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Vertigo

VAug 13 04

  • What Is It?
  • Symptoms
  • Diagnosis
  • Expected Duration
  • Treatment
  • When To Call A Professional
  • Prognosis
  • Prevention
  • What Is It?

    Vertigo is the illusion that either your body or your environment is moving (usually “spinning”). Vertigo can be a symptom of many different illnesses and disorders. The most common causes of vertigo are illnesses that affect the inner ear, including:

    • Benign positional vertigo — This is sudden episodes of a spinning sensation produced by a change in head position. The most likely cause is small crystals that break loose in the canals of the inner ear and touch the sensitive nerve endings inside.


    • Acute labyrinthitis (also called vestibular neuritis) — This is an inflammation of the balance apparatus of the inner ear, probably caused by a viral infection.


    •   Ménière’s disease — This causes recurrent episodes of dizziness, usually with ringing in the ear and progressive low-frequency hearing loss. Ménière’s disease is caused by a change in the volume of fluid inside the inner ear. Although the reason for this change is unknown, scientists suspect that it may be linked to loud noise, to a viral infection or to biologic factors inside the ear itself.

    Symptoms

    Vertigo can feel like the room is spinning or like you are spinning in the room, or it can be just a sense of imbalance. It may be associated with nausea, vomiting and ringing in one or both ears (tinnitus).

    Diagnosis

    The diagnosis of vertigo is made based on the description of what the person is feeling. What is causing the vertigo can be divided into two major categories, peripheral vertigo and central vertigo.

    Peripheral vertigo, which is much more common, includes benign positional vertigo, labyrinthitis and Ménière’s disease. Positional vertigo is diagnosed when maneuvering the head causes the vertigo and moving the head back to a neutral position relieves symptoms. Labyrinthitis and Ménière’s attacks usually come on abruptly and last for a few hours to a couple of days. There may be intense nausea and vomiting and variable hearing loss.

    Central vertigo is a more serious problem in the cerebellum (back part of the brain) or brain stem.

    Your doctor will evaluate your eye movements to look for abnormal jerking movements (nystagmus). The pattern of nystagmus may be helpful in determining if the problem is peripheral or central. If central vertigo is not suspected, then further diagnostic testing is usually not necessary.

    Expected Duration

    Depending on its cause, vertigo may last only a few seconds or persist for weeks or months.

    Prevention

    Vertigo can happen to anyone, and there is no way to prevent the first episode. Because vertigo can be associated with an intense sense of imbalance with falls, it is important to avoid situations in which a fall could cause significant harm, like climbing a ladder or working on a slanted roof.

    Treatment

    Your doctor may begin treatment by prescribing bed rest; medications that suppress the activity of the inner ear, such as meclizine (Antivert, Bonine and other brand names), dimenhydrinate (Dramamine) or promethazine (Phenergan); anticholinergic medication such as scopolamine (Transderm-Sco); or a tranquilizer, such as diazepam (Valium). Depending on the cause and duration of the vertigo, additional advice will be offered. For persistent benign positional vertigo, you may be given specific exercises to help reduce the symptoms.

    When To Call A Professional

    Call your doctor if you have a new episode of vertigo, especially if it is associated with headache and significant coordination problems. Also, call if you have mild vertigo that persists after a couple days.

    Prognosis

    Most cases of vertigo last for a few hours to a few days. Symptoms caused by acute labyrinthitis almost always go away without permanent injury. Other causes of vertigo may result in symptoms that are more persistent.

    Johns Hopkins patient information

    Last revised: December 8, 2007
    by Brenda A. Kuper, M.D.

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    All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.
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