Vertigo

Vertigo

Vertigo refers to a type of dizziness characterized by a sudden sensation of spinning or movement, even when one is stationary. It can be caused by various factors related to the nervous system and balance organs in the inner ear. Let's explore

the common causes of vertigo:

– Disorders of the nervous system in the brainstem and cerebellum

–  Abnormalities of balance organs in the inner ear

1. BPPV (Benign Paroxysmal Positional Vertigo):

   This is the most common cause of vertigo. It occurs when tiny calcium crystals dislodge and enter the wrong part of the semicircular canals. Symptoms include dizziness when changing positions, such as bending down, lying down, or sitting up. Episodes typically last less than a minute, resolve spontaneously, and recur with position changes.

2. Stroke:

   Found primarily in individuals over 45 years old with risk factors for stroke (such as hypertension, diabetes, and hyperlipidemia). Dizziness associated with stroke often persists for an extended period, lasting hours or even days. It is not related to changes in posture and is frequently accompanied by other neurological abnormalities like double vision, facial asymmetry, slurred speech, tongue deviation, weakness, or paralysis. Due to the potential severity and complications, immediate medical attention is necessary.

3. Meniere's Disease:

   This condition involves intermittent dizziness lasting minutes to hours, often accompanied by ringing in one ear (occasionally both). It may be associated with hearing loss. The exact cause is unknown, although some cases are linked to middle ear infections. Symptoms can be triggered by consuming excessive salt.

4. Vestibular Neuritis:

   Vestibular neuritis presents with prolonged dizziness lasting hours or days. It does not typically cause hearing problems or ringing in the ears. This condition is believed to result from a viral infection directly affecting the nerves or an autoimmune disorder. It is more common in younger individuals, with a higher prevalence in females. Headaches may also occur episodically.

5. Migraine:

   Some individuals experience dizziness as a component of their migraines. For some, dizziness may occur without headache or may occur separately from migraines triggered by factors like specific foods, caffeine intake, sudden cessation of caffeine, bright lights, strong odors, or menstruation.

Symptoms of dizziness that warrant a doctor's consultation at home:

- Dizziness accompanied by blurred vision

- Vertigo accompanied by limb weakness

- Dizziness associated with limb numbness

- Dizziness accompanied by speech difficulties

- Dizziness accompanied by hearing problems

Home diagnosis of vertigo may involve:

1. Hearing assessment (audiogram)

2. Evaluation of inner ear balance organ function (Video Electronystagmography: VNG)

3. Measurement of inner ear fluid pressure (Electrocochleography: ECOG)

4. Assessment of auditory nerve function (Evoked Response Audiometry)

5. Brain imaging such as CT scan

6. MRI to provide detailed images of the brainstem and cerebellum, which may be inconclusive in CT scans alone.

Basic self-care measures for individuals with vertigo at home:

1. Avoid postures or movements that trigger dizziness during episodes, such as sudden position changes or quick head turns.

2. Refrain from activities prone to accidents, like driving, while experiencing symptoms.

3. Take prescribed medications to alleviate dizziness, such as Betahistine or Dimenhydrinate.

4. Identify and avoid factors that contribute to dizziness, including inadequate sleep, stress, strong odors, and allergens.

5. Reduce or eliminate smoking and coffee consumption.

6. If symptoms persist or worsen, seek medical attention promptly.

For further information, please contact the Brain and Nervous System Center at Vibhavadi Hospital (Tel. 02561-1111 ext. 1214).

Dr. Kamolrat Phonwai, MD.

Neurologist at Vibhavadi Hospital.