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Vertigo/Dizziness

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Vertigo/Dizziness

Vertigo literally means the sensation of spinning.

Vertigo occurs when you feel that your surroundings are in motion. It is often described as a sensation of spinning, resulting in lightheadedness, disorientation, a feeling of falling, dizziness, and fatigue.

Vertigo Causes:

The most common cases of vertigo include:

Benign Paroxysmal Positional Vertigo (BPPV) – This is thought to occur from the displacement of tiny crystals in the inner ear, although this explanation is entirely theoretical. It causes spinning for several second associated with head or neck movements. It usually occurs for no known reason and may be associated with age and head trauma.

Cervical vertigo – This usually occurs with neck pain or a herniated disc. It results in an exaggerated feeling of movement with small positional changes of your head or neck, the exact symptoms of BPPV. The spinning sensation only lasts a few seconds and does not occur if you are sitting still or standing.

Lyme disease – Acute or recurrent Lyme disease can cause persistent or episodic vertigo. The mechanism is not known, but it can be diagnosed with blood testing and a thorough history.

Meniere’s Disease – This is thought to be due to a buildup of fluid in the inner ear, which results in fluctuating hearing loss, a sensation of aural fullness, and ringing or roaring in the ears. This type of vertigo often occurs in attacks and lasts for several hours or even days.This syndrome is very rare and the symptoms recur over a number of years. It is also a diagnosis of exclusion, which means all other causes must first be ruled out.

Vestibular neuronitis – This is a severe type of vertigo that causes a sudden feeling of spinning, usually upon waking in the morning. The cause is unknown, but thought to be due to a viral infection of the inner ear nerve. More likely, it may be due to impingement of the vestibular (balance) nerve in the tiny canal that contains it in the skull. It can be debilitating at first, for a day or two, then eventually resolves over weeks to months, often without treatment.

Less common causes of vertigo include:

  • Head or neck injury
  • Brain disorders such as a stroke or a tumor
  • Migraines

Vertigo Symptoms:

People who experience vertigo often feel as though they are spinning, swaying, unbalanced, nauseated, and they often vomit. They also can have anxiety related to the symptoms that causes sweating, heart palpitations, and fatigue. Symptoms of vertigo can last for a few seconds to a few hours and often come and go.

Vertigo Treatments:

There are various treatment options for vertigo. Dependent on the diagnosis, treatment may involve multidisciplinary methods to treat the root cause of the balance disorder. Acute and severe symptoms can be treated with medications, such as oral steroids, valium, or antihistamines. Physical therapy and vestibular rehabilitation, craniosacral work, acupuncture, lifestyle alterations, medications, are helpful treatment options. Surgery is  rarely necessary.

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Linda D. Dahl, MD