Vertigo is simply a type of dizziness commonly associated with vomiting, nausea and imbalance of body.
Vertigo is of 2 types:
- Peripheral vertigo – It occurs due to inner ear causes. The most common cause for this is Benign Paroxysmal Peripheral Vertigo (BPPV), which accounts for 32% of all common types of peripheral vertigo. Any cause of inflammation such as common cold and influenza cause transient vertigo if it involves the inner ear.
- Central vertigo – It occurs when the underlying cause lies within the central nervous system of the body. It includes the movement illusion which is not so prominent and nausea instead of a typical peripheral vertigo. It can be caused due to hemorrhage or infractions, tumors like vestibular schwannoma or cerebellar tumors.
Central vertigo also consists of neurologic defects like slurred speech and double vision with pathologic nystagmus.
Signs and symptoms of Vertigo
Vertigo is more common in older people as compared to older people while it has got a less specific age group. The occurrence rate is more in females as compared to males. One of the main reasons vertigo might be triggered remains the change in head’s position. Although vertigo is itself a symptom of several other related and unrelated diseases but there are some symptoms which are typical to it:
- Nauseatic feeling
- Feeling of imbalance while walking or sitting
- Blurred vision
- Nystagmus or jerky or abnormal movement of the eyes
- Excessive sweating
- Loss of hearing or less hearing
- Tinnitus or ringing of ears
These above symptoms may be intermittent or continuous and may last for a few minutes or even for hours. But there have been cases and incidences in which vertigo attacks have lasted from once to twice to thrice a week. This means that if not taken care of, the attacks might repeat.
Diagnostic tests for Vertigo
Tests for Vertigo
Various tests can be conducted for Vertigo. Some tests of vestibular systems such as electronystagmography, Dix-Hallpike maneuver, rotation tests, caloric reflex tests, computerized dynamic postugraphy are done in order to determine vertigo. CT scans or MRI scans are also used time to time to diagnose vertigo.
Electrocochleography, pure tone audiometry and auditory brain stem response tests are done as well in order to obtain a detailed condition of the existing attack of vertigo.
Treatment and medications for Vertigo
Diet with low salt content is highly recommended with a few intra-tympanic injections of antibiotic gentamicin or a benzodiazepine like diazepam or some other related antibiotics to sedate the vestibular system and thus prolong the effects of vertigo. A few Vertigo medications are:
- Anticholinergics such as scopolamine
- Anticonvulsants such as topiramate, valproic acid for the vestibular migraines only
- Antihistamines such as meclizine, betahistine, dimenhydrinate which may have antiemetic properties
- Beta blockers such as meta prolol for vestibular migraines
- Corticosteroids such as dexamethasone as a second line agent for the purpose of Meniere’s disease or methylprednisolone in some of the inflammatory conditions.
The above medications are usually prescribed for a period of 3 to 14 days during the occurrence of vertigo attack depending on symptoms. It is always recommended to take these medications on being prescribed by a doctor to avoid any adverse effects. Some side effects have also been reported with these medications which include drowsiness, constipation, insomnia, headaches, tiredness or indigestion. Some may cause muscle twitching of the shoulders, face and neck. These symptoms may disappear on discontinuing the medicines.