Vertigo

Vertigo is a common symptom caused by a variety of factors. Sufferers describe their symptoms in many different ways. Even healthy people occasionally experience dizziness, such as when they have had too little sleep or have physically overexerted themselves. Vertigo symptoms become much more common with age.

Warning symptoms

If a person experiences vertigo along with symptoms of disorientation, falls or vomiting, they should immediately see a doctor. When the heart beats too fast or too slow, this may cause symptoms ranging from vestibular vertigo to light-headedness or seeing black spots.

What will the doctor want to know?

It is important for the doctor to know how the patient is experiencing the sensations of vertigo. Vertigo is commonly thought of as a feeling of dizziness, tendency to fall or unsteady gait. What is essential for a diagnosis is also how long the symptoms last. A distinction is made between attack-like episodes of vertigo lasting seconds or minutes and vertigo that may last for several hours or even days and weeks. It is also helpful to know whether there something specific is triggering the dizziness, e.g. a change of position, medications or drugs (alcohol, etc.). The doctor will also ask about accompanying symptoms, such as nausea, vomiting, vision or speech disturbances, paresis, unsteady gait, etc.

Symptoms

Patients describe vertigo in many different ways. A distinction is made between rotatory vertigo (“like riding a carousel”) and vestibular vertigo (“sea-sick feeling”). Some patients feel frightened and helpless when they experience dizziness and instability and have the sense that the earth is moving under their feet.

Common causes

Certain illnesses can trigger symptoms of vertigo. The most common causes:

• positional vertigo: The person experiences rotatory vertigo when quickly changing positions. Crystals accumulate in the semicircular canals of the inner ear and stimulate the sensory cells. The prognosis is good. The treatment is to perform specific positional exercises.
• Vestibular failure: This condition is caused by a failure of the vestibular organ on one side of the body, resulting in rotatory vertigo lasting from days to a few weeks. The condition is treated with medication.
• People with low blood pressure often need some time in the mornings when they wake up before they feel steady on their feet (orthostatic vertigo). Another type of vertigo is vertical vertigo or motion sickness.
• Menière’s disease: This disease is accompanied by rotatory vertigo and ear noise lasting minutes or hours. Menière’s disease appears to result from a build-up of fluid in the inner ear and organ of equilibrium. Treatment usually involves the preventative use of medication.
• Phobic vertigo: This type of dizziness usually has other symptoms that may often vary. Many times there are triggering situations, such as confined spaces or crowds of people.
• Slight disturbances to the region around the organ of equilibrium, the neuromuscular spindles as well as to hearing and sight in old age can combine to produce “misinformation” resulting in sensations of vertigo.
• Multiple sclerosis, acoustic neurinoma and cerebral apoplexy can be associated with vertigo and balance disorders.
• Dizziness may also be related to a rare but benign tumor on the vestibulocochlear nerve (acoustic neurinoma). The treatment options are surgery and/or radiation therapy.
• Vertigo can also be a sign of a stroke (e.g. cerebellar infarction), which usually includes other symptoms as well (e.g. speech impairment, balance disturbances, paresis, ataxia).

Treatment possibilities

Specific causal treatment will be started when possible if there is a clear diagnosis, such as Meniere’s disease, cardiac dysrhythmia, etc. If the semicircular canals of the organ of equilibrium are the cause, positioning maneuvers may help to stop the dizziness. If the vertigo is triggered by a mental illness, a psychiatrist will be involved with the treatment.