Vertigo is a severe medical symptom during which the patient feels that the objects around him are spinning when actually they are not. The spinning sensation can occur anywhere anytime without any prior indication. Vertigo is often confused with dizziness which is less serious and usually does not require medical help. On the other hand, depending upon the severity, a vertigo episode may require emergency medical help. In the developed world, approximately 2-3% of the emergency department visits are due to vertigo.
Vertigo is either associated with problems in the CNS or the auditory canal. Overall about 125 million people suffer from vertigo each year. However, the good news is that extensive medical research over the years has provided us with detailed information about vertigo- its signs and symptoms, causes, diagnosis and cure. We have compiled this piece to provide you with every single detail that you should know about Vertigo if you or your close one is a sufferer. Our FAQ styled article is easier to navigate and will help you quickly find answers to all of your queries. Read more below:
Q1: What Is Vertigo? – Difference Between Dizziness and Vertigo:
Dizziness is simply lightheadedness (faintness) and unsteadiness (imbalance) while walking. With a dizziness natural treatment, you’ll be able to end the symptoms much quicker. Vertigo is, however, a severe form of dizziness. Vertigo is differentiated from general dizziness by a rotational or spinning movement in the head, the sufferer feels that the objects around him are moving while actually they are not. Patients often replace the terms dizziness and vertigo with each another but the medical reasons underlying vertigo are more serious. It is important to distinguish between general dizziness (lightheadedness and unsteadiness) and vertigo in order to get a proper treatment. This spinning motion is a characteristic symptom for vertigo. While dizziness can affect both young and elderly, vertigo is reported more commonly in elderly and females.
Q2: When Should Vertigo Be Suspected?
If you experience the following conditions your dizziness is serious and might be suspected as vertigo:
- You have frequent dizziness episodes,
- Your dizziness spells last longer than a minute,
- You experience a variety of symptoms during your dizziness episodes such as blurred vision, abnormal eyeball movement, speech difficulty, general weakness in body, lack of limb coordination or numbness, frequent unconsciousness or fever,
- You had a recent head injury,
- You experience dizziness during physical activities/workouts
Most of these symptoms would occur in combination. If they occur frequently, medical help should be immediately considered. Dizziness specifically associated with the motion of stationary objects, nausea and vomiting is Vertigo.
Q3: What Are the Signs and Symptoms of Vertigo?
There are some common signs and symptoms of vertigo but their extent may vary from patient to patient according to age and external factors. These symptoms can appear anywhere, anytime as a person slightly moves his head. The common signs and symptoms of vertigo include:
- Spinning, swaying or a tilting movement in the head
- Misbalance while walking
- A headache in a specific part (A migraine headache)
- Nausea and vomiting
- Abnormal ringing sound in ears cases leading to hearing loss in extreme cases
- Body fatigue and abnormal sweating
- Nystagmus i.e. abnormal movement of the eyes
- Panic and anxiety attacks
Q4: What Are the Causes of Vertigo?
Vertigo has two types, Peripheral Vertigo and Central Vertigo, both of which are associated with different causes. In order to understand the causes, it is important to understand these types;
1. Peripheral Vertigo: Occurs when there is a problem in the inner ear
2. Central Vertigo: Occurs when there is a problem in the sensory nerve pathway of the brain.
Causes of Peripheral Vertigo
Peripheral Vertigo happens due to the disturbance in the inner ear organs. There is a complex structure in the inner ear called labyrinth that contains organs for hearing and of balance. These organs send messages to the brain to maintain body balance in response to changes in gravity e.g. whenever a person stands after sitting or vice versa. Any disturbance in these organs leads to body misbalance and hence, vertigo. What causes this disturbance is usually inflammation from an ear infection. Common conditions associated with Peripheral Vertigo are:
- Labyrinthitis: “-itis” in medical terms is associated with inflammation. Labyrinthitis is inflammation of labyrinth and happens because of viral infection.
- BPPV: BPPV or Benign Proximal Positional Vertigo (BPPV) is disturbance in the crystal like particles present in the inner ear. These crystal like particles are made of calcium carbonate (CaCO3) and are responsible for sending positional information to CNS. As a result of BPPV, positional information continues to be send to the brain even after head movement is stopped leading to imbalance.
- Vestibular Neuronitis: Vestibular Neuronitis or Vestibular Neuritis is an inflammation of the brain that connects labyrinth to the brain. Remember Labyrinthitis is inflammation of the labyrinth itself.
- Meniere’s Disease: Meniere’s disease can lead to a very severe form of Peripheral Vertigo which may last from for several days. It is basically a build-up of fluid in the inner ear changing the pressure inside. In addition to Vertigo, Meniere’s disease can also lead to tinnitus (abnormal ringing sound in the ears) or hearing impairment.
- Head Injury: Peripheral Vertigo can also follow severe or minor head injury. If you experience symptoms of vertigo following a head injury, then other conditions (Labyrinthitis, BPPV, Vestibular Neuronitis, and Meniere’s disease) can be safely ruled out.
Causes of Central Vertigo
Central Vertigo is associated with problems of the CNS. It either involves disturbance of the brainstem (cerebellum) or those of thalamus. Cerebellum is responsible for maintaining vision and balance whereas thalamus receives and sends messages between body and the brain. The causes of Central Vertigo are
- A Migraine: An extreme headache experienced in a specific part of the head.
- Brain Tumor (Cancer): Tumor is an undifferentiated mass of cells. It may be located at the bottom of the brain (brainstem) in the cerebellum.
- Multiple Sclerosis: An autoimmune disease in which the immune system attacks the nerve fibers damaging their protective covering.
- Stroke: Stroke is an ischemic attack resulting from the deficiency of blood supply to the brain cells.
- Acoustic Neuroma: A non-cancerous mass of cells in the acoustic nerve (also called the cochlear nerve) which connects ear and the brain.
Q5: What is BPPV (Benign Paroxysmal Positional Vertigo)?
BPPV is a very common cause of vertigo, it can either lead to mild or intense episodes of vertigo. BPPV affects posterior semicircular canal in the inner ear. A mass of crystal like particles of calcium carbonate (CaCO3) and protein accumulates inside posterior semicircular canal. Whenever the head is moved for looking around, during sleep or for any normal activity, the crystal and protein particles start to move inside the canal resulting in sensation of head spinning or vertigo.
Q6: What Leads To BPPV?
BPPV is the accumulation of calcium and protein particles inside the inner ear canal. The build-up of these particles is explained by ear degeneration due to aging, inner ear (viral) infection or head injury. BPPV can also result from ear poisoning (ototoxicity) from medications and environmental chemicals.
Medications: Medications commonly responsible for ototoxicity are anticonvulsants, antidepressants, anti-hypertensives, over-the-counter medicines, pain relievers, and loop diuretics.
Environmental Chemicals: Environmental chemicals from air and industrial pollution such as tin, mercury and lead can damage ear nerves and cause ear poisoning.
Q7: What Is the Famous Carol Foster Method to Treat Positional Vertigo (BPPV)?
Associate Professor Carol Foster at the University Of Colorado Hospital in 2012 came up with a new and very effective method to treat BPPV. Her method is called “Half Somersault Maneuver” also known as the “Foster Maneuver“. This method took over the internet as the Simple Fix to Cure Vertigo. Here is how to perform it for right and left ear:
Half Somersault Maneuver for Right Ear
- Patient looks straight up to the ceiling
- Head is placed in a somersault position
- Head is turned to face right elbow
- Head is raised slightly upwards (face still facing the right elbow)
- Head is raised completely (face still facing the right elbow)
Half Somersault Maneuver for Left Ear:
- Patient looks straight up to the ceiling
- Head is placed in a somersault position
- Head is turned to face left elbow
- Head is raised slightly upwards (face still facing the left elbow)
- Head is raised completely (face still facing the left elbow)
Q8: Which Type of Doctors Should I Consult for Vertigo?
Which type of doctor you should consult for vertigo depends on what type of vertigo you have i.e. peripheral or central. You either consult an Otolaryngologist or a Neurologist.
Otolaryngologist: An Otolaryngologist is a specialized ENT. If you are suffering from peripheral vertigo (e.g. as a result of BPPV), your physician will refer you to an otolaryngologist.
Neurologist: If you are suffering from central vertigo, you will be referred to a neurologist who will treat you for CNS related disturbances.
Q9: I Have Ear Pain. Should I Suspect Vertigo?
You may or may not. Ear pain is not always associated with vertigo. If you have pain in the middle ear, then it is mostly safe to rule out vertigo. Mostly, pain in the inner ear is associated with vertigo. Should you have vertigo, your ear pain would be associated with other common symptoms for vertigo such as dizziness, vomiting, body weakness, loss of balance etc. Isolated symptoms usually do not lead to vertigo.
Q10: Can Alcoholism Lead to Vertigo?
Excessive or regular alcoholism in large amounts can lead to vertigo. Alcohol mainly affects the balance centers in the brain and the ear. Alcoholism is a common cause of labyrinthitis and BPPV both of which are conditions associated with peripheral vertigo.
It should also be noted that not in all persons would alcohol lead to vertigo. The probability of having vertigo due to alcoholism is different from person to person due to personal (e.g. size of the person) and external factors (e.g. hydration level, dietary habits).
Q11: Can Stress Cause Vertigo?
Stress can be an indirect and not a direct cause of vertigo. Chronic stress can lead to reduced breathing, low blood pressure and anxiety affecting parts of the brain that may become a reason for vertigo (central vertigo in this case).
Q12: What Are the Risk Factors for Vertigo?
Although females have a naturally higher predisposition to vertigo, the risk factors for vertigo are mostly external/ accidental. Two major risk factors for vertigo are head injuries and medications.
Head Injuries: Head injuries affect the brain increasing the chances of having vertigo.
Medications: Antiseizure, blood pressure and Antidepressant medications can lead to vertigo.
As a general rule, the factors that can lead to stroke can also lead to vertigo e.g. high blood pressure, drug intake (alcohol and smoking), heart disease etc.
Q13: Can Medications Lead to Vertigo?
Medications can lead to both lightheadedness and vertigo. Some medications that can lead to vertigo include antibiotics (especially aminoglycosidic antibiotics), antidepressants, sedatives, anti-seizure drugs and anti-cancer medications etc.
Q14: Is the Incidence of Vertigo Associated with Age?
Vertigo is extremely rare in young children. The incidence of vertigo increases during 20’s and can occur in people of all ages after that. The incidence is increased many times in old age when even slight misbalances result to major injuries or fractures.
Q15: Can 3-D Games Result in Vertigo in Children?
If children are playing 3-D games for a long time especially those which involve excessive motion, it may result in a brief vertigo episode but it would not last long in any normal case.
Q16: What Is the Treatment for Vertigo?
Different treatments are available for Vertigo ranging from self-care to physical therapies and medications.
Medical Treatment for Vertigo
Vertigo can be treated by oral medicines, medicines that are applied through skin (patch) or intravenous (IV) drugs. Some specific types of vertigo will require therapy through special medicines.
- Antibiotics would be used if vertigo is caused as a result of bacterial infection of the ear.
- Medications that induce urine are used for vertigo caused by Meniere’s disease.
Physical Therapy for Vertigo
Certain physical maneuvers are also used to treat vertigo.
- Vestibular Rehabilitation Exercises: The patient sits on the edge of the table and lies down to one side until vertigo goes away. This is immediately followed by the patient lying down on the other side. The action is followed until the vertigo fully distinguishes.
- Particle Repositioning Maneuver: This type of therapy is particularly used against BPPV. It involves repositioning of the head.
- Epley Maneuver: The patient is seated and the head is turned at 45 degrees. The body is then tilted backward with head in the same position. The position is held for almost a minute. The head is turned 90 degrees towards the unaffected ear, the position is again held for a minute.
Q17: What Are Some Home Remedies for Vertigo?
Various home remedies exist for vertigo but they should only be used once vertigo has been confirmed by a medical specialist. Some home remedies against vertigo include:
- Vitamin D supplementation especially in the case of BPPV
- Use of herbs such as ginger, coriander and ginko can cure vertigo as they have anti-inflammatory properties.
- Increased fluid intake.
- Use of essential oils such as peppermint, lavender or ginger.
Be sure to discuss these home remedies with your doctor before using.
Q18: How Should I Sleep with Vertigo?
People with vertigo attacks can have serious difficulty in sleeping. Better positioning and head placement will help in having a better sleep. Combining this information with the most effective vertigo remedies can help you conquer the problem for once and all.
Before Bed Tips
- Avoid spicy foods
- Avoid looking at your phone
- Do not use your bed for doing office work
Sleep Positioning and Head Placement
There is no single sleep position that will work for all. Vertigo patients have to figure out themselves which position suits them the best. It will be a discomfort for a few nights but you will eventually find it. In most cases, sleeping in an inclined position will help.
Also, consider having more than one pillows while sleeping as elevation of the head will help the vertigo go away.
Q19: How Is Vertigo Diagnosed?
Most people would report vertigo as dizziness. Yet, differentiation is very important for treatment. The doctors would first thoroughly ask you for all the symptoms you have been experiencing. Certain tests are performed for the diagnosis of vertigo:
- MRI or CT Scan
- Eye Movement Test: Your doctor will ask you to track a moving object and will observe your eyeball movement as your eyes do the tracking.
- Head Movement Test: Performed usually in the case of BPPV. The doctor will perform simple head movements to confirm the diagnosis.
- Rotary Chair Test: The patient sits on a machine controlled seat that moves slowly in a circular direction.
- Posturography: The patient stands with bare feet on a platform and his balance under various conditions is tested.
Q20: What Are Some Lifestyle Changes to Get Rid of Vertigo?
Dr. Josh Axe – A doctor of natural medicine, chiropractic and clinical nutritionist has listed down six lifestyle tips which should be adopted by vertigo patients:
- Physical Therapy: Physical therapy that addresses vestibular organs.
- Head Maneuvers: Head Maneuvers for the repositioning of calcium stones such as the Canalith Repositioning Procedure or the CRP. This technique is also recommended by the American Academy of Neurology.
- Stress Control: Chronic stress can greatly reduce a person’s immunity and lifestyle (stressed people are less likely to exercise and get a full sleep) making him more prone to developing vertigo. Stress should be controlled by having a good social circle, sleeping enough, exercise and meditation.
- Eating healthy and staying hydrated: Eating healthy and staying hydrated can reduce the risk of inflammation and help in getting rid of vertigo.
- Getting enough rest: A 7-8 hours’ sleep is necessary for proper muscle recovery and overcoming dizziness.
- Seeking medical help: It’s extremely important to discuss your symptoms in detail with your doctor so the exact cause underlying vertigo could be determined.
Q21: Which Foods Should Be Avoided for Vertigo?
The following foods should be avoided for vertigo:
- Foods High in Salt: High sodium can alter the fluid level in your body giving rise to vertigo episodes. Avoid foods that have artificially salt added in them such as packet chips and other snacks, canned soups or vegetables, ready to eat frozen items etc.
- Foods High in Sugar: Sugary foods also alter the fluid balance of the body. Avoid foods such as candies, jams, jellies, syrups, pancakes, baked goods (cakes, pastries, donuts, pies), soft drinks etc.
- Aged Meats: Aged meats are high in tyramine- an amino acid that triggersa migraine. Aged meats such as pepperonis, salamis, sausages should be avoided for vertigo.
Q22: Which Foods Can Treat Vertigo?
Certain foods that help treat vertigo include:
- Foods hat Are Rich in Vitamin C: Vitamin C enriched foods such as fruits and vegetables can be effective against vertigo e.g. strawberries, citrus fruits, tomatoes, broccoli, sweet potatoes, green peppers, leafy green vegetables etc.
- Foods that Contain Vitamin B6: Vitamin B6 is extremely important for red blood cells, nervous system and immune system. B6 enriched foods include breakfast cereals, fish, poultry, peanut butter, walnuts, spinach, bananas, avocados etc.
- Ginger: Ginger is effective against nausea and motion sickness. Ginger also reduces inflammation and heart diseases which are some of the factors that lead to vertigo.
Q23: How Long Does Vertigo Last?
How long a vertigo lasts depends upon what exactly is the causing factor. If it is caused by BBPV then symptoms will usually take about 7 days to go away completely. However, if it is caused by inflammation then it will not go away unless inflammation is treated. Vertigo can also be permanent if a severe head injury is the cause of it.
Q24: What Activities Should I Refrain from During a Vertigo Episode?
The activities that involve a lot of movement should be avoided during vertigo attacks e.g. shopping, eating out etc. Visual distractions such as moving vehicles, ceiling fans should also be avoided. Audio distractions including should also be shut down e.g. headphones or radio.