Vertigo

Overview

Dizziness affects almost 30% of the population. Vertigo is a type of dizziness where you feel as if you and/or your surroundings are spinning or falling when there is actually no movement. This type of dizziness causes almost 3% of all hospital emergency room visits. It affects more women than men, and the incidence increases with advancing age. Normally, your brain receives spacial orientation information from your ears, eyes, and balance-sensing nerves in your body. Vertigo occurs when your brain receives conflicting information from one of these three sensory systems. Therefore, vertigo is actually not a disease, but a symptom of a condition affecting one of these sensory systems.

Symptoms & Diagnosis

Characteristic sensations of vertigo, such as spinning, tumbling, tilting, or falling may last from a few minutes to many days. Often times, nausea, vomiting, sweating, visual difficulties, and lack of balance are associated symptoms.

Vertigo can occur when you are exposed to unfamiliar movements, such as spinning for an extended period of time or riding on a roller coaster or a boat.  It can also occur after too many alcoholic drinks or as a side effect of a medication. The most common type of vertigo is known as benign paroxysmal positional vertigo (BPPV). This type of vertigo is usually the result of a sudden head movement and is often accompanied by lightheadedness, nausea, imbalance, and nystagmus. These types of vertigo are normally harmless and easily corrected. More complex causes of vertigo include:

  • Meniere's Disease and Meniere's Syndrome, which are also accompanied by low frequency hearing loss and ringing in the ears
  • Head injuries which cause dizziness (referred to as post-traumatic vertigo)
  • Inner ear inflammation as a result of bacterial or viral infection
  • Vascular diseases that cause decreased blood flow to the brain
  • Migraine headaches

Medical Treatment

The primary medical treatment for vertigo relies on the use of pharmaceutical drugs; however, the type of medication prescribed depends on the cause of the vertigo. For example, if inflammation of the inner ear is causing vertigo, an antihistamine or a corticosteroid may be prescribed to help reduce the inflammation. Antiemetics may also be used to suppress nausea that may accompany vertigo.
How We Can Help

Remember, vertigo is just a symptom. Therefore, in order to treat vertigo properly, it is vital to identify its underlying cause.

The first step we take in identifying the cause is to take a thorough patient history. Often times, patients are unaware that an event in their life was actually the cause of their vertigo. Next, we perform a physical and neurological exam, paying special attention to eye movements and balance. Eye movement irregularities or specific balance difficulties are important clues in identifying the cause of vertigo. Once we identify what is causing your vertigo, we can determine whether we are able to help with your case.

Many cases of vertigo are caused by a miscommunication between the brain and the balance-sensing joints in the body, specifically the neck and the ankles. In our office, this type of vertigo stands no chance. Some types of vertigo improve with nutritional and/or lifestyle changes. Other types, such as BPPV, respond well to a simple repositioning exercise and can be alleviated in one session.