Vertigo is the sensation that the room or environment around you is spinning, even though you’re standing or sitting still. Many people describe vertigo episodes as feeling dizzy or off-balance
Vertigo isn’t really a disease but rather a symptom of various conditions, most notably related to the vestibular (balance) system in the inner ear.
While vertigo is a symptom itself, it’s usually accompanied by some other unpleasant symptoms.
● Dizziness
● Lightheadedness
● Balance issues
● Headaches
● Nausea or vomiting
● Tinnitus (ringing in ear) symptoms
● loss of balance
● with or without hearing loss
● ear fullness sensation
The ability to balance is controlled by the inner ear balance system, vision, and proprioception (muscles and joints sensing the body’s location)
The portion of the balance system (also called the vestibular system) located in the inner ear is comprised of several fluid filled tubes and compartments that detect motion and gravity.
incorrect signal in this balance system causes mismatch between what the eyes see and muscles sense, that leads to a sensation of dizziness or vertigo./p>
● Benign paroxysmal positional vertigo – This is the most common form, caused by loose particles (“crystals”) of calcium in the inner ear. In compartment of inner ear there are crystals (otoconia) that help sense gravity. These crystals can dislodge from their normal location due to a variety of factors, and enter into the semicircular canals causing vertigo.
● Meniere’s disease – This occurs because of an abnormality with the fluid in your inner ear. Excess endolymph buildup in the inner ear can interfere with the normal balance and hearing signals between the inner ear and the brain.
● Labyrinthitis – This is an inner ear infection that causes inflammation of the inner ear
● Vestibular neuritis – Also an inner ear infection, vestibular neuritis affects the vestibular nerve, which carries signals from the nerve to the brain to help with balance.
● Vestibular Migraine (Migraine Associated Dizziness) - Atypical migraine, these may consist of less severe headaches accompanied by episodes of vertigo.
● Cholesteatomas – These are growths of tissue that develop behind the eardrum and typically cause hearing loss but, in some cases, can lead to vertigo.
● Extensive medical history - taking with questions
● Thorough physical exam, especially of the head and ear
● Audiological evaluation - An audiologist conducts a variety of hearing tests which help doctors to assess whether there is a problem with the nerve that connects the inner ear to the brain, and whether dysfunction affects both ears.
● Vestibular function tests - The doctor confirms the diagnosis by observing nystagmus — jerking of the person’s eyes that accompanies the vertigo caused by changing head position, over the edge of the examining table
● Video Nystagmography ( VNG ) - it is used to evaluate the function of the inner ear using a series of visual and sensory tests. While wearing the goggles, you are seated in front of a large television screen. A video camera with an infrared lens is built into the goggles and records your eye movements during the test. A variety of shapes, objects, and spots of light appear on the screen, and you are asked to perform certain tasks with your eyes while keeping your head still and recording of the response is done.
● Imaging - In some people with vertigo—in particular those who also have hearing loss—doctors may recommend an MRI / CT scan to obtain a closer look at the inner ear and surrounding structures.
Vertigo and Dizziness is very common and you are not alone. It affects your everyday life and you may often opt out of doing certain things that you enjoy because of it. We help detect the underlying cause of the condition and personalize a treatment solution for each patient.
Most centres treat vestibular symptoms with pharmacological interventions, using drugs such as vestibular suppressants, benzodiazepines, antihistamines, etc.
At SAGAR ENT, we stem away from using drug therapies as a method for rehabilitation. Our therapies focus on the use of individualized, non-pharmacological, and non-invasive treatment modalities. For benign paroxysmal positional vertigo, in which tiny inner ear crystals that maintain balance are displaced, we offer canalith repositioning treatment.
In this technique, a therapist moves your head in a specific series of positions to dislodge the improperly placed crystals in the inner ear. These positions include lying down and turning your head to one side, then rolling onto that side and holding the position.
Usually no medications are required for BPPV unless the patient has severe nausea or vomiting.
This disorder is associated with dizziness, ringing in the ear, hearing loss, and pressure in the ear. Along with a complete medical history and physical exam, Along with a complete medical history and physical exam, we perform, Hearing test, Balance test, Magnetic resonance imaging (MRI) scans – imaging if necessary.
Treatment will include medications, Intra Tympanic injections, change in diet, Balance therapy.
An acute syndrome, consisting of spinning vertigo, nausea, and sometimes vomiting, lasting for several hours to several days. The most common cause is a virus of the inner ear. The acute condition is treated with medications. Persistent imbalance may be treated with vestibular physical therapy / balance therapy.
Migraine is increasingly recognized to be a cause of vertigo. It can occur even in the absence of headaches. The “classical” migraine syndrome consists of an aura, or forewarning symptom such as dizziness, followed by a severe, disabling headache with intolerance of light and sound.
Vestibular migraine may be difficult to diagnose because there is no confirmatory test. Clues include a daily pattern, vague start and end, sensitivity to light and sound, and sensitivity to certain foods. There are several treatment options, including anti-migraine drugs, beta-blocker drugs, verapamil, antidepressants, and Diamox. Dietary modification is also often advised.
OTHER POSSIBLE CAUSES - If vertigo is a symptom of a condition that requires surgery—for example, an acoustic neuroma, cholesteatoma behind the ear drum, we recommend the appropriate procedure.