Vertigo: Things you need to know

A person suffering from vertigo will experience spinning dizziness. Vertigo can be a sign of a variety of problems. When there is a problem with the inner ear, brain, or sensory nerve route, this can happen.

Dizziness, including vertigo, can strike anyone at any age, but it is more common in people over 65.

Vertigo can be a short-term or long-term problem. It can happen during pregnancy or as an indication of a bacterial infection in the ear. Vertigo can occur in people who have an inner ear problem such as Ménière’s disease.

What is it?

vertigo symptoms

Vertigo is a spinning dizzy experience in which the user feels as though the room or surrounding environment is whirling in circles around them. Many people confuse the phrase with a fear of heights, which is incorrect.

Vertigo can occur when a person stares down from a great height, but it usually refers to any momentary or persistent dizziness caused by inner ear or brain disorders.

It is a symptom, not an illness. Vertigo can be caused by a variety of factors.

Symptoms

Vertigo causes a person to feel as though their head or the space around them is spinning or moving.

Vertigo is a symptom, but it can also lead to or be accompanied by other symptoms.

These may include the following:

  • a feeling of fullness in the ear
  • headaches
  • nystagmus, in which the eyes move uncontrollably, usually from side to side
  • balance problems
  • lightheadedness
  • a sense of motion sickness
  • nausea and vomiting
  • ringing in the ear, called tinnitus

Causes

Vertigo can be caused by a number of factors, the most common of which are an imbalance in the inner ear or an issue with the central nervous system (CNS).

The following are some of the conditions that might cause vertigo.

Labyrinthitis

When an infection causes inflammation of the inner ear labyrinth, this condition can develop. The vestibulocochlear nerve is located within this region.

This nerve transmits information regarding head motion, location, and sound to the brain.

A person with labyrinthitis may experience hearing loss, tinnitus, migraines, ear pain, and visual problems in addition to dizziness with vertigo.

Vestibular neuritis

Vestibular neuritis, or inflammation of the vestibular nerve, is caused by an infection. It’s comparable to labyrinthitis, however it doesn’t cause hearing loss. Vertigo is a symptom of vestibular neuritis, which can be accompanied by blurred vision, acute nausea, or a sense of being off balance.

Cholesteatoma

The middle ear develops this noncancerous skin growth as a result of chronic infection. It can damage the middle ear’s bone structures as it grows beneath the eardrum, causing hearing loss and dizziness.

Ménière’s disease

This disease causes an accumulation of fluid in the inner ear, which can cause vertigo, ringing in the ears, and hearing loss. People between the ages of 40 and 60 are more likely to develop it.

Ménière’s disease affects an estimated 615,000 people in the United States, with doctors diagnosing roughly 45,500 new cases each year, according to the National Institute on Deafness and Other Communication Disorders.

Although the actual cause is unknown, blood vessel constriction, a viral infection, or an immunological reaction are all possibilities. It’s also possible that it has a hereditary component, implying that it runs in some families.

Find out more about Ménière’s disease.

Benign paroxysmal positional vertigo (BPPV)

The otolith organs are structures in the inner ear that hold fluid and calcium carbonate crystal particles.

These crystals become dislodged and fall into the semicircular canals when BPPV is present. During movement, each dropped crystal comes into contact with sensory hair cells within the cupula of the semicircular canals.

As a result, the brain receives erroneous information about a person’s location, resulting in spinning dizziness. Vertigo usually lasts less than 60 seconds, however nausea and other symptoms can occasionally develop.

Other considerations

Vertigo can also be caused by:

  • migraine headaches
  • a head injury
  • ear surgery
  • perilymphatic fistula, when inner ear fluid leaks into the middle ear due to a tear in either of the two membranes between the middle ear and inner ear
  • shingles in or around the ear (herpes zoster oticus)
  • otosclerosis, when a middle ear bone growth problem leads to hearing loss
  • syphilis
  • ataxia, which leads to muscle weakness
  • stroke or a transient ischemic attack, which people sometimes refer to as a mini stroke
  • cerebellar or brain stem disease
  • acoustic neuroma, which is a benign growth that develops on the vestibulocochlear nerve near the inner ear
  • multiple sclerosis

Vertigo can also be caused by prolonged bed rest and the use of certain drugs.

Vertigo in pregnancy

During pregnancy, nausea and dizziness are frequent complaints. Hormonal changes, which influence the properties of the fluid in the body, appear to play a role.

Changes in the inner ear’s fluid properties can cause symptoms such as:

  • tinnitus and hearing difficulties
  • vertigo
  • a feeling of ear fullness
  • instability with loss of balance

In a 2010 study, 82 pregnant women were polled. More than half of them said they felt dizzy in the first two trimesters, and one-third said they felt dizzy in the third trimester.

Nausea is typical throughout pregnancy, but it usually subsides as the pregnancy proceeds. Many of the women who took part in the poll related nausea to dizziness. Balance issues were also frequent, albeit they tended to get worse in the second and third trimesters.

The authors hypothesized that hormonal changes in the inner ear cause modifications during pregnancy. They argued that as the woman becomes accustomed to the new ear balance, her nausea and dizziness symptoms improve.

The worsening of balance issues during pregnancy could be due to changes in body weight and posture.

In 2017, scientists published four case studies in their research. The authors speculated that hormonal changes during pregnancy could contribute to BPPV, with estrogen, in particular, playing a role.

During pregnancy, drug treatment for nausea, dizziness, and other vertigo-related symptoms may be offered, but a woman should seek medical guidance. Some treatments might not be appropriate at this time.

Is it hereditary?

Vertigo is not always hereditary, but it is a common symptom of a variety of diseases and disorders.

Some of these appear to be caused by unique hereditary variables and may be passed down via families. There could be a hereditary or genetic component to recurrent vertigo.

Scientists have been studying the genetic profile of several vertigo-related diseases.

The following are some examples of disorders that might cause vertigo and appear to be caused by genetic factors:

  • bilateral vestibular hypofunction
  • familial Ménière ‘s disease
  • familial episodic ataxia
  • migrainous vertigo

A doctor may inquire about a person’s family medical history if they are experiencing vertigo.

Vestibular migraine can involve vertigo. Find out more about this condition here.

Treatment

Some types of vertigo go away on their own, but an underlying condition may necessitate treatment.

Antibiotics or antiviral drugs may be prescribed by a doctor in the case of a bacterial infection or antiviral drugs in the case of shingles.

Some symptoms can be alleviated with the use of medications. Antihistamines and antiemetics are among the medications used to treat motion sickness and nausea.

If various therapies are ineffective, surgery may be required. BPPV and auditory neuroma are two disorders that may benefit from this treatment.

Antihistamines can be purchased over the counter.

Treating Ménière’s disease

Ménière’s disease people may be prescribed medications by their doctors. Meclizine, glycopyrrolate, or lorazepam are some of the medications that can aid with dizziness caused by this condition.

Other possibilities include:

  • having a doctor inject antibiotics or corticosteroids into the middle ear
  • avoiding caffeine, chocolate, and alcohol and not smoking tobacco
  • limiting sodium intake and using diuretic therapy to reduce fluid levels
  • trying pressure pulse treatment, which involves fitting a device to the ear

Home remedies

Individuals can assist overcome vertigo and lessen its consequences by taking efforts at home.

Changes in your way of life

Vertigo can be reduced by doing the following steps:

  • using a cane when walking, if necessary
  • sleeping with the head raised on two or more pillows
  • making adaptations in the home
  • turning on lights when getting up at night to help prevent falls
  • lying still in a quiet, dark room when the spinning is severe
  • sitting down as soon as the feeling of dizziness appears
  • taking extra time to perform movements that may trigger symptoms, such as getting up, looking upward, or turning the head
  • squatting instead of bending over to pick something up

Anyone suffering from vertigo or other forms of dizziness should avoid driving or climbing a ladder.

Herbal treatments

Some herbal remedies may aid in the alleviation of symptoms.

These are some of them:

  • ginkgo biloba
  • ginger root
  • cayenne
  • Gongjin-dan
  • turmeric

There isn’t enough proof to say whether herbal therapies can help with vertigo. However, a clinical trial studying the impact of Gongjin-dan is under underway.

In a 2015 study, 60 people who went to the emergency room with dizziness and vertigo discovered that 30 minutes of acupuncture helped them feel better. More research is needed, however, to prove the efficacy of this therapy strategy.

Before trying any alternative remedies, people should see their doctor. If vertigo occurs abruptly or worsens, they should contact a doctor since they may need treatment for an underlying condition.

Exercises

In certain circumstances, exercises can help ease discomfort.

The Epley maneuver for BPPV

Some people with BPPV-related vertigo may benefit from a procedure known as the Epley maneuver.

The goal of the technique is to transport calcium carbonate particles from the semicircular canals back to the vestibule’s otolith organs, where they are less prone to cause inner ear complaints.

For BPPV involving the left inner ear:

  1. Sit on a bed and place a pillow behind the body where the shoulders will be on lying down.
  2. Rotate the head 45 degrees to the left.
  3. Keeping the head in position, lie down on the back with the shoulders on the pillow so that the head tilts back slightly and touches the bed. Hold for 30 seconds.
  4. Rotate the head to the right by 90 degrees and hold for 30 seconds.
  5. Turn the body and head, in their current positions, 90 degrees to the right. Hold for 30 seconds.
  6. Slowly sit up and lower the legs on the right-hand side of the bed.
  7. Hold for a couple of minutes while the inner ear makes adjustments.

Types

There are several varieties of vertigo, each with a different cause.

Peripheral vertigo

This type of case accounts for roughly 80% of all cases. Inner ear issues are the most common cause of peripheral vertigo.

The inner ear’s tiny organs deliver messages to the brain via nerve signals in response to gravity and the person’s posture. When people stand up, this procedure allows them to maintain their balance.

Vertigo can be caused by changes to this system. Inflammation and BPPV are two prevalent causes. Ménière’s disease and acoustic neuroma are two more possible causes.

Central vertigo

Central vertigo is caused by issues with the central nervous system. It is usually caused by an issue with the brain stem or cerebellum. This type of case accounts for about 20% of all cases.

Vestibular migraine, demyelination, and malignancies in the afflicted CNS region or regions are all possible causes.

Vertigo can be caused by an issue with the cervical spine. More information can be found here.

Diagnosis

The doctor will investigate the source of the dizziness. They will perform a physical examination, inquire about the person’s dizziness, and take their medical history.

Some easy tests may be performed by the doctor.

Here are two examples:

Romberg’s test: The doctor will ask the person to stand with their arms by their sides and their feet together and ask them to close their eyes. It could be a sign of a CNS problem if the person becomes unstable when closing their eyes.

Fukuda-Unterberger’s test: The subject will be asked to march for 30 seconds on the spot with their eyes closed by the doctor. If they rotate to one side, it could be a sign of a lesion in the labyrinth of the inner ear, which could cause peripheral vertigo.

The doctor may recommend a head CT or MRI scan to acquire more information based on the findings of this and other procedures.

Sources:

  • https://www.ncbi.nlm.nih.gov/books/NBK430797/
  • https://rarediseases.org/rare-diseases/benign-paroxysmal-positional-vertigo/
  • https://vestibular.org/about-vestibular-disorders/causes-dizziness
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459064/
  • http://vestibular.org/cholesteatoma
  • https://www.medicalnewstoday.com/articles/160900
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782948/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178912/
  • https://clinicaltrials.gov/ct2/show/NCT03219515
  • https://www.salisbury.nhs.uk/leaflets/HomeEpleyManoevrePI1403.pdf
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306472/
  • https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2006-951620
  • https://www.vertigotreatment.org/post/home-remedies-for-vertigo
  • http://www.racgp.org.au/afp/200805/200805kuo.pdf
  • https://www.nidcd.nih.gov/health/menieres-disease
  • https://www.nhs.uk/conditions/labyrinthitis/
  • https://www.aafp.org/afp/2005/0315/p1115.html
  • https://www.nhs.uk/conditions/vertigo/
  • https://www.nhs.uk/conditions/vestibular-neuronitis/