Vertigo is one of the commonest symptom experienced by many people and is one of the commonest reason why opinion of a doctor is sought. What exactly is vertigo? What are the causes of vertigo? Is it serious? Is it treatable? Can it recur once treated? There are many doubts regarding this in our mind. Lets try to find answer to these questions.
What is vertigo?
Vertigo means illusion of self motion or motion of environment which can be commonly described as “spinning sensation”. People often use other term like dizziness, giddiness, “chakkar” sensation, faintness, light headedness, disorientation, imbalance etc. Vertigo is often accompanied by other symptoms like nausea, vomiting, imbalance while walking, swaying of gait, tendency to fall, ringing in ears, deafness, heaviness in ears, sweating etc. Many people vaguely use the term vertigo when in true sense they are not having any true vertigo. Its the responsibility of the treating doctor to elicit proper history to exactly know whether patient truly has vertigo or some other issue which mimic like a vertigo.
What causes vertigo?
Situated deep within our ear is an apparatus which is responsible for maintaining balance and orientation of our head and body called as vestibular apparatus. Any disturbance or disease of this apparatus can give rise to vertigo. Viral infection is one of the common cause of this disturbance in which vertigo is short lasting and only needs symptomatic treatment. Also calcium specks in inner ear and get dislodged from their original position causing severe vertigo on turning neck side to side or above downwards. Such people often have very severe episodes of vertigo when they look upwards or get up from bed or lie down. This condition is called benign paroxysmal positional vertigo (BPPV). Certain exercises advised by doctor can bring back these calcium specks to their normal position, often leading to dramatic relief. Also the vestibular apparatus can swell due to excess fluid causing intermittent episodes of vertigo with vomiting, ringing in ears and slowly progressive deafness, a disease called as meniere’s disease. Apart from vestibular apparatus the nerve which carries impulses from vestibular apparatus to brain can get affected due to various reasons causing vertigo. Finally the stem of brain and cerebellum (called as small brain in common language) can become affected due to reduced blood supply (stroke) or due to inflammation causing vertigo.
Apart from this, other disorders like heart problems, very low or very high blood pressure, migraine, low sugars etc can cause vertigo like symptoms.
Is vertigo serious?
Though most of the disorders causing vertigo are not serious it is always important to rule out a serious cause like stroke by visiting a doctor. Prolonged vertigo not responding to treatment, vertigo associated with imbalance in walking or inability to stand without support, vertigo associated with double vision, change in voice, weakness in any limb, numbness in face or body, visual impairment, fever, loss of consciousness indicate a serious underlying problem for which urgent medical consultation should be sought.
Is vertigo treatable?
Treatment of vertigo depends on underlying cause. Vertigo related to viral illness is often self limiting and just requires symptomatic treatment for few days to weeks. Positional vertigo often dramatically responds to exercise. Other causes like meniere’s disease can have prolonged course with intermittent severe episodes of vertigo which require symptomatic medication. Vertigo related to brain stroke can be potentially serious and requires hospitalization along with necessary work-up and management of stroke and its risk factors.
To summarise, vertigo is a common symptom experienced mostly by all of us sometime or the other in our life. Though harmless and self limiting on many occasions it could be a symptom of a serious underlying illness. Correct and prompt diagnosis is the key to the successful management of this disorder.
MD DM (Neurology)
Consultant, Neurology & Epileptology