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VERTIGO

Vertigo is a sense that you or environment are spinning or moving even though it is not moving.


It is usually due to a problem with the inner ear but can also be caused by vision problems and other conditions.

Vertigo may be described as a feeling that you yourself are spinning around, known as subjective vertigo, or The feeling of rotation of the surrounding environment known as objective vertigo.

Symptoms of Vertigo

  • A sensation of movement (including spinning), either of yourself or the external environment
  • unsteadiness, including finding it difficult to walk in a straight line
  • light-headedness
  • feeling faint
  • Whistling

Other symptoms that may accompany dizziness include

  • headache
  • nausea and vomiting
  • ringing or other sounds in the ears (tinnitus)
  • difficulty hearing
  • staggering gait and loss of coordination (ataxia)
  • unusual eye movements, such as flitting of the eyes (nystagmus)
  • finding it difficult to see clearly when moving, for example, when reading a sign while walking or driving

Causes of dizziness and vertigo


A wide range of conditions and diseases can cause dizziness, including

  • 1. Inner Ear Problems – Disorders of the inner ear account for about half of all cases of persistent (ongoing) dizziness. Disorders include Meniere’s disease, benign paroxysmal positional vertigo (BPPV) and vestibular neuritis.
  • 2.Anxiety Disorders – Stress or anxiety may play a role in causing dizziness or, more commonly, may be a contributing factor in dizziness from other causes, such as inner ear disease.
  • 3.Brain Disorders – A common cause of dizziness is migraine, even without the headache that most people associate with a migraine. Very rarely, stroke or other brain diseases.
  • 4.Other Conditions – Some cases of dizziness are due to underlying medical conditions such as low blood pressure, infection, some heart problems (such as cardiac arrhythmias) and hypoglycaemia (low blood sugar).
  • 5.Drugs - Drugs that are used to treat conditions such as epilepsy, coronary heart disease and high blood pressure can also cause dizziness in some people.

Diagnosis of dizziness and vertigo


In trying to work out the cause of a person’s dizziness, investigations may include

  1. Medical History, including careful questioning about the nature of the dizziness
  2. Physical Examination, which may include observing eye movements, positional testing and a blood pressure check
  3. Specialized Balance Testing
  4. VEMP Test (Vestibular Evoked Myogenic Potential test ).this test includes
    (A)cVEMP- CERVICAL VESTIBULAR EVOKED MYOGENIC POTENTIAL TEST
    (B)oVEMP- OCCULAR VESTIBULAR EVOKED MYOGENIC POTENTIAL TEST

the above tests helps us estimate the ratio and status of inferior vestibular nerve which plays an important role in managing the body balance

It also give an information if the problem is on one side- Unilateral or both side- Bilateral. Along with Central level of Peripheral Level of Pathology Can be detected with the above test.

    Subjective Evaluation:
Including Fukuda test , Head impulse test , Romberg test, Dix Hallpike Test and other many more depending on the patient history . These test helps us to undertand the patient perception during the session/ episode of vertigo. Also helps in diagnosis between central and peripheral pathology


Ecogh – Electro Cochleagraphy Test: This is usually needed to asses Meniere’s Disease, which is usually seen more in females than compared to males. This test results helps us to analyze the endolymph status in the ear which usually causes Vertigo/ Dizziness.
CT or MRI scans of the inner ear or brain
Other tests relating to specific conditions


Treatment of dizziness and vertigo

Treatment depends on the cause of the dizziness that may be uncovered by your doctor. Potential treatment options may include:


  • canalith positioning procedures, which are a special set of exercises designed to remove inner ear ‘crystals’ in benign paroxysmal positional vertigo (BPPV)
  • Balancing exercises/ aka Vestibular Rehabilitation therapy to ‘retrain’ the nervous system, which are usually prescribed by a vestibular specialist or Audiologist
  • Counseling and cognitive Behavioral therapy where anxiety or stress is a factor
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