Vertigo is a sensation of feeling off-balance as if the world is spinning around you. It can commonly feel like a spinning or unintentional swaying movement. Other symptoms can include nausea, vomiting, ringing in the ears, or loss of hearing in one ear. Vertigo usually points to a problem with the inner ear, often an imbalance. But in more rare cases, it can be caused by a problem in the central nervous system.
Peripheral and central are the two types of vertigo that are associated with the inner ear or central nervous system, which one depends on where the imbalance is taking place inside the body. Once the type of vertigo is established, doctors can then narrow down the diagnosis to what is causing the dizziness and create a treatment plan. Treatment can include medications, therapies, and if severe enough, then surgery may be an option. All of this is dependent on the cause of vertigo.
Types of Vertigo
Peripheral
Peripheral vertigo is classified as being caused by the inner ear, or vestibular system, being imbalanced in some way. The vestibular system controls the body's balancing capabilities. In order to diagnose you with peripheral vertigo, a doctor must examine the ears of the afflicted for any signs of infections. They may also check the individual's balance and perform a quick movement test to see how they react. In this movement test, the individual is quickly moved from a sitting position to a laying position, and the doctor will check the corresponding eye movements. The most common disorders associated with the peripheral type of vertigo is benign paroxysmal positional vertigo (BPPV), Meniere's disease, and labyrinthitis.
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Peripheral Associated Disorders
Benign paroxysmal positional vertigo (BPPV) is the most common disorder related to the inner ear. BPPV happens when calcium carbonate deposits break off of the occipital membrane and float around in the vestibular labyrinth, or semicircle canal, of the ear. This movement in the semicircle canal creates the feeling of motion, even if the afflicted individual is sitting still. The motion sensation will get worse with even the slightest of head movements. The most common cause of BPPV is being struck in the head or, in some way, receiving a head injury. Sometimes there is no cause of BPPV, and when that is the case, the disorder is called idiopathic BPPV.
Meniere's disease is caused by an uptick in the amount of endolymphatic fluid, which is the fluid contained in the inner ear. Typically it only affects one ear, and in addition to it causing moderate to severe vertigo spells, it also can lead to hearing loss in the afflicted ear. The vertigo spells are spontaneous and can last up to 24 hours and can be accompanied by nausea and vomiting. Meniere's disease is considered a chronic illness, and while medications can be given to lessen the impact, the condition will always be present.
Labyrinthitis is an infection of the labyrinth of the inner ear canal. It's usually caused by a bacterial ear infection or viral infection like the cold or flu. Because of this, the common symptoms associated with labyrinthitis are fever, earache, and nausea. Over the counter, antihistamine medications can sometimes help ease the symptoms, and if there is an active infection, a doctor may prescribe an antibiotic for the treatment. Labyrinthitis is commonly cleared up in about one to three weeks, about the same amount of time as the infection that caused it.
Central
Central vertigo is classified as being caused by a disease or injury to the central nervous system, usually affecting the cerebellum or brainstem. This affliction can produce hallucinations of motion in the surrounding area. Neurological defects can also appear; these can include double vision or slurred speech. Medical imaging of the brain, such as MRI and CT scans, as well as neurological testing can be used to determine if there is something in the central nervous system that is damaged to the point of causing vertigo. Disorders commonly associated with central vertigo include migraine headaches, strokes, or tumor growth in the cerebellum.
Central Associated Disorders
Migraine headaches are a primary headache disorder described by reoccurring headaches in moderate to severe tendencies. They are thought to be caused by the nerves or blood vessels of the brain and how they contract. These headaches can cause vertigo either by it being a symptom of the migraine or being a part of the neurological disorder that is causing the migraine. Those who suffer from migraines tend to develop motion sickness, a form of vertigo, relatively easily compared to non afflicted persons. Motion sickness happens when there is an unmatched visual input in comparison to the vestibular sensations present in an individual.
Strokes that occur in the cerebellum or the brainstem can cause central vertigo. It is caused by either a sudden interruption of blood supply to the brain or a brain vessel bursting and bleeding into brain tissue. A stroke is sudden and requires immediate treatment to prevent widescale damage to the part of the brain it occurred in. A stroke can also cause sudden confusion, trouble speaking coherently, or numbness on one specific side of the body. If treatment is administered quickly and brain damage is minimalized, there is less of a chance of the stroke causing central vertigo.
Tumors are masses of tissue formed by an accumulation of abnormal cells. Unlike normal cells that perform their function and then die off, abnormal cells continue growing. If the cells are malignant or cancerous, they can aggressively invade the surrounding tissue and damage it. The symptoms of a tumor can include vertigo and other balancing problems, seizures, problems with memory, or personality changes. These are typically diagnosed by either a CT scan or an MRI. These imaging studies allow doctors to see the different parts of the brain to determine if something is growing where it shouldn't be. A biopsy of the tumor, which is a collection of tissue taken from the tumor and tested, will be able to tell how serious it is.
Treatment of Vertigo
The treatment of vertigo depends on what it is that's causing it. If there is no known cause, then vertigo can simply clear up on its own. This happens when the brain and the inner ear adapt to whatever change occurred to cause the dizziness. Vestibular rehabilitation is a type of physical therapy for strengthening the vestibular system and helps train your other senses to compensate for vertigo. For those afflicted with BPPV, canalith repositioning maneuvers are suggested. These are specific head and body movements that are done to move the calcium deposits out of the semicircle canal so that they can be absorbed by the inner ear. Medicine is the next treatment given to those that suffer from vertigo. Sometimes medication is provided to reduce nausea that accompanies the dizziness. But other times, like when an infection is causing it, antibiotics may be prescribed. Finally, for the more severe cases, surgery may be considered. This is more for those with a tumor causing vertigo and must have it removed anyway.
