Vertigo is a specific type of dizziness in which an individual falsely perceives that a spinning motion is taking place. This sensation is generally a symptom of a disorder involving the peripheral vestibule system (the components of the inner ear). Vertigo exists in two forms, subjective and objective. In the subjective form, a person feels as though he is turning in space, while in the objective form he feels the world is revolving around him.
Mechanism
Normally, when you move your head, a signal is sent to an apparatus of your inner ear, referred to as the labyrinth, which is composed of three canals (semi-circular in shape) suspended in fluid. The labyrinth sends the information regarding head movement to the vestibular nerve. This nerve then transmits the information to the brain stem and cerebellum. When vertigo occurs, it is usually due to a problem somewhere within this peripheral vestibule system.
Features
Vertigo sufferers report feeling dizzy, light headed and off balance. Often they report that objects are whirling around them or that they are being moved in a particular direction. These sensations are generally sudden and unexpected. They last from several seconds to several minutes and may come and go at intervals. As vertigo is most often a symptom of a specific disorder, other symptoms unique to those disorders often occur. For example, in Meniere's disease (which causes some cases of vertigo), the victim may experience hearing loss, ear pressure and a ringing of the ears.
Causes
The most common form of vertigo is referred to as benign positional paroxysmal vertigo (BPPV). This is an inner ear disorder with vertigo that commonly happens when you shake your head or change positions in bed. This type of vertigo generally disappears within a few seconds. What causes BPPV is not known in most cases, but it can be due to a infection of the respiratory system or a minor head injury. Other causes of vertigo include Meniere's disease (an inner ear disorder), central nervous system abnormalities including epilepsy and multiple sclerosis, migraine, brain tumors and transient ischemic attacks (TIAS), which are often referred to as mini-strokes.
Diagnosis
As vertigo is a symptom rather than a disorder itself, it is important for the physician to accurately diagnose the condition responsible for it. Doctors will generally take a clinical history first and then perform a physical and neurological examination. The physician will look for issues with the patient's strength, equilibrium, coordination and walking stride. An electronystagmography (ENG) may be performed, which tests hearing, eye movement and alterations in position and posture. Magnetic resonance imaging (MRI) may be performed to examine the brain tissue and arteries in the head and neck. Once a definitive diagnosis is obtained, the physician can outline a treatment plan.
Treatment
Treatment for vertigo will depend on the issue causing the symptom. If a medication, rather than a disorder, is causing the vertigo, it may be discontinued or the dosage lowered. Often, a particular treatment called vestibular rehabilitation therapy is employed. This treatment is a series of exercises designed by a physical therapist under the direction of the physician. The goal of the treatment is to improve balance and decrease dizziness. In cases of BPPV, the Epley maneuver (or canalith repositioning procedure) is often employed. This technique involves sitting, lying and changing head and body position in a specific order and for a specific amount of time. It is generally performed under a doctor's direction.
Complications
There are a few serious complications due to vertigo. The most serious of these is the heightened possibility of falls, which can result in varying degrees of injury. Those who experience vertigo can also be injured in car accidents and when operating heavy machinery due their equilibrium problems. Aside from this concern, vertigo sufferers often undergo self-esteem issues, become irritable and suffer from depression.
