Vertigo

Vertigo is a symptom, rather than a condition itself. It is the sensation of everything moving or spinning around you. The sensation might be mild or so severe that it affects your daily activities. Attacks can develop suddenly and lasts a few seconds or they might last longer. Other symptoms include loss of balance, nausea and vomiting and dizziness.

There are two types of vertigo – Peripheral and Central, depending on cause.

Peripheral Vertigo

This is the most common type often caused by problem with the balance mechanisms of the inner ear. The most common causes include benign paroxysmal positional vertigo (BPPV), head injury, labyrinthitis, vestibular neuronitis, menieres disease and certain medications.

Benign paroxysmal positional vertigo (BPPV)

This is one of the most common causes of vertigo and needs special mention. It can occur during specific head movements, while standing up or bending over, crossing the road or turning in bed. In fact any sudden movement of the head can bring this on. BPPV involves short, intense recurrent attacks of vertigo (usually lasting a few seconds to a few minutes). It is often accompanied by nausea and sometimes vomiting. You may also experience your eyes moving uncontrollably called nystagmus. Light headedness and a loss of balance can last for several minutes or hours after the attack. BPPV is thought to be caused by small fragments of debris (calcium carbonate crystals) which break off from the lining of the channels in your inner ear. The fragments do not cause a problem unless they get into one of the ears fluid filled canals. When the head is still the fragments sit at the bottom of the canal. However certain head movements cause them to be swept along the fluid filled canal, which sends confusing messages to your brain causing vertigo. BPPV usually affects older people with most cases occurring in people older than 50 years of age. BPPV may occur for no apparent reason or may develop after an ear infection, ear surgery, head injury or prolonged bed rest.

Central Vertigo

This is caused by problems in part of your brain such as cerebellum or brain stem. Causes of central vertigo include migraines, multiple sclerosis, acoustic neuroma a rare benign brain tumor on the acoustic nerve, brain tumor in the cerebellum, transient ischemic attacks and certain medications.

Treatment

This depends on the underlying cause. For BPPV the Epley manoeuvre which involves performing four separate head movements to move the fragments that cause vertigo to a place where they no longer cause symptoms can be tried. Each head position is held for at least 30 seconds. Medications that may help include prochlorperazine and certain antihistamines. This should be taken for at least two weeks. The gingko EGb 761 can also help and should be taken for at least three months.

Again it is important that any new onset vertigo or recurrent attacks, you must consult a doctor to rule out any of the serious causes of vertigo.

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