Diseases

Vertigo

Neurological disease

Vertigo is a form of dizziness, in which a sense of rotation or spinning is experienced, whereas the body in fact doesn’t make those movements. Vertigo is often accompanied by nausea, vomiting and balance disorder. This condition is an important symptom of BPPV (benign paroxysmal positional vertigo), vestibular neuritis (labyrinthis) and Ménière’s disease.


Cause

Vertigo is caused by a disturbance of the vestibular system. This is a small vulnerable organ inside the ear. If it doesn’t function properly, the brains receive wrong information. Then a person sees everything turning or has the sensation of moving, falling or turning.

People can have vertigo in the following cases:

Very occasionally, the cause is not in the vestibular system, but in the brains, such as in case of multiple sclerosis. Vertigo may occur in divers, caused by oxygen poisoning, when dived with a gas mixture of enriched oxygen.


Symptoms

The signs and symptoms of vertigo may vary by condition:


Diagnosis

Making the diagnosis of vertigo needs specialized examination. With the so-called Dix-Hallpike test, in which the head and upper body are suddenly tumbled backwards from a seated position, the dizziness can be induced. Usually, a typical eye movement can be seen, which can be recorded with a video camera during the balance test.


Treatment

Since vertigo is often the manifestation of an underlying cause, it isn’t necessary to treat the dizziness itself. Little can be done against dizziness. There is no medication that can reduce or stop it. One should therefore look for the underlying cause and remedy the situation. If there is a presumption that the inner ear is causing the problem, a hearing test will be done. Hearing will be tested with the aid of a headphone. In addition, a balance test can be carried out too, in which can be studied how the patient responds to certain stimuli and thus can be tried to figure out where the problem is located. Sometimes, an MRI can be made in order to exclude other underlying causes. If it's presumed that the dizziness is based on a vascular problem, an ultrasound and Doppler test will be done in many cases, in which the vessel wall is examined and the flow of blood is studied.


Prognosis

When the symptoms disappear, depends on the cause. The vertigo in BPPV usually passes on its own within four weeks. In case of vestibular neuritis, the symptoms usually disappear within a week. In case of Ménière’s disease, the attacks of vertigo can keep coming back. But it can take longer than a year before there will be another attack.


Considerations

If a person suffers from vertigo for the first time, the initial advice is: just try to continue what you are doing. Further advice will depend on the cause:

Some adjustments in daily activities can ensure that a person has less problems with vertigo. This can be done by:


Facts


See also

Ménière's Disease

Multiple Sclerosis (MS)

Tinnitus

Dix-Hallpike Test

Doppler Ultrasound

Hearing Test

Magnetic Resonance Imaging (MRI)

Medical Ultrasound

Videonystagmography

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