subject: Vertigo (Dizziness) [print this page] Vertigo (Dizziness) Vertigo (Dizziness)
Vertigo (Dizziness)
Vertigo is a symptom characterized by spinning or whirling feeling due to disturbance in brain fluid. It is not a disease however could be symptom of many diseases. It can be basically of two types.
Subjective Vertigo: You feel that you are moving about
Objective Vertigo: You feel the surrounding objects are moving.
It occurs due to disorder in the inner ears, vestibular nerve, brainstem and cerebellum. These parts together constitude the vestibular system and it integrates our senses and movement. It also helps in preventing the objects from going out of focus when the body moves.
A condition called benign paroxysmal positional vertigo (BPPV) occurs due to hypertension or sudden change in posture. It is indicated by lightheadedness, nausea, imbalance and falling etc.
Causes
In some cases the cause of vertigo can't be ascertained. Most of the symptoms of vertigo arise due to disorders in peripheral Vestibular system or central vestibular system. Peripheral vestibular disorders include BPPV, Cogan's syndrome, Mnire disease, Ototoxicity and Vestibular neuritis. Along with BPPV the patient may also undergo hearing loss, reduced cognitive function and the facial muscles may weaken. Cogan's syndrome is recognized by inflammation in connective tissue of the cornea and consequently leads to vertigo, tinnitus and loss of hearing. Fluctuating pressure in endolymph or the inner ear fluid indicates Mnire disease which may also show same symptoms as BPPV however the extent is more severe. Viral infection in vestibular nerve cells may cause inflammation and lead to vestibular neuritis. Otoliths, the deposition of calcium carbonate and protein, in ear may build up and move around the posterior semicircular canal. During body movement these crystals may trigger inner ear sensors causing vertigo
Treatment and Medication
Vertigo can be treated by using one or more of the following:
Vestibular rehabilitation therapy (VRT)
Canalith repositioning procedure or Epley maneuver (CRP)
Semont maneuver
In VRT, a physical therapist designs exercise to train the brain and body synchronization that can be done at home and required to be done multiple times. These exercise targets brain to adapt and compensate vertigo during head movement, eye movement, tracking with the eyes and walking. CRP treats BPPV and works by moving the Otoliths in posterior semicircular canal to another inner ear canal where these crystals are absorbed in the body. CRP includes series of head and body movements. Another form of treatment includes Semont maneuver.
Ear infection due to bacteria like otitis media and labyrinthitis can be treated with amoxicillin or ceftriaxone. Meclizine, Antivert, clonazepam, Phenergan or other benzodiazepines can be used to cure BPPV. Prednisone and gentamicin helps in vertigo caused by Mnire disease.
