24/09/2024
WHAT IS VERTIGO???
Vertigo is a false sensation that makes you or your surroundings seem to spin. While intensities vary, it is a condition that can hinder a person in their daily activities. It is a feeling that usually worsens when the person is moving their head. It is commonly described as dizziness or dizzy spells.
Primarily, there are two types of vertigo (Marks, 2021):
1⃣Peripheral vertigo: This type of vertigo is caused by problems in the inner ear area or the vestibular nerve (a connection between the inner ear to the brain). This is the most common type of vertigo.
2⃣Central vertigo: This type of vertigo happens when there is a glitch in the brain. This usually occurs in the cerebellum portion.
Causes & Triggers of Vertigo
There are various factors that can incur vertigo in persons. Possible causes and triggers are as follows:
🔹Benign paroxysmal positional vertigo (BPPV): This is the most frequent cause of vertigo. BPPV is an inner ear disorder where changes to the head’s position can cause vertigo. People with BPPV usually experience it when leaning back, turning over or sitting up.
🔹Meniere’s disease: This is a disease of the inner ear that can influence balance and hearing. Usually, it is only present in one ear. It can cause dizziness, a feeling of spinning, ringing, varied hearing loss and a feeling of fullness.
🔹Labyrinthitis: When the inner ear labyrinth is inflamed or infected, the transmission of information to the brain is muddled. Sounds, position and head motion are among the information affected. This leads to experiences of headache, ear pain, vision issues, tinnitus or hearing loss.
🔹Vestibular neuritis: While similar to labyrinthitis, this is an inflammation of the vestibular nerve. It does not affect the person’s hearing but it causes vertigo. Other side effects could be blurred vision, nausea, or a feeling of being off balance.
🔹Cholesteatoma: An abnormal, non-cancerous growth that forms behind the eardrum. This can occur after multiple instances of ear infections. Cholesteatoma can develop large enough to affect hearing and balance.
Vertigo Diagnosis
Vertigo can be diagnosed in several methods. Your signs and symptoms will indicate to your doctor on which tests to run or prioritise. Some of the tests may be as follows:
🔸Fukuda-Unterberger’s test: You’ll be allocated in a spacious room. A small piece of tape or similar will be placed on the floor in front of your toes to mark your starting position. You’ll be asked to close both eyes, hold your arms outstretched in front of you, and march in place for 30 seconds. If you tilt or lean towards one side, it could indicate inner ear problems, resulting in vertigo.
🔸Romberg’s test: For this test, you’ll be ask to stand with your two feet together (shoes removed). Arms are to be placed next to the body or crossed in front. The medical advisor will ask you to first stand with eyes open, and subsequently with eyes closed. This test is scored by counting the seconds that you are able to stand with eyes closed. If you feel unbalanced or unsteady, you may have issues with your central nervous system.
Head impulse test: This is a quick test to assess the ability to keep your eyes focused on the target even when your head is tilted by the examiner. Targets may be the examiner’s nose or a spot on the wall. Your inner ear balance system will be checked on how it works to control your eye movement when your head is moving.
Vestibular test battery: During this session, the audiologist may perform any of the following tests (this list is not exhaustive).
Videonystagmography (VNG): Provision of information on how certain parts of the inner ear system and eye reflexes are working. It is a test that requires you to wear goggles to monitor eye movement.
Rotary chair: Provision of information on how the inner ear balance system is working. You’ll be asked to answer questions with eyes opened, while the chair sways to the right and left.
Modified clinical test of sensory interaction on balance (mCTSIB): This lets your provider know how vision, sense of touch in your feet and inner ears are contributing to the dizziness. You’ll be asked to stand on a firm and foam surface. Your job is to stay as steady as possible in the given positions.
Risk of falls assessment: Evaluates factors that could foresee which people are likely to experience future falls and injuries.
Aside from these, radiographs may be requested. Examples of these would be CT (computed tomography) scans and magnetic resonance imaging (MRI).
Medication: Treating the condition that caused vertigo as a side effect can reduce its severity. This may mean having your healthcare provider to prescribe antibiotics or steroids. Other effects such as nausea or motion sickness can also be subsided by medication.
Vestibular rehabilitation: This physical therapy may assist in alleviating symptoms if vertigo is the result of an inner ear problem. It is an exercise-based program to improve balance and reduce dizziness-related issues.
Canalith repositioning procedure (CRP): As BPPV is caused by the displacement of tiny crystals of calcium carbonate (known as canalith) in the inner ear, this is a method to remove these trapped particles and reposition them into a suitable area for reattachment, dissolvent or breaking up.
Surgery: If vertigo is caused by a critical illness, surgery may be necessary to treat the overall condition.
