Vertigo is a symptom, not a medical condition. It’s the sense that you or your surroundings are moving or whirling.
This sensation can be subtle or severe enough to make it difficult to maintain your balance and do daily duties.
Vertigo attacks might occur unexpectedly and last only a few seconds or they can last much longer. If you have severe vertigo, your symptoms may be persistent and extend for several days, making it difficult to go about your daily activities.
In This Article...
What is the best vertigo treatment?
Which of these therapy options is best for each patient depends on their individual diagnosis:
- Vertigo caused by migraines usually responds to migraine-prevention medicines.
- Nonspecific medications like dimenhydrinate (Dramamine) and meclizine are the best treatments for acute vertigo (Bonine). Dr. Fahey adds that these medications are eventually withdrawn because they can impair long-term healing.
- Vertigo that develops within the first five minutes of standing is usually caused by a reduction in blood pressure (orthostatic hypotension). (Dramamine) and meclizine are two drugs that can be utilized in this condition (Bonine). Patients can also use thigh-high compression stockings or abdominal binders, raise the head of the bed, and boost salt and fluid consumption.
What is the most common cause of dizziness?
The most prevalent cause of vertigo is BPPV. Infection. Vestibular neuritis is a viral infection of the vestibular nerve that causes severe, continuous dizziness. Labyrinthitis is a condition that causes acute hearing loss.
Is it possible to get rid of vertigo?
Is it possible to treat vertigo? Physical therapy, medicine, surgery, and time are all effective treatments for vertigo. Waiting is what I mean by time because many causes of vertigo resolve on their own. Because there are so many reasons of vertigo, familiarity with the condition is crucial when choosing a doctor.
What are the top ten symptoms of vertigo?
When you have vertigo, you may feel as if you are spinning or moving when you are not. Alternatively, you may believe your surroundings are moving when they aren’t.
Vertigo is often mistaken for dizziness, although it is not the same as being light-headed.
For persons with vertigo, even small movements are excruciatingly painful, and the illness can interfere with daily activities.
What causes your episodes and the sort of vertigo you encounter will most likely determine your symptoms.
Is walking beneficial for vertigo sufferers?
Overview. Walking is a simple but effective vertigo exercise. It can aid in the improvement of your balance. Walking with more balance allows you to perform more independently, which may lead to increased self-confidence.
Is vertigo a stroke symptom?
Brain stem stroke symptoms Some symptoms may be present without the distinctive sign of weakness on one side of the body. Vertigo, dizziness, and lack of balance are all symptoms of a brain stem stroke. Doubtful vision
When does vertigo become dangerous?
Vertigo is a feeling that your surroundings are spinning in circles around you. It can make you feel light-headed and unbalanced. Vertigo is not a medical condition. Rather, it’s a symptom of a variety of problems.
Are there different types of vertigo?
- When there is a problem with the brain, central vertigo ensues. Infections, brain tumors, traumatic brain damage, and stroke are all possible causes.
What should I know about vertigo vs dizziness?
While both dizziness and vertigo are signs of a balance disorder, they are not the same. Dizziness is the sensation of being off balance. Vertigo causes you to feel as if you’re moving or that your surroundings are whirling.
Who does vertigo affect?
Vertigo attacks can strike anyone at any age, but the elderly are more susceptible. Women are slightly more likely than males to feel vertigo. Vertigo is a common side effect of pregnancy for some women.
How long does vertigo last?
Vertigo bouts can last anywhere from a few seconds to many minutes. However, in severe situations, vertigo can last for hours, days, weeks, or even months.
What does vertigo feel like?
Vertigo is often compared to motion sickness. It may give you the sensation of spinning, swaying, or tilting. When you stand, walk, change postures, or move your head, you may feel more unbalanced.
Is vertigo a serious condition?
Although vertigo might be frightening, it is not a dangerous condition. Vertigo, on the other hand, can be linked to other potentially dangerous health issues. If you have recurring or persistent vertigo attacks, you should notify your healthcare physician.
How can I avoid vertigo while sleeping?
It is predicted that more than 40% of people aged 40 and up would have vertigo symptoms at least once in their lives. Sleeping can be a great difficulty when you’re experiencing symptoms like dizziness, headaches, nausea, and odd eye movements. This is because many of the aforementioned scenarios commonly occur while lying down. If you’re seeking to obtain a good night’s sleep while struggling with vertigo, we’ve put up a list of helpful hints.
A significant number of vertigo episodes are caused by small crystals in the inner ear that have developed to the point where they can disrupt balance nerves. Unfortunately, in a horizontal position, this issue is frequently exacerbated. As a result, keeping your head slightly raised during the night is a smart idea. Wedge-shaped pillows, even those designed for travel, may be able to provide more support for your head and neck than typical options.
The second major worry is which sleeping positions are ideal for avoiding dizziness and sickness. Many specialists advise sleeping on your back since the crystals in your ear canals are less prone to become disrupted and cause a vertigo attack. If you have to get up in the middle of the night, rise slowly rather than making any rapid head or neck movements. Vertigo symptoms can be triggered by sudden jolts or movements.
Another possibly effective approach that may be done right before bedtime is to make a few head motions to disperse the crystals in your inner ear. Specific motions such as turning your head from one side to the other while lying on your back, known as “canalith repositioning manoeuvres,” have been demonstrated to provide viable outcomes. However, this is based on the assumption that you have benign paroxysmal positional vertigo, which is a type of vertigo (BBPV). If you’ve been diagnosed with this sort of vertigo by a professional, the BBPV therapy procedures outlined above could be quite beneficial.
However, there are a variety of causes for vertigo and dizziness, so it’s a good idea to speak with one of our skilled specialists to determine the best course of action.
Is vertigo a life-threatening condition?
Vertigo is an erroneous perception of movement in one’s self or surroundings that can be rotational (i.e. spinning) or translational (ie, a sense of floating upward). Vertigo can be caused by a variety of factors, but the common denominator is a problem with the vestibular system, which includes the inner ear labyrinth and the CNS structures that interpret signals from the labyrinth. Unlike general “dizziness,” vertigo is never constant, but rather happens in single or recurring episodes. Vertigo can be either spontaneous (as in vestibular neuritis or Mnire’s illness) or induced (as in benign paroxysmal positional vertigo). (1) As in this case, vertigo is frequently accompanied by nausea and vomiting when it is severe.
When patients first suffer vertigo, especially if it is accompanied by nausea and vomiting, they usually seek medical help almost away, usually in an emergency department. The Table lists the common causes of vertigo seen in emergency rooms. Most individuals with vertigo who present to an ED can be treated conservatively with vestibular suppressants and antiemetics and sent home. A tiny number of patients with vertigo will need to be admitted to the hospital for intravenous fluids to address dehydration or for additional therapy, such as for a cerebellar infarction. (2) Vertigo is occasionally the presenting symptom of a life-threatening, curable disease, such as a cerebellar hemorrhage, as in this case. (3)
What aspects of this instance show that the anomaly occurred in the CNS rather than the labyrinth? Unfortunately, determining whether vertigo is caused by the central (brain) or peripheral (inner ear) vestibular system is difficult, if not impossible, because vertigo and most accompanying signs and symptoms (such as nausea, vomiting, and diaphoresis) can be the same in both. However, several indications and symptoms of vertigo may refer to the inner ear or the brain. Hearing loss and tinnitus, for example, point to an inner ear problem, whereas cranial nerve or cerebellar abnormalities point to a brain problem. This patient’s vertigo was not accompanied by any signs or symptoms that pointed to the brain as the source. Several symptoms and indications, while not pathognomonic for a central etiology, are so strongly indicative of a CNS disorder that brain imaging should be acquired as soon as possible if they are present with vertigo. Headache is one such symptom, despite the fact that it is an inconsistent indication of central vertigo and can also be observed in peripheral disorders. An inability to ambulate in a patient with vertigo should also notify the treating physician that a central process is quite likely, requiring rapid brain imaging. (4) There is no evidence in the case record that the patient’s gait was assessed (either initially or following treatment for vertigo and nausea). Vertical and horizontal direction-changing nystagmus are both central symptoms; unidirectional horizontal nystagmus can be either peripheral or central.
Given the risks of missing a central lesion, many evaluation facilities now nearly always do brain imaging for patients who present with new-onset acute vertigo, even if no definite or suggestive CNS symptoms are present. Although such imaging of vertigo patients is unlikely to reveal a structural problem, it is the only non-invasive way to rule out a life-threatening illness. Although a non-contrast computed tomography (CT) scan of the brain is sufficient for excluding a life-threatening bleed, magnetic resonance imaging (MRI) is just as accurate. (5) MRI can also detect recent ischemic infarctions and arterial dissections using magnetic resonance angiography.
Despite having a simple, treatable disease, what caused this patient’s death? Specifically, three different physicians failed to seriously consider a central cause of vertigo, as evidenced by I each examiner’s omission of a complete neurologic examination, and (ii) the third attending’s failure to obtain brain imaging, despite the presence of headache in a patient who had presented with vertigo more than six hours earlier and had been treated with three different vestibular suppressants. Clinicians should remember that a peripheral vertigo localisation cannot be validated with certainty. A peripheral localization is an exclusionary diagnosis made when no symptoms, signs, laboratory data, or imaging evidence indicate to a central process. Cerebellar lesions can mimic peripheral vestibular diseases because the cerebellum has multiple connections with central vestibular systems. This appears to be the case in this case: the patient’s presenting symptom complex of vertigo, vomiting, and visual intolerance were all caused by a cerebellar hemorrhage (the Figure, of a cerebellar infarction, demonstrates the vascular anatomy), most likely due to involvement of the vestibulocerebellumthat is, the flocculonodular lobe, which is located at the cerebellum’s caudal extent.
Was there a need for a neurology consultation in this case? Most likely not. If any of the three attendings had considered seeking a neurologic consultation, it was likely because they were seriously considering a central disorder. With or without a formal neurologic consultation, they should have assessed the patient’s gait and obtained diagnostic brain imaging.
In one case, a patient had three different attendings in the period of six hours, indicating a clear “system failure.” It is unrealistic to expect each new attending to perform a comprehensive neurologic examination on each patient in a crowded emergency room. Because the brain regions that might induce vertigo are limited to the brain stem and cerebellum, a focused neurologic examination can successfully identify a central abnormality when the presenting symptom is vertigo. To rule out a central abnormality, an abridged examination should search for an altered level of consciousness, gaze palsy (6), or a central (eg, vertical or horizontal direction-changing) kind of nystagmus, face numbness or weakness, upper extremity incoordination, or the capacity to walk. When a patient with vertigo is “passed off” to another clinician, this type of concentrated assessment should be repeated. When the room lights are dimmed to relieve vertigo, it is occasionally possible to examine a patient’s eye movements. Even if many attendings were not involved in the case, this patient should have been evaluated repeatedly, at least at hourly intervals, to make a diagnosis in a timely manner, because a patient’s health might alter over the period of hours.
- Most individuals with vertigo who present to an ED can be treated conservatively with vestibular suppressants and antiemetics and sent home. Vertigo is occasionally the first symptom of a cerebellar hemorrhage, which is a life-threatening but curable illness.
- There is no central (vertical or horizontal direction-changing) nystagmus.
- The location of vertigo in the periphery (i.e. inner ear) cannot be confirmed with precision. A peripheral localization is an excluding diagnosis made when there are no symptoms, signs, laboratory findings, or imaging indications of a central process.
Professor of Otolaryngology and Neurology at the University of Pittsburgh School of Medicine, Joseph M. Furman, MD, PhD
