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Vertigo

Updated: Jan 12, 2023


Vertigo is a symptom, rather than a condition itself. It's the sensation that you, or the environment around you, is moving or spinning. This feeling may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks.

Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making normal life very difficult.

Other symptoms associated with vertigo may include:

  • loss of balance – which can make it difficult to stand or walk

  • feeling sick or being sick

  • dizziness


Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you're spinning or that the inside of your head is spinning. BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head's position.

BPPV occurs when tiny calcium crystals called otoconia come loose from their normal location on the utricle, a sensory organ in the inner ear.

If the crystals become detached, they can flow freely in the fluid-filled spaces of the inner ear, including the semicircular canals (SCC) that sense the rotation of the head. Otoconia will occasionally drift into one of the SCCs, usually the posterior SCC given its orientation relative to gravity at the lowest part of the inner ear.



The otoconia will not cause a problem when located in an SCC until the person’s head changes position, such as when looking up or down, going from lying to seated or lying to seated in bed, or when rolling over in bed. The otoconia move to the lowest part of the canal, which causes the fluid to flow within the SCC, stimulating the balance (eighth cranial) nerve and causing vertigo and jumping eyes (nystagmus).


One of the most common treatments of BPPV is the Epley Manoueveure. A series of movements to get the Otoconia re seated in its correct position.


Menieres Disease/Syndrome

Ménière’s disease/syndrome is a long term, progressive vestibular condition affecting the balance and hearing parts of the inner ear. Symptoms are acute attacks of vertigo (severe dizziness), fluctuating tinnitus, increasing deafness, and a feeling of pressure in the ear.


Endolymph a fluid within the middle chamber of the Cochlea housing the Ears Scilia extends through the Semi circular canals of the Labrynth the organ of balance the build up/over production of Endolymph causes the Basilar Membrane to stretch causing Tinnitus and hearing damage usually to the lower frequency part of our hearing.

The Endolymph also rushed around the semi circular canals sending messages to the brain regarding our movement in contradiction to messages received from other parts of the body ie the eyes causing the symptoms much like travel sickness.


Treatment for Ménière's disease

There's no cure for Ménière's disease, but medicine can help control vertigo, nausea and vomiting.

The 2 medicines usually recommended by GPs are:

  • prochlorperazine, which helps relieve severe nausea and vomiting

  • antihistamines, which help relieve mild nausea, vomiting and vertigo

The aim is to get the medicine into your body as soon as possible, at the first sign of symptoms.

You may also need treatment for:

  • tinnitus

  • hearing loss

  • loss of balance (which is treated with vestibular rehabilitation)

Distress is common in people with Ménière's disease, as it's a difficult and unpredictable condition.


If you are experiencing Vertigo the best advice will always be to seek medical advice from your GP.


Sources

https://www.menieres.org.uk/information-and-support/symptoms-and-conditions/menieres-diseasehttps://www.nhs.uk/conditions/menieres-disease/

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