The term vertigo has been derived from the latin word ‘
vertere’ that means ‘to turn’.
Simply put it is a sensation that might be
described as a pre-syncope, light-headedness, disequilibrium to describe that
feeling of floating in our environment and losing our sense of direction.
According to a recent report by a French study, 1-year
prevalence for vertigo was 48.3%, for unsteadiness 39.1%, and for dizziness
35.6%.
The vestibular system comprises of the labyrinthine part
of the inner ear and its connections in the brain stem and cerebellum, which
are the balance regions of the brain.
Equilibrium Pathway:
Vertigo
is caused by the abnormal functioning of the vestibular system that is
responsible for managing our balance, motion perception and response of eye
movements to different positions.
Broadly, vertigo may be classified as peripheral and
central in etiology.
- Peripheral vertigo means that it is originating at the ear end of the vestibular system;
- Central vertigo means that the causation lies some where in the brain.
Common causes of the peripheral vertigo are:
Benign paroxysmal positional vertigo (BPPV), thought to be
caused by a displacement of otolith particles, calcium deposits in the inner
ear, is the most common type of peripheral vertigo in the clinical practice, twice as common in women than
men, usually affects older people and most often arises without a known cause
(idiopathic). While most cases are spontaneous, BPPV vertigo can also follow
head injury, reduced blood flow in a certain area of the brain (vertebrobasilar
ischemia), labyrinthitis: inflammation of the inner ear labyrinth and
vestibular nerve (the nerve responsible for encoding the body's motion and
position, ear
surgery, prolonged bed rest.
Other common peripheral causes of vertigo are :
- Vestibular neuronitis - this is thought to be due to inflammation of the vestibular nerve.
- Ménière's disease: caused by inflammation, usually infective & thought to be caused by high pressure of a fluid in a compartment of the inner ear .
Most common
of the central vertigo is Vertiginous Migraine that would be associated with
the headache.
Other
rare but important causes are:
▪
stroke and transient
ischemic attack
▪
cerebellar
brain tumor
▪
acoustic
neuroma (a
non-cancerous growth on the acoustic nerve in the brain) and
▪
multiple
sclerosis
Let's make one thing very clear, that cervical
spondylosis is not a cause of the vertigo as most of us try implying cervical spondylosis as the cause of our unexplained vertigo though emotional upheavals may sometimes cause pre
syncope type of states that may be confused with vertigo and may be
misinterpreted leading to unnecessary investigation.
As described above, most
of the cause of vertigo are benign and there is nothing to worry about. But we
all should know the red flag signs so that we know when to call the doctor for
evaluation.
Please
consult a Neurologist if there is:
- worsening vertigo or disequilibrium,
- imbalance or in-coordination of the movement,
- associated non relieving headache,
- recurrent vomiting,
- loss of consciousness associated with vertigo,
- double or blurred vision,
- speech difficulty,
- limb weakness,
- atypical “non-peripheral” vertigo, such as vertical movement;
Peripheral
vertigo should be best evaluated by an ENT expert. So, ENT opinion is warranted if vertigo is:
- short duration,
- episodic,
- postural vertigo
- associated with hearing loss and /or tinnitus
Medications are prescribed according to the etiology of the vertigo. Apart from the medicine your doctor might tell you a few exercises that might improve your vestibular system function and hence the vertigo.
Contributed by :
Dr Sweta Singla
MD, DM Neurology
No comments:
Post a Comment