Vertigo

Vertigo

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Definition

What is vertigo?

Vertigo is a condition in which the sufferer feels as if the environment around him is spinning or floating. This condition will also make the sufferer lose balance, making it difficult to simply stand or even walk. The best way to describe vertigo is to rotate your body several times and feel the resulting condition.

Please note, vertigo is not a disease name. However, a collection of symptoms that can occur suddenly or last for a certain period of time at a time.

Signs & Symptoms

What are the symptoms of vertigo?

Common symptoms of this disease are dizziness, the sensation of a spinning head or head kliyengan, and loss of balance. These signs will trigger the sufferer to experience nausea, vomiting, excessive sweating, headaches, and sometimes even accompanied by nystagmus (abnormal eye movements), ringing in the ears (tinnitus) and the sensation of falling. Usually, this condition will disappear and can last for several minutes, hours, or even days.

Please consult a doctor if your condition does not improve. The doctor will usually ask for your symptoms, do a simple examination, and recommend further tests. Especially if the frequency you experience this disease, including often.

Cause

What are the causes of vertigo?

The actual cause of vertigo depends on the type of vertigo experienced. In general, there are two types of vertigo which are classified according to their causes. Each condition also has its own cause.

1. Peripheral vertigo

This is the type of vertigo that is most often experienced by most people. The cause of peripheral vertigo is caused by a disturbance in the inner ear that functions to regulate body balance.

When you move your head, the inside of your ear will tell you where your head is and then send a signal to your brain to maintain balance. However, if there are problems on the inside of the ear, then you will feel pain and dizziness. This can occur due to inflammation in the inner ear or due to a viral infection.

In addition, this type of vertigo is caused by several other things such as:

  • Benign paroxysmal positional vertigo (BPPV)

BPPV is the most common cause of vertigo, which is a condition in which the inner ear vestibuler is disturbed and is triggered by sudden changes in position and head movements. For example:

  • Change the position of the head from an upright position to bow suddenly
  • Wake up suddenly from sleep
  • Movement to look head up

BPPV conditions are also more susceptible to experience by people who have had surgery to their ears, have a history of head injury, have an ear infection, and are in a period of healing and bedrest .

Experts suspect that BPPV occurs due to the presence of crystalline flakes of kabonate that escape from the walls of the inner ear canal. So like this, in the middle ear, there is a carbonate crystal that functions to create the illusion of motion. When changes in head position occur suddenly, these crystals will enter the part of the ear that contains fluid balance.

The entry of these crystals stimulates abnormal fluid movements when you move certain heads. Well, this is what makes a person unbalanced and the world around him feels spinning.

This condition usually occurs in a short time and is often experienced by people over the age of 50 years. However, it is also possible if younger people can experience this condition.

  • History of head injury

Another cause of peripheral vertigo is due to the impact of a history of head injury. People who have had a head injury before, may experience inner ear disorders which then cause vertigo.

  • Experiencing labirintitis

Labirintitis is inflammation and infection that occurs in the inner ear, especially in the winding and fluid filled channels. This inner ear plays an important role in controlling one's hearing and balance. Inner ear infections are usually caused by viruses and bacteria, for example in people with the flu or colds.

If you experience this disease due to labirintitis, other symptoms that will also arise are nausea, vomiting, loss of hearing ability, ear pain, and fever.

  • Vestibular neuronitis

Vestibular neuronitis is inflammation that occurs in the nerves of the ear that are directly connected with the brain. This inflammation is caused by a viral infection that usually occurs suddenly without accompanied by other symptoms or signs, even there is no problem in the ability of hearing.

This condition can occur for several hours a day. Symptoms of loss of balance, head kliyengan, nausea, and even vomiting. Although this inflammation occurs in the nerves of the ear, this condition does not usually make the sufferer experience hearing loss.

  • Ménière's disease

Ménière's disease is a rare disease that attacks the inner ear. Although Ménière's disease is rare, this condition can be a very severe cause of vertigo. Even in some cases, symptoms include ringing in the ears, and hearing loss within a certain period of time.

If you experience Ménière's disease, the symptoms that appear will be experienced for several hours or even days. This disease is also accompanied by symptoms of severe nausea and vomiting. Although quite dangerous, experts have not been able to ascertain what is the cause of Ménière's disease.

2. Vertigo central

In contrast to peripheral vertigo caused by disorders of the ear and organ balance, central vertigo occurs due to problems in the brain. The part of the brain that most influences the incidence of this disease is the cerebellum or cerebellum.

Here are some conditions that cause central vertigo:

  • Migraine, which is an unbearable headache accompanied by throbbing pain and is often experienced by young people. Migraines are usually experienced by young people and are considered as one of the common causes of this disease. Avoiding triggers and treating migraines can usually alleviate this disease.
  • Multiple sclerosis, a nerve signal disorder that occurs in the central nervous system - the brain and spine - which is caused by errors in a person's immune system.
  • Acoustic neuroma is a benign tumor that grows on the vestibular nerve, which is the nervous system that connects the ear to the brain. So far the acoustic neuroma is caused by genetic abnormalities.
  • Brain tumors that attack the cerebellum or cerebellum, resulting in impaired coordination of body movements.
  • Stroke, the blockage of blood vessels that occur in the brain.
  • Take several types of drugs that can cause side effects of vertigo.

Diagnosis

How is vertigo diagnosed?

Just like the initial diagnosis of disease in general, the doctor will ask everything related to the headache that you feel in detail. Starting from the sensation of vertigo experienced (floating, rocking, or turning), triggers of vertigo, frequency of appearance, duration, and so forth.

In addition, your doctor will also ask about your medical history, including a history of migraines, head injuries or ear infections in the near future, and medications that you routinely consume.

If necessary, the doctor will carry out further physical examination stages. This examination is intended to see auditory function, eyeball movement, and brain function. Some of the inspection methods include:

  • Head impulse test

The patient is asked to focus on staring at the tip of the doctor's nose while his head is moved quickly to one side. If the patient's eyes remain focused on the doctor's nose during this movement, the test results are negative rather than vertigo.

  • Romberg test

The patient is asked to stand with both feet together, first open his eyes then the doctor will order to close his eyes for some 20-30 seconds. The test results are positive if the patient loses balance or falls after closing the eyes.

  • Unterberger test

The patient stands with both legs straight ahead and walks in place by raising the knee as high as possible for 30 seconds with eyes closed. If he positively experiences vertigo, he will turn sideways, towards the problematic side.

  • Nystagmus test

Examination is done to determine the uncontrolled movement of the eyeball (nystagmus) by instructing the patient to perform a fast maneuver that can trigger vertigo. When the test is taking place, the patient will be monitored using an Electronystagmography (ENG) and Videonystagmography (VNG) tool that functions to record eye movements using special glasses.

  • Hearing examination

This examination uses a tuning fork test and audiometry performed by an ENT doctor, especially if you experience tinnitus (buzzing ears) or hearing loss.

  • Supporting investigation

In addition to some of the tests mentioned above, to further ensure the doctor will also conduct a series of other supporting tests such as blood and urine tests, x-rays, CT scans, and MRI.

Drug

How to treat vertigo?

Often the symptoms of vertigo will improve over time even without treatment, one of them by resting. This happens because your brain can adjust to changes in the inner ear, in an effort to maintain body balance.

Even so, there are various treatments that are determined based on the cause and severity of vertigo experienced by the patient, including:

1. Vertigo caused by Benign Paroxysmal Positional Vertigo (BPPV)

Doing some simple head maneuvers below can be one way to overcome the dizziness you experience.

Epley maneuver

  • Sit up straight on the edge of your bed with your legs hanging. Turn your head 45 degrees to the left. Put a pillow under you, so when you lie down, the pillow will rest between your shoulders and not under your head.
  • Lie down immediately, head facing the mattress (fixed at a 45 degree angle). The pillow must be under your shoulder. Wait 30 seconds.
  • Turn your head 90 degrees to the right without lifting it. Wait 30 seconds.
  • Turn your head and body from the left side to the right side, so you can see the floor. Wait 30 seconds.
  • Slowly sit down again, but stay in bed for a few minutes.
  • Repeat the movement instructions from different sides and do this movement three times before going to sleep each night, until you are not dizzy again for 24 hours.

Foster / Half Somersault maneuver

  • Sit cross-legged and tilt your head up at the ceiling for a few seconds.
  • Touch the floor with your head (prostration). Slide your chin into your chest so that the head touches or enters the knee. Wait for about 30 seconds.
  • Still in prostrate position, turn your head towards the ear that has a problem (if you feel dizzy on the left side, turn your face to the left elbow). Wait 30 seconds.
  • Then with a quick motion, raise your head until it is horizontal with your back. Keep your head at a 45 degree angle. Wait 30 seconds.
  • After that with a quick movement also raise your head and sit upright, but keep your head facing your shoulders in the same position as the problematic ear. Then, stand up slowly.

You can repeat it several times to reduce dizziness. After the first round, rest for 15 minutes before continuing to the second round.

After performing some of the maneuvers mentioned above, try not to move your head too far up or down in a few moments.

If you don't feel better for a week after trying the exercise, talk to your doctor immediately, and ask what you should do next. You might not be doing the exercise correctly, or maybe there is something else that is causing your headaches.

2. For vertigo caused by Ménière's disease

If your vertigo is caused by this disease, there are several things you can do to help alleviate these two symptoms, namely:

  • Limit consumption of salt and diuretics to reduce the volume of fluid stored in the body
  • Avoid caffeine, chocolate, alcohol and cigarettes
  • Do physiotherapy to overcome balance disorders
  • Acupuncture and acupressure for some people can reduce the symptoms of both, but until now there has been no scientific evidence that it is effective.

3. Taking certain medications

To reduce symptoms, your doctor can prescribe vertigo so that you feel more comfortable. Some drugs that are commonly used to relieve symptoms of this disease such as headaches, nausea and vomiting include: meclizine, promethazine, diphenhydramine, dimenhydrinate, and lorazepam.

The doctor will also consider giving antibiotics or steroids that work to reduce swelling and cure infections. As for Ménière's disease, diuretics (water pills) can be prescribed to reduce the pressure from fluid buildup.

Information on dosage and other types of drugs, always consult your doctor or pharmacist before starting treatment.

4. Vestibular rehabilitation therapy (VRT)

This therapy is done if the complaints experienced are dizziness and difficulty maintaining body balance. This is a type of physical therapy to strengthen the vestibular system. Functionally, the vestibular system plays a role in maintaining balance, coordination, and control of body movements.

5. Operation

Source

Vertigo: Causes, Symptoms, and Treatments - http://www.medicalnewstoday.com/knowledge/160900/vertigo-causes-symptoms-treatments accessed on 30 August 2017

Vertigo - http://www.webmd.com/brain/vertigo-symptoms-causes-treatment#1 accessed on 30 August 2017

Home Remedies for Vertigo - http://www.webmd.com/brain/home-remedies-vertigo#1 accessed on 30 August 2017

Medical Treatment of Vertigo - http://american-hearing.org/disorders/medical-treatment-of-vertigo/ accessed 30 August 2017

Vertigo Causes - http://www.nhs.uk/Conditions/Vertigo/Pages/Causes.aspx accessed 30 August 2017

Benign Paroxysmal Positional Vertigo: Lifestyle and Home Remedies - http://www.mayoclinic.org/diseases-conditions/vertigo/basics/lifestyle-home-remedies/con-20028216 accessed on 30 August 2017

Reviewed Date: August 29, 2018 | Last Edited: August 29, 2018

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