Vertigo – causes, treatments medications and home remedies
What is the meaning of vertigo?
Vertigo is an abnormal feeling in which a person feels the surrounding objects and the background are spinning around him when they are not. It is a symptom and not a disease in itself. The underlying pathology may vary from a problem of the ear to systemic disease. Usually, vertigo, dizziness, and imbalance go hand in hand.
Vertigo and dizziness are amongst the most common symptoms that people seek help from doctors. It can occur temporarily or for the long-term. Also, its intensity can vary from mild to severe. The causes of each are different. Therefore, a thorough examination starting from the head to toe and multiple medical investigations are needed for making a proper diagnosis.
Associated other symptoms
- Loss of balance
- Tinnitus – Ringing sensation inside the ear
- Nausea and vomiting
- Ear pain
- Nystagmus – An abnormal movement of the eyes
Causes of vertigo
The main sensory organ that detects our body movements and balance is labyrinthine of the inner ear. The brain reads our body motions by the movements of the fluid inside semicircular canals of the labyrinthine. Therefore, any disease affecting the inner ear can cause vertigo, especially if it’s involving the semicircular canals, utricle or the saccule.
Labyrinthitis, inflammation of the labyrinthine, is quite common. This is usually caused by viral infections and settles as the infection fades off.
Vestibular neuritis causes vertigo in some people. It’s the inflammation of the vestibulocochlear nerve, the nerve that supplies the inner ear.
Vertigo attributed to Ménière’s disease is common among adult females. They typically have headache and tinnitus (ringing sound inside the ear) along with vertigo. It occurs due to excessive fluid buildup inside the labyrinthine. Vertigo in Ménière’s disease occurs in an episodic pattern and it’s tough to cure completely by medications alone.
Benign Paroxysmal Positional Vertigo (BBPV) is the most common cause of vertigo in the US. It’s typically seen among the adult population. The pathology of BBPV is thought to be a defect of the otoliths which are calcium carbonate crystals inside the labyrinthine.
Migraine is notorious to cause vertigo. It usually starts during adolescence and young adult age. Migraine is a severe throbbing type of headache associated with visual, auditory, or sensory hallucinations. However, not all people having migraines develop vertigo.
In addition to these causes, the following conditions may also be associated with vertigo.
- Low blood sugar
- Menstruation or pregnancy
- Injuries or trauma to the head or ear
- ear surgery
- Cerebellar damage
- Side effects of certain medication (e.g.-Aminoglycosides)
- Strokes of the cerebellum or brainstem
- Brain tumors
- acoustic neuroma – A tumor of the vestibulocochlear nerve
- Demyelination disorders (e.g.-Multiple sclerosis)
The treatment method depends on the cause of it. Most of the mild vertigo settles with time. Therefore, it doesn’t require any interventions. But in the case of a Cholesteatoma or an acoustic neuroma, surgical treatment is essential for the recovery of the patient.
Vestibular suppressants can be used for the symptomatic relief of vertigo. Anticholinergics, (Hyoscine butyl bromide), antihistamines (promethazine), and benzodiazepines (diazepam) belong to this category of drugs. The patient should not self-medicate using these drugs and even if prescribed by a doctor, should not be continued for more than a week since it can mask the underlying disease.
Exercises for vertigo
Several exercises may help to improve it, especially in benign causes like BPPV.
The Epley maneuver
- If the problem is in the right ear,
- Sit on the edge of the bed and keep a pillow behind.
- Turn your head 45 degrees to the right and lie down on the back. The head should remain still and the shoulders should rest on the pillow.
- Remain in the same position for 30 seconds and turn your head 90 degrees to the opposite (right) side. Remain 30 seconds again.
- Then turn your head and body both by 90 degrees further to the right side. Remain 30 seconds
- Slowly get up and sit on the bed for a few minutes.
There are other exercises for vertigo including,
- Brandt-Daroff exercise
- Semont Maneuver
- Foster Maneuver.
Each of these exercises has indications and contraindications. However, in a case of head trauma, the patient should never try doing these exercises. Ideally, the exercises should be initiated after consulting a doctor or an ENT surgeon.
Treatment at home/ Home remedies
- Reduce your work-load. Take rest for a day or two.
- Get rid of anxiety by being happy
- Have enough sleep
- Do regular exercises
- Be well-hydrated
- Eat nutritious food to maintain the body hemoglobin level
- Remedies like Ginger tea, almonds, turmeric, and cayenne