Vertigo is a type of dizziness that causes a sensation of movement when standing still. It can be divided into two types, peripheral and central, and can be caused by problems with the inner ear, infections, medication, or brain damage. Treatment depends on the underlying cause. Benign paroxysmal positional vertigo is a common form that can be treated with exercises or surgery. Meniere’s disease can cause dizziness, hearing loss, and a feeling of fullness in the ear and is treated with a low-sodium diet, diuretics, and medication. Central vertigo is caused by an injury or problem with the central nervous system and can be caused by tumors, strokes, or degenerative diseases.
Vertigo is a form of dizziness that causes a sensation of movement when standing still. At times, it may feel like the affected person or the room is rapidly spinning or swaying. This feeling can cause a person to lose their balance temporarily, and some people feel nauseous and vomit during or after an episode. Vertigo is usually divided into two different types, peripheral and central, depending on the origin of the sensation.
Peripheral vertigo
Peripheral vertigo occurs when there is a problem with the vestibular system. These are the organs and structures that help a person know their position in space, detect head movements, and enable the person to maintain balance. The vestibular nerve sends signals from the vestibular system to the brain.
Within the vestibular labyrinth, an organ in the inner ear, are structures called otolithic organs and fluid-filled semicircular canals that detect movement and allow the brain to determine the position of the head relative to the ground. The otolithic organs contain calcium crystals that make people sensitive to gravity and motion. Problems with the inner ear, such as inflammation from illnesses like the flu or a cold, can disrupt this system and cause dizziness.
Benign paroxysmal positional vertigo
Benign paroxysmal positional vertigo (BPPV) is one of the most common forms. It is characterized by brief bouts of dizziness, typically when there are sudden changes in the position of the head, such as when a person tilts their head up or down or sits up in bed. A person with BPPV may have difficulty with balance when standing or walking, with feelings of dizziness ranging from mild to severe. BPPV, while distressing, is not a serious condition and is usually treated with exercises to move the head and remove the crystals that are causing the problem. In some cases, surgery may be required.
Often there is no specific cause of BPPV, although the vestibular labyrinth plays an important role. If crystals move from the otolithic organs into the semicircular canals, they can become very sensitive to changes in the position of the head. This movement can be caused by a blow to the head, but often has no clear reason. Some migraine sufferers are also diagnosed with BPPV, although it’s not clear whether there is a connection between the two.
Meniere’s disease
This disease, whose cause is not fully understood, can cause the pressure of the fluid in the inner ear to fluctuate, causing dizziness, hearing loss, and a feeling of fullness in the ear. To treat Meniere’s disease, a patient may be placed on a low-sodium diet and prescribed a diuretic to manage fluid in the inner ear, which can help reduce or lessen symptoms. Treatment often also includes medications to relieve the nausea that accompanies the episodes. In some cases, medications may be injected directly into the middle ear or surgery may be done to remove the structures causing the symptoms.
Other causes
An ear infection, cold, or flu can cause swelling in the inner ear, which can trigger vertigo. The vestibular nerve can also become infected or compressed, so that it can no longer transmit signals properly between the ear and the brain. There are some drugs that can disturb the function of the vestibular system as well. In some cases, once the illness passes or the medication is stopped, the dizziness may go away, but it may be permanent.
Central vertigo
Central vertigo is caused by an injury or problem with the central nervous system, which includes the brain and spinal cord. Often, this disorder results from lesions in the brainstem, the lower part of the brain that connects to the spinal cord. Problems with the cerebellum, the area in the lower back of the brain that plays a vital role in coordinating movement, can also cause dizziness.
Tumors or strokes can also cause brain damage leading to balance problems. Degenerative diseases, such as Parkinson’s disease or multiple sclerosis, can also cause dizziness, along with other symptoms. Treatments tend to focus on treating the cause of the damage. The brain is a very complex and sensitive organ, so this type of dizziness tends to respond slowly to treatment and isn’t always completely treatable.
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