly identified.
When a patient presents with symptoms of vertigo, the physician will do a physical exam. The physical examination may reveal problems such as eye movement issues, lack of coordination, loss of balance, weakness, or a sensory loss. These symptoms would suggest a central cause for the vertigo. Tests can be done even if these symptoms do not readily appear during the time of the office visit. Testing may include an MRI to scan the head or an MRA to scan the blood vessels inside the head, a head CT, caloric stimulation to test the eye response, EEG, lumbar puncture, blood tests, or electronystagmography.
Persistent vertigo, or vertigo that continues unrelieved, may very well interfere with things such as working, driving, and other important facets of every day life. It can also lead to severe falls which may incur broken bones, lacerations, head injuries, and even death. These complications can be anywhere from annoying to life threatening, depending on the severity of the vertigo and how often it affects the patient.
Before treatment of vertigo can begin, the cause must be identified. More harm than good can come from treating the wrong causes of vertigo. Antihistamines, anticholinergics, benzodiazepines, and promethazine may be used to treat the symptoms of vertigo.
Specific head positions can trigger attacks of vertigo, and thus should be identified as early as possible as even short episodes of vertigo are likely to be dangerous given the wrong situation. The physician may need to place restrictions on activities such as driving, working, and other daily activities especially while the cause of vertigo is being sought.
Those who suffer from long term vertigo need to understand their symptoms and how to keep themselves safe despite these symptoms. Vertigo can lead to serious accidents if left untreated and uncontrolled. Controlling vertigo is the key to living a fairly normal life. While it is possible to have a single episode of vertigo, it is much more common to have multiple episodes. A physician should be notified at the onset of vertigo symptoms. If an episode of vertigo is significantly different from other episodes of vertigo, a physician should be contacted right away. Vertigo should be taken seriously by both physicians and patients. Patients will need to learn that their vertigo is likely to strike during specific triggers, and learn to recognize those triggers.
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