vertigo clinic
What is called vertigo or Dizziness?
It is not a disease but rather symptoms of several different syndromes. The sensation of spinning or whirling usually occurs as a result of a disorder in vestibular system which is responsible for integrating sensory stimuli and movements and keeping in visual focus as the body moves.
The vestibular system consist of the two labyrinths of the Ear, the proprioceptive impulse from joint and muscle, the eyes and the central nervous system i.e., the brain and the cerebellum. Based on proper clinical history and proper bed side examination and other investigations (laboratory) and test like Electronystagmography, Video HIT, CT scan and MRI of brain, 98% of the vertigo may be diagnosed. The subsequent treatment almost often be of a combination of behavioural and physiotherapy together with adequate medication.
What causes vertigo?
There are a number of different causes of vertigo. Vertigo can be defined based upon whether the cause is peripheral or central. Central causes of vertigo arise in the brain or spinal cord, while peripheral vertigo is due to a problem within the inner ear.
Peripheral causes:
- The structures in the inner ear may become inflamed spontaneously. Small crystals or stones found normally within the inner ear can become displaced and cause irritation to the small hair cells within the semicircular canals, leading to vertigo. This is known as benign paroxysmal positional vertigo (BPPV).
- Infection of the vestibular nerve can cause dizziness, or vertigo. This is called vestibular neuronitis, vestibular neuritis, or labyrinthitis.
- Fluid buildup within the inner ear or the endolymphatic system causes Ménière's disease, vertigo that also includes hearing loss and tinnitus (ringing in the ear). The cause of this fluid accumulation is unknown.
- Acoustic neuromas, tumors of the vestibular nerve, may also present with these three symptoms.
- Presbyvestibulopathy, a condition which is seen with aging .the hair cells of the utricle and saccule reduces with aging and hence sense of imbalance increased with aging
Central causes:
- Concussion or traumatic brain injury may be associated with vertigo.
- Strokes may cause vertigo and loss of coordination.
- Multiple sclerosis
- Tumors of the brain and spinal cord
- Some patients with a type of migraine headache called vestibular migraine may develop vertigo as a symptom.
- Vestibular paroxysmia, a condition in which irritation of vestibular nerve occur due to microvascular compression causing multiple short span attacks of vertigo
Functional causes
- Persistent postural phobic perceptual dizziness
- Mal debarquement syndrome
- Psychogenic dizziness
Follow-up for Vertigo
Is There a Way to Prevent Vertigo?
- Those with risk factors for stroke should control their high blood pressure and high cholesterol and stop smoking.
- Individuals with Meniere's disease should limit salt in their diet.
What Is Vertigo Prognosis?
The prognosis depends on the source of the vertigo.- Vertigo caused by problems in the inner ear, while usually self-limited, in some cases can become completely incapacitating. The use of drugs and rehabilitation exercises is the mainstay of treatment. Most commonly, this will cure the symptoms or make the condition tolerable.
- The prognosis of vertigo from a brain lesion (tumor or stroke) depends on the amount of damage done to the central nervous system. Vertigo caused by a brain lesion may need emergency evaluation by a neurologist and/or neurosurgeon and may lead to permanent disability.
What are the risk factors for vertigo?
Head injuries may increase the risk of developing vertigo. Ear infections may impact the vestibular nerve, leading to development of labyrinthitis. Vertigo may be a side effect of many medications, including some antiseizure medications, blood pressure medications, antidepressants, and even aspirin. For some people, drinking alcohol can cause vertigo.
The risk of stroke increases with poorly controlled high blood pressure, diabetes, and smoking. About 2%-3% of a population is at risk of developing BPPV; older women seem to have a slightly higher risk of developing this condition.
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