FAQ's on Vertigo

Q- What is Vertigo?
Ans- Vertigo is the feeling that you or your environment is moving when no movement occurs. Imprecisely called dizziness, it is described as an illusion of movement.

Q- What are the causes of Vertigo?
Ans- Vertigo can be caused by problems in the brain or the inner ear.
Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements.
Inflammation within the inner ear (labyrinthitis). This condition is characterized by the sudden onset of vertigo and may be associated with hearing loss.
Meniere’s disease is composed of a triad of symptoms: episodes of vertigo, ringing in the ears, and hearing loss.
Acoustic neuroma is a type of tumor causing vertigo. Symptoms include vertigo with one-sided ringing in the ear and hearing loss.
Vertigo can be caused by decreased blood flow to the brain and base of the brain. Bleeding into the back of the brain called cerebellar hemorrhage is characterized by vertigo, headache, difficulty in walking, and inability to look toward the side of the bleed. The result is that the person's eyes gaze away from the side with the problem. Walking is also extremely impaired.
Multiple sclerosis in which there is inability of the eyes to move past the midline toward the nose.
Head trauma
Migraine, a severe form of headache, may also cause vertigo.
Ligamental injuries of the upper cervical spine can result in head-neck-joint instabilities which can cause vertigo

Q- What are the symptoms of Vertigo?
Ans- Vertigo should not be confused with symptoms of lightheadedness or fainting. To determine if true vertigo exists, you must describe a sensation of disorientation or motion. In addition, you may also have any or all of these symptoms:
Nausea or vomiting, sweating and abnormal eye movements. The duration can be from minutes to hours and can be constant or episodic. The onset may be due to movement or change in position. It is important to tell your doctor about any recent head trauma as well as any new medications you may be taking. You may have hearing loss and a ringing sensation in your ears. You might have visual disturbances, weakness, difficulty speaking, decreased level of consciousness, and difficulty in walking.

Q- When to seek medical care?
Ans- The majority of cases of vertigo are harmless but let your doctor check out any new signs and symptoms of vertigo to rule out any potentially serious or life-threatening causes. Certain signs and symptoms of vertigo may require evaluation in a hospital's emergency department:
Double vision, headache, weakness ,difficulty in speaking, abnormal eye movements, altered level of consciousness, not acting appropriately, or difficulty in arousing, difficulty in walking or controlling your arms and legs.

Q- What are the exams and tests for Vertigo?
Ans- The evaluation of vertigo consists primarily of a medical history and physical exam.
The history is comprised of 4 basic areas. The doctor will ask you about the
following areas:
During the exam, the doctor will want to find out if true vertigo exists. Report any sensation of motion, nausea, vomiting, sweating, and any abnormal eye movements.
The doctor will ask about how long you have had symptoms and whether they are constant or come and go. Do the symptoms occur when you move or change position? Are you currently taking any new medications? Has there been any recent head trauma or whiplash injury?
Are there any other hearing symptoms? Specifically, report any ringing in the ears or hearing loss.
Do you have weakness, visual disturbances, altered level of consciousness, difficulty in walking, abnormal eye movements, or difficulty in speaking?
The doctor may perform special tests such as a CT scan if a brain injury is suspected, blood tests, specifically to check blood sugar levels, and the use of an ECG to look at the heart rhythm.

Q- What are the treatments for Vertigo?
Ans- (A) Self-Care at Home
Home therapy should only be undertaken if you have already been diagnosed with vertigo and are under the close supervision of a doctor.
(B) Medical Treatment
The choice of treatment will depend on the diagnosis.
Vertigo can be treated with medicine you take by mouth, as a skin patch, or drugs given through an IV.
Specific types of vertigo may require additional treatment and referral:
Bacterial infection of the middle ear requires antibiotics.
For Meniere disease, in addition to symptomatic treatment, people might be placed on a low salt diet and may require medication used to increase urine output.
A hole in the inner ear causing recurrent infection may require referral to an ear, nose, and throat (ENT) specialist for surgery.
In addition to the drugs used for benign paroxysmal positional vertigo, several physical maneuvers can be used to treat the condition.
Vestibular rehabilitation exercises consist of having you sit on the edge of a table and lie down to one side until the vertigo resolves followed by sitting up and lying down on the other side, again until the vertigo ceases. This is repeated until the vertigo is no longer inducible.
Particle repositioning maneuver is a treatment based on the idea that the condition is caused by small stones in the inner ear. Your head is repositioned to move the stones to their normal position. This maneuver should be repeated until the abnormal eye movements are no longer visible.

Q- What are the medications for Vertigo?
Ans- Medications commonly prescribed are :Meclizine hydrochloride (Antivert), Diphenhydramine (Benadryl), Scopolamine transdermal patch, Promethazine hydrochloride (Phenergan) and Diazepam (Valium) Take these medications only as directed by and under the supervision of your doctor.

Q- What are the follow-up for Vertigo?
Ans- Anyone with a new diagnosis of vertigo should follow up with their doctor or be referred directly to a neurologist or ENT specialist.