As a child, did you ever play a game of spinning around and around and then stopping? Recall how when you stopped, the world seemed to continue spinning around you. This same type of feeling is similar to the feelings that someone would experience with vertigo. It can be caused by the structures of the ear (peripheral vertigo) or in the brain (central vertigo). Often it is mainly caused by a malfunction of one or more of the structures in the inner ear. These structures make up the vestibular system, which is responsible for balance. While the most common types of vertigo, such as motion sickness and BPPV are not life threatening, there are some dangerous causes. For example, central vertigo can be caused by stroke or head injuries. Recurring or unexplained vertigo should be evaluated by a physician. Following is a list of common causes of peripheral vertigo in no particular order.
- Motion sickness
- Calcium deposits in the inner ear (benign paroxysmal positional vertigo - BPPV)
- Meniere's disease
- Paget's disease
- Inflammation or damage to nerves
- Tumors in the inner ear or nerves
- Antibiotics - minocycline
Feelings of vertigo can be very disruptive to normal everyday activities. Commonly accompanying vertigo are nausea, vomiting, and nystagmus (quick jerking eye movements in one direction while slow return in the other direction). Other symptoms of vertigo include:
- Balance problems or a feeling that you are standing still while the world is spinning around you
- Feeling pulled in different directions
- Problems with hearing and vision
Prevention and Treatment
In vertigo disorders, there isn't a one-size-fits-all treatment. Proper diagnosis of the cause of vertigo will be crucial; however, surgical procedures and medications will not always provide the solution.
Motion Sickness - With motion sickness, situations that cause vertigo can often be avoided. Staying off rocking boats or reading in automobiles are ways to help prevent the onset of vertigo in these instances. If the situation cannot be avoided, staring at a stationary object may help to maintain a sense of balance and prevent adverse symptoms. In cases where the situation will be planned, such as going on a cruise, a scopolamine patch may be worn to help waylay feelings of vertigo.
BPPV - BPPV is a disorder which causes calcium deposits to float in the semi-circular canals of the inner ear, causing vertigo during movement. Treatment of this disorder involves a series of rotating head positions, which aids in moving the debris out of the semi-circular canals and into other areas of the ear where symptoms won't occur and the deposits will be broken up. This canalith repositioning procedure must be performed by a specialist.
Meniere's Disease - Meniere's disease is a more difficult cause of vertigo to treat, because the cause of the disease is still unknown. What is known is that the fluid in the inner ear is not in balance, which causes the symptoms of vertigo. There is no known cure for Meniere's disease, but with appropriate treatments, many of the symptoms may be controlled. Treating the fluid balance by changing to a low-salt diet and using a diuretic (water pill) may be helpful. Several medications that may either prevent or relieve symptoms of vertigo include:
Surgical procedures to treat Meniere's disease include:
- Injection of the antibiotic gentamicin or steroids
- Removal of parts of the inner ear - based on symptoms
- Severing the vestibular nerve - hearing will remain intact, however balance from inner ear will no longer be available to the brain
Vestibular rehabilitation may be indicated by your doctor, depending on the severity of symptoms and the treatments that were performed. There you will learn to work with a different sense of balance to compensate for the deficits caused by Meniere's disease.
Learning to Manage Peripheral Vertigo - Because vertigo is directly related to the fluid balance in the inner ear dietary changes may help to keep this balance in check. Your doctor can help you make the most appropriate changes to your diet, which will likely include a change in the amount of salt, sugar and caffeine you consume. Support groups are available to help you cope with vertigo, and other members can share different ways in which they manage their disease. Recent studies suggest that there is a certain set of exercises which may be beneficial in managing BPPV. These are called The Epley Manuever, Semont Manuever and Brandt-Daroff exercises. While studies have shown that these exercises may be done at home you should not attempt to do them without talking to your doctor and receiving instruction from a physical therapist.
Most cases of vertigo are temporary but there are chronic cases of this disease. Suffering from vertigo can be both frightening and debilitating but by educating themselves about this disease and employing the help of a physician experienced in treating vertigo many patients can lead a relatively normal life.