What Is Vertigo?
The sensation of the surroundings moving about or the feeling of yourself moving around when the background remains still is Vertigo.
It is a common ENT symptom for which patients seek treatment.
At the outset, there are some similar sensations which must be distinguished from Vertigo
- Lightheadedness — momentary sensation of fainting when you feel you may lose consciousness. There is no true rotatory sensation and it is usually related to the blood vessels.
- Imbalance — The sensation of being unable to maintain balance or swaying to one side or another — this is usually related to some problem with the cerebellar part of the brain or its connections.
- Syncope — a momentary loss of consciousness. this is usually related to momentary stoppage of circulation to the brain.
For a patient to be diagnosed to be having true vertigo, there must be a sensation of objects moving around, either horizontally or vertically.
Vertigo is a Symptom and not a Disease.
Once a patient is diagnosed to have true vertigo we look for a cause for it.
There are many causes of Vertigo, some of which are
1. BPPV — Benign Paroxysmal Positional Vertigo — a momentary sensation of spinning, usually related to a movement of the neck. It lasts for a very short duration and is self-limiting. It is caused by building up of some calcareous crystals in your semicircular canals — the three paired canals that maintain our body in equilibrium, and they reside in the inner ear. BPPV is one of the commonest causes of Vertigo, especially in the elderly. For the diagnosis as well as management some simple procedures are performed in the ENT OPD.
2. Acute Vestibular Neuritis — This is because of a viral infection, an acute episode of severe vertigo which is usually preceded by a viral fever or a cold. The giddiness usually resolves over days to weeks. Bed rest in the initial phase may be necessary.
3. Meniere’s Disease — a common cause of debilitating giddiness, this disease is accompanied by Tinnitus (a constant buzzing sound in the ears), Nausea and Vomiting, as well as a low-frequency hearing loss. The disease is recurrent and attacks can come out of the blue. A well-regulated lifestyle, reduction of salt intake and medication for the acute attack are the way we manage this.
4. Acute Labyrinthitis — a severe sudden attack of giddiness, associated with severe nausea and vomiting, extreme prostration, usually requiring hospitalization. An audiogram will reveal a sensorineural hearing loss. The patient may take a long time to recover completely and vestibular rehabilitation exercises are helpful.
Remember Cervical Spondylosis does not cause Vertigo
Vertigo is a symptom and its causes are fairly easy to diagnose. Treatment will depend upon the cause. Some investigations are sometimes required.
