VERTIGO

Symptoms: Spinning sensation, nausea and vomiting, dizziness, balance problems, hearing loss in one or both ears, tinnitus (ringing in the ears), headaches, motion sickness, a feeling of fullness in the ear and nystagmus (a condition that causes your eyes to move from side to side rapidly and uncontrollably.

Causes: Inner ear issues (Benign paroxysmal positional vertigo, Meniere's disease, Labyrinthitis, Vestibular neuritis), Migraines, Head injury or stroke, Anxiety and Medications.

Risk Factors: Risk factors include individual characteristics (gender, age), Certain medical conditions, such as diabetes, high blood pressure, multiple sclerosis and inner ear problems, Medications, and substances (medications, alcohol consumption).

Prevalence: Studies suggest Vertigo is very common, especially in adults over 50. Research indicates around 7-10% of adults experience vertigo at some point in their lives.

Severity: Mild to severe

Which doctor to consult: GP (general physician), ENT specialist (Otolaryngologist) and Neurologist.

OVERVIEW: 

Vertigo is a spinning or dizziness sensation caused by Certain medical conditions, medications, and substances. It disrupts balance and can range from mild to severe, causing nausea and vomiting in serious cases.

Vertigo is a sensation that disrupts your sense of balance, making you feel like you or your surroundings are spinning. Inner ear problems, migraines, or certain medications can cause this unpleasant feeling. While vertigo itself isn't usually severe, it can be quite disorienting and sometimes accompanied by nausea or vomiting. If you experience vertigo, consult a doctor to determine the underlying cause and getting appropriate treatment is essential.

Vertigo, which causes unpleasant spinning or dizziness, disrupts balance. It can have various causes and severities. While home remedies and lifestyle adjustments might help, consulting a doctor is crucial. They can pinpoint the root cause of your vertigo, be it inner ear issues, migraines, or medications. With a proper diagnosis, you'll receive the most effective treatment plan to conquer those dizzying spells.

There's no single "gold standard" test for diagnosing Vertigo. The doctor will choose the most appropriate tests based on their suspicion of the cause. If your Vertigo is mild and resolves quickly, tests might not be necessary.

If you are experiencing persistent or severe Vertigo, you must consult a doctor for a diagnosis and appropriate treatment. Early intervention can help prevent complications and improve your overall well-being. Only some people with Vertigo will need extensive testing, which the doctor will order based on your specific situation. These tests aim to identify the underlying cause of your Vertigo so the most appropriate treatment can be provided.

TYPES OF NAUSEA: 

Vertigo can be categorized in two main ways:

By Origin: This categorizes vertigo based on where the problem causing the dizziness originates.

• Peripheral Vertigo: This is the most common type, originating from issues within the inner ear.

• Central Vertigo: Less common; this type originates from problems in the brain, specifically the brainstem or cerebellum.

By Cause: This categorizes vertigo based on the specific underlying condition causing the dizziness. Here are some common examples within each origin category:

Peripheral Vertigo:

Benign paroxysmal positional vertigo (BPPV): Tiny calcium particles get dislodged in the inner ear canals, causing brief episodes of vertigo, especially with head movement. 

Meniere's disease: This disorder causes vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness in the ear. 

Labyrinthitis: An inflammation of the inner ear, often caused by a viral infection, leading to severe vertigo, hearing loss, and nausea. 

Vestibular neuritis: Inflammation of the vestibular nerve, which carries balance signals from the inner ear to the brain. Symptoms are similar to labyrinthitis but without hearing loss.

Central Vertigo:

Stroke: A blood flow blockage in the brain can disrupt balance signals. 

Migraine (including vestibular migraine): Migraines can cause a variety of symptoms, including vertigo. 

Multiple sclerosis: This neurological disease can damage the brainstem and cerebellum, leading to vertigo. 

Tumours: Tumours in the brain can disrupt balance signals. 

Head injury: A blow to the head can damage the inner ear or brain stem, leading to vertigo.

SYMPTOMS: 

The main symptom of vertigo is a sensation that you or your surroundings are spinning or moving when you're not. This can be very disorienting and unpleasant. Here are some other common symptoms of vertigo:

• Nausea and vomiting

• Headaches

• Dizziness

• Balance problems

• Feeling off-balance or unsteady

• Difficulty focusing the eyes (nystagmus)

• Hearing loss or tinnitus (ringing in the ears)

• Motion sickness

• A feeling of fullness in the ear

The specific symptoms you experience, and their severity can vary depending on the underlying cause of your vertigo.

CAUSES

If you are experiencing Vertigo, it is important to consult a doctor to determine the underlying cause and get appropriate treatment. There are many causes of Nausea, some of the most common causes are listed in the table below:

RISK FACTORS:

Several factors can increase your risk of experiencing vertigo. These can be broadly categorized into individual characteristics, medical history, medications and substances, and other external factors. Here's a breakdown:

Individual Characteristics:

Gender: Women seem to have a slightly higher risk of developing Benign Paroxysmal Positional Vertigo (BPPV), the most common type of vertigo.

Age: Older adults are more prone to conditions that cause vertigo, and they're also more likely to take medications that can be a side effect.

Medical History:

• Previous Vertigo Episodes: If you've had vertigo, you'll likely experience it again.

• Head Injuries: A past concussion or head trauma can damage the inner ear and increase vertigo risk.

• Inner Ear Infections: Infections like labyrinthitis can inflame the inner ear and lead to vertigo.

• Migraines: Certain migraines, known as vestibular migraines, can cause vertigo as a symptom.

• Other Neurological Conditions: Multiple sclerosis, strokes, and tumours in the brain or spinal cord can affect balance and cause vertigo.

Medications and Substances:

• Certain Medications: Antibiotics, antidepressants, anti-seizure medications, and some blood pressure medications can have vertigo as a side effect.

• Alcohol: Drinking alcohol can disrupt the inner ear and trigger vertigo.

Other External Factors:

• Dehydration: When you're dehydrated, it can affect your blood pressure and inner ear function, potentially leading to vertigo.

• Motion Sickness: People prone to motion sickness may also be more susceptible to vertigo episodes.

• Anxiety and Stress: While not a direct cause, anxiety and stress can worsen vertigo symptoms.

Additional Risk Factors for BPPV (most common type):

• Vitamin D Deficiency: Low vitamin D levels may be a risk factor for BPPV.

• Osteoporosis: Bone loss associated with osteoporosis can increase the risk of developing BPPV in the inner ear.

• High Cholesterol: High cholesterol levels may be linked to an increased risk of BPPV.

It's important to note that this is not an exhaustive list, and some people may experience vertigo without any known risk factors. If you're concerned about vertigo, consulting a healthcare professional for proper diagnosis and treatment is recommended.

POSSIBLE COMPLICATIONS: 

Vertigo itself isn't inherently dangerous, but it can lead to some complications that can impact your daily life. Here's a breakdown of the possible complications:

Impact on Daily Activities: Frequent vertigo episodes can make it difficult to perform daily tasks safely, like driving, working at heights, or even walking. This can significantly affect your quality of life and independence.

Falls and Injuries: Vertigo's disorientation and dizziness can significantly increase your risk of falls, especially for older adults. Falls can lead to severe injuries like bone fractures, head trauma, and even hip fractures.

Anxiety and Depression: The fear of falling or experiencing another vertigo attack can lead to anxiety and even depression. This can worsen the overall experience and make daily life more challenging.

Social Isolation: Vertigo can make it difficult to go out and socialize due to dizziness or fear of falling, leading to social isolation and loneliness.

Underlying Conditions: In some cases, vertigo can be a symptom of a more serious underlying health condition, such as migraines, stroke, or brain tumours. While uncommon, it's essential to get evaluated by a doctor to rule out these possibilities.

Remember, early diagnosis and proper treatment can help manage vertigo symptoms and reduce the risk of complications.

PREVENTION: 

While there's no guaranteed way to prevent all types of vertigo, lifestyle changes and strategies can help reduce your risk of experiencing episodes or lessen their severity. Here are some approaches for vertigo prevention:

Manage Underlying Conditions: If you have a known condition that triggers vertigo, like migraines or inner ear infections, proper management of that condition can significantly reduce vertigo risk.

Stay Hydrated: Dehydration can affect your inner ear function and potentially lead to vertigo. Drinking plenty of fluids throughout the day is crucial.

Limit Alcohol and Caffeine: Excessive alcohol and caffeine intake can disrupt your inner ear balance and increase vertigo risk. Moderation is key.

Reduce Stress: Stress and anxiety can worsen vertigo symptoms. Practices like meditation, yoga, or deep breathing exercises can help manage stress and potentially reduce vertigo frequency.

Epley Manoeuvre (BPPV Specific): If your vertigo is caused by BPPV (Benign Paroxysmal Positional Vertigo), specific manoeuvres like the Epley manoeuvre can help reposition inner ear canaliths and significantly reduce vertigo episodes. A healthcare professional can teach you this manoeuvre properly.

Movement Strategies: Certain head movements or quick position changes can trigger vertigo for some people. A physical therapist can help develop exercises to improve balance and reduce sensitivity to these triggers. This can help you anticipate and manage potential triggers.

Get Enough Sleep: Adequate sleep is essential for overall health, and good sleep hygiene can help regulate your inner ear function and potentially reduce vertigo risk.

Avoid Smoking: Smoking can restrict blood flow to the inner ear and potentially contribute to vertigo. Quitting smoking can have numerous health benefits, including reducing vertigo risk.

Dietary Changes: Migraine-associated vertigo may benefit from a diet that avoids common migraine triggers like foods high in tyramine or MSG. Consulting a doctor or dietician can help identify potential dietary triggers for your case.

Note: Remember, these are general recommendations. It is always recommended to consult a healthcare professional for personalized advice based on your specific situation and vertigo type.

WHEN TO SEE A DOCTOR? 

You should see a doctor about vertigo in a few different scenarios:

Sudden or Severe Vertigo: If you experience a sudden onset of vertigo, especially severe, it's best to seek medical attention promptly. This could indicate a more serious underlying condition.

Persistent Vertigo: If your vertigo lasts more than a few days or comes back frequently, consult a doctor. They can help identify the cause and recommend appropriate treatment.

Vertigo with Other Symptoms: If you experience vertigo along with other concerning symptoms like:

• Sudden severe headache

• Chest pain

• Difficulty breathing

• Numbness or weakness in limbs

• Fainting

• Double vision

• Rapid heartbeat

• Confusion or slurred speech

• Difficulty walking or stumbling

• Ongoing vomiting

• Seizures

• Sudden hearing loss or change

• Facial numbness or weakness

These symptoms can indicate a stroke or other serious issue and require immediate medical attention.

In summary, if your vertigo is sudden, severe, persistent, or accompanied by other concerning symptoms, be cautious and see a doctor to get a proper diagnosis and treatment plan.

DIAGNOSIS: 

There's often no single test for diagnosing vertigo. Doctors use a combination of information and tests to reach a diagnosis.

Early diagnosis is crucial for getting the proper treatment and managing vertigo effectively. 

Diagnosing vertigo typically involves a two-pronged approach: gathering information and performing tests. Here's a breakdown of what to expect:

Information Gathering:

Medical History: Your doctor will likely ask detailed questions about your vertigo experience, including: 

• How it feels (spinning, tilting, etc.)

• When it started and how often it occurs

• Duration of episodes

• Any triggers you've noticed (head movements, stress, etc.)

• Other symptoms (hearing loss, nausea, etc.)

• Past medical conditions and medications

Physical Examination:

Ear Exam: Your doctor will examine your ears using an otoscope to check for signs of infection or inflammation.

Neurological Exam: This may involve testing your reflexes, balance, eye movements, and 

coordination to assess potential nervous system involvement.

Diagnostic Tests (if needed):

Dix-Hallpike Manoeuvre: This simple test involves moving your head and body in specific positions to see if it triggers vertigo, helping diagnose BPPV (Benign Paroxysmal Positional Vertigo), the most common type.

Romberg Test: Here, you stand with your feet together and eyes closed. Difficulty balancing can indicate inner ear or nervous system issues.

Hearing Tests: These can rule out hearing-related issues that might contribute to dizziness.

Imaging Tests (MRI or CT scan): In some cases, if there's concern about a more serious underlying condition, imaging scans might be used to get a detailed view of the brain and inner ear.

It's important to remember that this is a general overview. The specific tests your doctor recommends will depend on your situation and the details of your vertigo experience.

TREATMENT: 

The treatment for Vertigo depends on the underlying cause. Here's a breakdown of different approaches:

• Antihistamines: These medications (like meclizine) can help reduce dizziness and nausea associated with vertigo.

• Canalith Repositioning Procedures: For BPPV (most common type), specific manoeuvres like the Epley manoeuvre can help reposition inner ear canaliths and significantly reduce vertigo episodes. A healthcare professional can teach you this manoeuvre properly.

Rehabilitation Exercises:

• Vestibular Rehabilitation Therapy (VRT): This physical therapy program involves specialized exercises designed to improve balance, reduce dizziness, and help your brain compensate for inner ear dysfunction.

Lifestyle Modifications:

• Staying Hydrated: Dehydration can worsen vertigo, so drinking plenty of fluids is crucial.

• Limiting Alcohol and Caffeine: Excessive intake can disrupt inner ear function and increase vertigo risk. Moderation is key.

• Managing Stress: Stress and anxiety can exacerbate vertigo symptoms. Practices like meditation or deep breathing exercises can be helpful.

• Identifying and Avoiding Triggers: If you notice certain head movements or activities trigger vertigo, try to avoid them or modify them as much as possible.

In some cases, depending on the cause, additional treatments might be considered:

• Surgery: In rare instances, surgery might be an option for specific inner ear problems or severe migraine-associated vertigo that doesn't respond well to other treatments.

Here are some additional things to keep in mind:

• Not all vertigo requires treatment. Sometimes, simple manoeuvres or lifestyle changes can resolve the issue, especially with BPPV.

• Early diagnosis is essential to getting the proper treatment and managing vertigo effectively.

• If you have concerns about vertigo or any persistent symptoms, consult a healthcare professional for a proper diagnosis and a personalized treatment plan.

Remember, I can't provide specific medical advice. It's crucial to consult a doctor to determine the best course of treatment for your situation.