What is vertigo?

Vertigo, or dizziness, is a symptom, not a disease. The term vertigo refers to the feeling of spinning, unsteadiness or whirling that happens as a result of a disturbance in balance. There may be two different feelings, namely:

• • Feeling of movement of oneself, called subjective vertigo

• • Feeling of movement in nearby objects, called objective vertigo.

Causes

Vertigo usually results from a disorder in the structures of the inner ear (the peripheral vestibular system). Dizziness may also occur as a result of a disorder in the balance centre of the brain (central vestibular system). Consumption of too much alcohol beverages can also cause vertigo. In some cases, the cause of vertigo is unknown.

Disorders and symptoms

Sudden vertigo may indicate peripheral vestibular disorders, such as:

• • Benign paroxysmal positional vertigo (BPPV)

• • Cogan’s syndrome

• • Ménière disease

• • Ototoxicity (ear poisoning)

• • Vestibular neuritis.

If you experience any of the following symptoms, you may have a peripheral vestibular disorder:

• • Lightheadedness and imbalance

• • Blurred vision

• • Fatigue and reduced energy

• • Headache

• • Heart palpitations

• • Inability to concentrate

• • Motion sickness

• • Muscle ache (especially of the neck and back)

• • Nausea and vomiting

• • Reduced thinking and memory ability

• • Sensitivity to bright lights and noise

• • Sweating.

Vertigo caused by a central vestibular disorder usually develops gradually. In addition to vertigo, central vestibular disorders (e.g. stroke or migraine) may cause the following symptoms:

• • Double vision

• • Headache

• • Inability to speak due to muscle weakness

• • Lack of coordination

• • Nausea and vomiting

• • Weakness.

Severe vertigo can be disabling and may result in complications such as irritability, loss of self-esteem, depression and injuries from falls. Falls are the leading cause of serious injury in people over the age of 65.

Treatment

Treatment for vertigo depends on the underlying cause and most causes are easily treated. Consult your doctor if you experience symptoms of vertigo.

If vertigo is caused by bacteria, it may be treated with antibiotics or an operation in the case of chronic ear infections. In this procedure an incision is made in the eardrum and a small tube (grommet) is placed in the opening to prevent fluid and bacteria from building up inside the ear.

In vestibular rehabilitation therapy (VRT) physical exercises are used to treat vertigo. The aim of treatment is to improve balance and prevent falls by restoring normal function of the balance centre of the inner ear. Through these exercises, the brain adapts to and compensates for whatever is causing the vertigo. The success of this treatment depends on several factors including the following:

• • Age of the person

• • Thinking and memory ability

• • Coordination and muscle control

• • Overall health of the person

• • Physical strength.

Other conditions that may cause vertigo can also be treated with medication, for example Ménière disease and migraine.