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Diseases & Conditions

Vertigo

VertigoMedicationsPrognosisSymptomsTestsTreatmentTypes

What is Vertigo?

Vertigo is a type of dizziness caused by the dysfunction of the vestibular system in the inner ear. The person feels movement even though he/she is stationary.

Medication for Vertigo

Medication for vertigo may be taken orally, through medicine patches or through an IV. The common medications that may be taken as prescribed and under the supervision of a doctor are:

  • Meclizine hydrochloride (Antivert)
  • Diphenhydramine (Benadryl)
  • Scopolamine transdermal patch (Transderm-Scop)
  • Promethazine hydrochloride (Phenergan)
  • Diazepam (Valium)

Prognosis of Vertigo

The prognosis depends on the causes of vertigo. If it occurs due to problems in the inner ear, drugs and exercises are the main treatments available. Symptoms can be incapacitating while they last but may completely go away with treatment or at least make it tolerable. If vertigo is due to problems with the central nervous system, it will require surgery or drugs to correct it. Recovery depends on the extent of damage done to the nervous system.

Symptoms of Vertigo

  • Vomiting
  • Excessive perspiration
  • Nausea
  • Blurred vision
  • Difficulty in speaking
  • Lower level of consciousness
  • Unsteadiness
  • Hearing loss

Differential diagnosis of Vertigo

Vertigo can be caused by multiple reasons. The most common among them are:

  • BPPV- It is one the common causes of vertigo and is typically observed when there is a change in position as the name suggests. It usually lasts for less than a minute and can be cured with the help of repositioning movements.
  • Vestibular Migraine-It is the second most common cause and occurs when there is an association between vertigo and migraines.
  • Ménière's disease usually has vertigo occurring along with it and often ends in loss of hearing with the worsening of the disease.
  • Vestibular neuritis-caused due to viral infections in the inside of the ear, it often results in lifelong balance problems.
  • Motion Sickness-It is a common symptom of vertigo usually seen in people with ear infections. Dizziness and feeling lightheaded are the symptoms involved. Sometimes the eyes jerk very fast to one side. Symptoms disappear if the person sits still with eyes closed.

Exams and tests for Vertigo

  • Vestibular system function tests – ENG (Electronystagmography), Rotation tests, Caloric Reflex test, Rotation tests, CDP (Computerized Dynamic Posturography)
  • Auditory system function tests - Pure-tone Audiometry, Acoustic-reflex, ECoG (Electrocochleography), Speech Audiometry, OAE (Otoacoustic Emissions), ABR (Auditory Brainstem Response test)
  • Other tests for diagnosis – MRI (Magnetic Resonance Imaging) and CAT or CT (Computerized Axial Tomography)

Treatment for Vertigo

Treatment for vertigo depends on the cause.

  • Infection of the middle ear usually requires antibiotics.
  • Meniere's disease is treated based on the symptoms. In addition to this they may have to follow a low salt diet and take medication to increase urine output.
  • Repeated infections that cause holes in the inner ear will require corrective surgery.
  • Benign paroxysmal positional vertigo can be treated with the epley maneuver in addition to the prescribed drugs.
  • Anticholinergics and antihistamines are also commonly used for vertigo treatment.

Types of Vertigo

It can be classified into two depending on where the dysfunction is located.

  • Peripheral-When the problem occurs in the inner parts of the ear or sensory system it is known as otologic, vestibular or peripheral. BPPV (Benign paroxysmal positional vertigo) is the most common cause. Superior canal dehiscence syndrome, Ménière's disease, visual vertigo and labyrinthitis are the other causes.
  • Central- When the parts of the brain which controls balance causes vertigo, it results in neurological deficits like slurred speech, pathologic nystagmus or double vision. It can create a sense of disequilibrium. Migraine headaches, multiple sclerosis, lateral medullary syndrome and other conditions which engages the central nervous system can also cause vertigo.