Exploring Vertigo

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A. Vertigo in nutshell

One of the most prevalent and commonly reported medical conditions, vertigo gives you the feeling that you are in motion when you actually aren’t. Basically, the condition makes you feel ‘off balance’ where one of the more common sensations is of things spinning and moving around you. However, needless to say, they aren’t. Feeling dizzy and lightheaded are often symptoms as well as indicators of vertigo. But one must bear in mind that lightheadedness and vertigo are not the same thing.

Vertigo-Nutshell

B. What could be the cause behind such a condition?

It is most commonly observed that a condition of the inner ear is what leads to vertigo. Some of the causes include:

a. Benign Paroxysmal Positional Vertigo (BPPV): This is a condition characterized by the accumulation and clogging of the inner ear canal by minute particles of calcium (canaliths). It is the inner ear that transmits signals to the human brain about the body and head movements in accordance to gravity. By doing this, the body balance is maintained. Generally, BPPV might happen without any reason as such. But old age is surely a catalyst.

b. Meniere’s disease: Another inner ear disorder that is assumed to be the result of varying pressure and accumulation of fluid in the ear, loss of hearing, tinnitus and vertigo are often caused by Meniere’s disease.

Meniere’s disease

c. Labyrinthitis or Vestibular Neuritis: This problem of the inner ear is mostly caused by a viral infection. This inflames the inner ear and the nerves that help regulate and maintain body balance.

B1: Other causes of vertigo include:
a. Injury to the neck or head
b. Tumor, stroke or other problems of the brain
c. Few medications that can damage the ear
d. Migraines

C. The common indicators of Vertigo are:
Often, a sudden change in the head’s position can trigger Vertigo. The most commonly reported sensations are those of:
a. Head spinning
b. Swaying
c. Tilting
d. Misbalanced
Other symptoms may be:
e. Vomiting
f. Nausea
g. Nystagmus (abnormal movements of the eye)
h. Sweating
i. Headaches
j. Loss of hearing
Note: The symptoms may oscillate and persist for a few minutes or even hours for that matter.

D. Treatment for vertigo

The treatment varies with the causes. Many a times, the condition gets resolved without having to administer any treatment. This is because the brain gradually adapts to the changes in the inner ear by resting on other mechanisms to regulate body balance. Some of the treatment options include:

a. Vestibular Rehabilitation: It is a type of physical therapy, the main objective of which is to strengthen the vestibular system (the system that controls balance and equilibrium in mammals). Recurrent spells of vertigo warrant this sort of a treatment. It trains and sharpens the other senses in order to recompense for vertigo.

b. Epley maneuver: This constitutes of movements of the body and the head in order to address BPPV. This procedure is designed to move the calcium crystals into a chamber of the inner ear where these can be easily absorbed by the system. You might experience slight discomfort while the procedure is being carried out.

c. Medications: Medications to relieve symptoms of vertigo such as motion sickness or nausea might be administered in a few cases. Steroids and antibiotics can treat vertigo that might have been the result of an inflammation or infection/s.

d. Surgery: In cases with more complicated causes, a surgery might be required to tackle the condition.

Note: If vertigo is caused by underlying problems such as a neck/brain injury or tumors, addressing these will resolve the condition automatically.

E. How to deal with Vertigo at home or work

It is important you remember that vertigo, along with its symptoms such as nausea, motion sickness or the recurrent bouts of dizziness, can certainly make it difficult to go through the day. However, few simple maneuvers have been designed which can provide quick relief if vertigo starts when you’re in the midst of something, either at your workplace or your home. Individuals over the age of 60 are the most susceptible to BPPV, which is again one of the simplest to treat as well. It is always wise to consult a doctor who can help you with the maneuvers correctly.

1. The Epley Maneuver– (Considering the vertigo originates from your left side)
a. Sitting right on one edge of the bed, slowly rotate your head towards your left side (but not till the left shoulder).
b. Place a pillow in such a way that when you lie down to rest, the pillow is below your shoulders to rest on it rather than your head.
c. Then lie down so that your head rests on the bed and your shoulders, on the pillow (still at the same angle).
d. Wait for about 30-45 seconds for any symptom of Vertigo to cease.
e. Then turn your face halfway to your right side and stay for 30 seconds.
f. The next step is to rotate your body and head on its side to the right side, and all the while, you should be looking down at the floor.
g. Hold position for another 40 seconds.
h. Gradually sit up, but don’t get off your bed just now.

(If vertigo originates on the right side, simply reverse the above mentioned instructions).
Do this exercise thrice before hitting the bed at night till you find you haven’t experienced any dizziness in a full day.

2. The Semont Maneuver

This technique is similar to the Epley Maneuver. Repeat the exercise thrice at night till you don’t complain of dizziness in one full day.

3. The Brandt- Daroff Procedure
a. Start this exercise while sitting straight up on your bed.
b. Tilt your head slowly, approximately at an angle of 45 degree, off from the particular side where the vertigo has affected. Then lie down on either side.
c. Hold stance for 30-40 seconds or till the time it takes for the vertigo to cease completely (whichever takes longer).
d. Get back to your original seated position.
e. Repeat the drill with the other side.
(Repeat the exercise about 5 times each session and make sure you are doing three of such sessions each day for 2 weeks).

F. Follow Up
After performing these exercises, ensure that you aren’t tilting your head too much in any of the directions. If you don’t feel better even after 7 days of doing these exercises, consult your doctor without any further delay. He/she will be able to guide you accordingly. It can either be that you aren’t carrying out the exercises correctly or that some other underlying cause is at the bottom of the dizziness that you experience.

If you are suffering from any of the above symptoms, download Portea’s mobile app and chat with our doctor to get your health concerns addressed.

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Dr Rahul has Masters in Maxillofacial Surgery with an overall experience of six years. Since the last 2 years, he is working in the Medical operations team of Portea. An Alumni of the Rajiv Gandhi University of Health and Science, he has previously worked with Nationwide- The Family Doctors while as their Chief Consultant Maxillofacial Surgeon and Implantologist. He has a special interest in Facial Trauma Surgery, Dental Implantology and Facial aesthetic surgery. It is not only medicine that fascinates Rahul. He is a die-hard sports enthusiast with a strong passion for Football, Basketball, and Cricket and occasionally strums the guitar, too.

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