Vertigo

Vertigo can be caused by many kinds of disorders of the balance system. Most commonly they are due to inner ear problems. Less commonly, central nervous system, systemic disorders like inadequately controlled BP or Diabetes or psychological disorders may be implicated. Amongst the commoner causes are disorders like Benign Paroxysmal Positional Vertigo (BPPV), Meniere’s disease, Vestibular migraine, Labyrinthitis, Vestibular neuritis, head injury stroke, etc.

BPPV is one of the most common causes of vertigo. The full form of BPPV is Benign Paroxysmal Positional Vertigo. In this condition, the patient complains of spinning on getting up from bed or turning the head to certain positions. BPPV is caused by a displaced calcium carbonate crystals with the inner ear. It is treated by identifying the position of the crystals in the ear and repositioning them with specific exercises.

VNG or video nystagmography is an important test to evaluate dizzy patients. High speed infra red cameras are used to record eye movements in different tests. The tests allow the doctor to check the functioning of different parts of the balance system and their connections in the brain.

Vertigo can be caused by different diseases of the ear and brain. A complete evaluation will help to ascertain the cause. But some general instructions include avoiding _____, be careful in dark areas or stairs. Avoid alcohol and try to reduce your caffeine (Tea/Coffee) intake.

Vertigo is treatable ! Identifying the cause of your vertigo will help the doctor decide whether you require medicines or exercises to control your problem.

After a detailed history, the vertigo patient should undergo a thorough vestibular evaluation. This will include tests like Videonystagmography, Video Head impulse test, Subjective Visual Vertical and Dynamic Visual Acuity. Some patients may require an MRI of the brain. Audiometric tests to measure the hearing function should also be done.

Vertigo is treatable ! A series of tests done by your doctor will help identify the cause of your vertigo. Once the cause is identified, treatment with medicines or rehabilitation exercises would be advised.

Vestibular rehabilitation is very important to help dizzy patients recover their balance. It works on the principle of helping the brain develop alternate strategies to improve balance function. Vestibular rehabilitation exercises need to be tailored to work on the weak balance areas identified by the vestibular tests. They need to be progressively challenging to help the patient recover balance over several weeks.

Excessive screen time especially using moving screens (as in scrolling) or playing computer games can aggravate vertigo caused by Vestibular migraine.

Avoid driving if you feel dizzy ! During dizziness, the reflexes of the person may be affected which can compromise control over the vehicle.

Any defect in the balance system resulting in vertigo, unsteadiness or imbalance will affect the day-to-day activities of the patient and diminish the quality of life. It may cause a drop in the confidence of the patient as well as induce a fear of falling or movement. Treating vertigo will help restore the balance and confidence of the patient. The fear of movements may cause the patient to restrict themselves to a sedentary lifestyle and lead to depression or anxiety.