Vertigo is a sensation of feeling off balance. If you have these dizzy spells, you might feel like you are spinning or that the world around you is spinning\ This feeling may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks. To understand vertigo, it’s helpful to understand the anatomy of the ear. Sound waves travel through the outer ear canal until they reach the eardrum. From there, the sound turns into vibrations, which transmits in the middle ear via three small bones — the incus, the malleus and the stapes — to the cochlea and finally to the vestibular nerve, which carries the signal to our brain that interprets those nerve impulses as sound.
The inner ear is not involved with hearing. It is composed of three semicircular canals, positioned at right angles to each other, that are lined with sensitive nerve cells, which act like a gyroscope for the body. This arrangement of the semicircular canals, in combination with the hair cells within the utricle and saccule and otoliths (tiny structures that trigger the hair cells in response to movement), make up the vestibular system.
Causes of Vertigo
Vertigo is often caused by an inner ear problem. Some of the most common causes include:
BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny calciumparticles (canaliths) are dislodged from their normal location and collect in the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps you keep your balance.
BPPV can occur for no known reason and may be associated with age.
Meniere’s disease. This is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears (tinnitus) and hearing loss.
Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection (usually viral). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance
Less often vertigo may be associated with:
• Head or neck injury
• Brain problems such as stroke or tumor
• Certain medications that cause ear damage
• Migraine headaches
• Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making normal life very difficult.b benign paroxysmal positional vertigo (BPPV) – where certain head movements trigger vertigo
• migraines – severe headaches
• labyrinthitis – an inner ear infection
• vestibular neuronitis – inflammation of the vestibular nerve, which runs into the inner ear and sends messages to the brain that help to control balance.
• Concussion or traumatic brain injury may be associated with vertigo.
• Strokes may cause vertigo and loss of coordination.
• Multiple sclerosis
• Tumors of the brain and spinal cord
• Some patients with a type of migraine headache called vestibularmigraine may develop vertigo as a symptom. Some cases of vertigo improve over time, without treatment. However, some people have repeated episodes for many months, or even years, such as those with Ménière’s disease.
There are specific treatments for some causes of vertigo. A series of simple head movements (known as the Epley manoeuvre) is used to treat BPPV.
Medicines, such as prochlorperazine and some antihistamines, can help in the early stages or most cases of vertigo.
Symptoms of Vertigo
Vertigo is often triggered by a change in the position of your head.
People with vertigo typically describe it as feeling like they are:
• Pulled to one direction
Other symptoms that may accompany vertigo include:
• Feeling nauseated
• Abnormal or jerking eye movements (nystagmus)
• Ringing in the ears or hearing loss
The most well-known of these treatments is the Epley maneuver or canalith repositioning procedure. During this treatment, specific head movements lead to the movement of the loose crystals (canaliths) within the inner ear. By repositioning these crystals, they cause less irritation to the inner ear and symptoms can resolve. Because these movements can initially lead to worsening of vertigo, they should be done by an experienced health care professional or physical therapist.
Depending on what’s causing your vertigo, there may be things you can do yourself to help relieve your symptoms. Your GP or the specialist treating you may advise you to:
• do simple exercises to correct your symptoms
• sleep with your head slightly raised on two or more pillows
• get up slowly when getting out of bed and sit on the edge of the bed for a minute or so before standing
• avoid bending down to pick up items
• avoid extending your neck – for example, while reaching up to a high shelf
Some types of vertigo resolve without treatment, but a person may need treatment for an underlying problem.
A doctor may, for example, prescribe antibiotics for a bacterial infection or antiviral drugs for shingles.
Medications are available that can relieve some symptoms. These drugs include antihistamines and anti-emetics to reduce motion sickness and nausea.
Surgery may be necessary if other treatments are not effective. BPPV and acoustic neuroma are two conditions for which this may be appropriate.
Fear of heights
The term vertigo is often incorrectly used to describe a fear of heights. The medical term for a fear of heights and the dizzy feeling associated with looking down from a high place is “acrophobia