Vertigo: What is it, its symptoms, what causes it and how to cure it.

Vertigo is common in society.

Vertigo is common in society. However, there is a lot of inaccurate information circulating in the society about the definition and treatment of vertigo. What is vertigo and what causes it? How is vertigo treated? You can find the answers to all these questions in the rest of the article.

What is Vertigo?

Vertigo is a form of dizziness in which a person perceives things around them as if they are spinning. Rather than being a disease, vertigo is a symptom common to many different diseases. Disorders in the inner ear, brain and nerve pathways between these two can cause vertigo.

Vertigo can be a temporary condition or it can affect the person for a long time.

Vertigo can be divided into different groups:

• Peripheral Vertigo: Peripheral vertigo is seen in approximately 80% of total vertigo cases. Peripheral vertigo usually occurs as a result of a problem with the inner ear. Small organs in the inner ear are responsible for sensing gravity and sending information about the person’s position to the brain. Thanks to this connection, people can maintain their balance while standing. Any problem in this connection results in vertigo.
• Central (Central) Vertigo: Problems with the brain stem or cerebellum, that is, the central nervous system, cause central vertigo. The proportion of central vertigo cases among total vertigo cases is approximately 20%.

What are the symptoms of vertigo?

People with vertigo perceive themselves or the people around them as if they were spinning or moving. Although vertigo itself is a symptom, it may accompany some other symptoms. Some of the symptoms that may occur with vertigo:

• balance problems
• Dizziness
• Feeling sick (motion sickness) with movement
• Nausea, vomiting
• Ringing in the ears (tinnitus)
• Feeling of fullness in the ear, ear congestion
• Headache
• Uncontrolled flickering of the eyes to one side, resembling a tremor, nystagmus

What Causes Vertigo?

Vertigo occurs due to a disorder in the structures in the inner ear that are responsible for balance or a problem in the central nervous system. Disorders that cause vertigo can be listed as follows:

• Labyrinthitis: There is a structure in the inner ear called the labyrinth, where the vestibulocochlear nerve responsible for hearing and balance is located. Labyrinthitis is inflammation of this structure as a result of infection. This inflammation in the inner ear impairs the function of the vestibulocochlear nerve. Damage to the vestibulocochlear nerve, which has many functions such as head movements, body position and hearing, causes disruptions in message transmission to the brain. As a result, people suffering from labyrinthitis may show some of the symptoms ranging from vertigo to hearing loss, headache to tinnitus.
• Vestibular Neuritis: Inflammation of the vestibular nerve is called vestibular neuritis. Although this disease is similar to labyrinthitis, the person’s hearing is not affected in vestibular neuritis. In patients with vestibular neuritis; Symptoms such as vertigo, blurred vision, severe nausea, loss of balance, and falling may occur.
• Cholesteatoma: Cholesteatoma is a noncancerous mole-like structure that develops in the middle ear, usually due to recurrent infections. As the cholesteatoma grows behind the eardrum, it can damage the bone structures in the ear, causing problems such as hearing vertigo and hearing loss.
• Meniere’s Disease: Meniere’s disease is a disease that occurs due to fluid accumulation in the inner ear and causes vertigo attacks. In addition to vertigo, people with Meniere’s disease may also experience symptoms such as hearing loss and tinnitus. This disease is most common in people between the ages of 40-60. How Meniere’s disease develops has not yet been fully elucidated. It is thought that the disease may be caused by narrowing of blood vessels or autoimmune. There are findings showing that infection and genetic predisposition may also play a role in the development of the disease.
• Benign Paroxysmal Positional Vertigo (BPPV): In the inner ear, there are structures containing fluid and calcium carbonate crystals known as otolith organs. In BPPV, calcium carbonate crystals come out of where they should be and fall into the semicircular canals. These crystals falling into the semicircular canal touch the sensory hair cells in the canal with every movement. Due to this incorrect placement of the crystals, the brain cannot receive accurate information about position and movement from the ear. In this case, it causes dizziness and vertigo. In BPPV, patients experience vertigo attacks that usually last less than 1 minute. However, symptoms such as nausea may also occur in these patients.

Some other conditions that cause vertigo are as follows:

• Migraine
• head injury
• ear surgery
• Perilymphatic fistula (ear fluid flowing towards the middle ear as a result of the rupture of the membrane between the inner ear and middle ear)
• shingles
• Otosclerosis (growth of bones in the inner ear)
• syphilis
• Ataxia
• Stroke
• Diseases involving the cerebellum or brain stem
• acoustic sound
• Multiple Sclerosis (MS) disease

How is Vertigo Diagnosed?

A detailed medical history is taken from people who consult a doctor to diagnose vertigo. Thus, possible causes of the patient’s dizziness are tried to be determined. To detect conditions that may cause dizziness, imaging methods such as examination, blood test, ultrasound or MRI can be used.

Some of the frequently performed neurological examinations in patients presenting with dizziness are as follows:

• Examination of eye movements called nystagmus
• head shake test
• Romberg Test: The doctor tells the patient to stand up and stand upright. Then he asks the patient to put his feet together and close his eyes. The patient’s loss of balance after closing his eyes indicates that the patient may have a problem with the central nervous system.
• Fukuda-Unterberger Test: In this test, the patient is asked to pretend to walk in place for 30 seconds with his eyes closed. If the patient turns to one side when stopped, this may indicate that the patient has a problem with the inner ear.
• VNG test, which is becoming widespread today: evaluation of eye movements and visual muscle movements with the help of glasses and a computer.
• Evaluation of eye movements using caloric tests and VNG device.

What are the symptoms that occur with vertigo?

Vertigo is a problem that is more common in pregnant women than in the rest of the society. Hormonal changes during pregnancy also cause the fluid balance in the pregnant woman’s body to change. The fluid in the inner ear is also affected by this change. Therefore, problems such as vertigo, nausea, hearing difficulties, balance problems and ear fullness may occur in pregnant women due to fluid change. While complaints of nausea are more intense in the beginning of pregnancy, they decrease towards the end of pregnancy. Balance disorders increase in the second and third trimesters of pregnancy. As the person’s body adapts to fluid changes due to hormonal changes, a decrease in vertigo may be observed.

There are medications that help relieve many different symptoms such as nausea, vertigo, and loss of balance during pregnancy. However, pregnant women must consult their doctor before using these drugs and start taking appropriate medications after receiving the doctor’s approval.

What Should Be Done in a Vertigo Attack?

In some cases, vertigo goes away on its own without the need for treatment. However, in order to permanently correct vertigo, the condition that causes this condition must be eliminated.

Antibiotics can be used to treat vertigo caused by infection, or antiviral medications can be used to treat vertigo caused by shingles.

Antihistamine or antiemetic (anti-nausea) medications may be given to the patient to relieve symptoms such as nausea, vomiting, and motion sickness that may occur with vertigo.

Surgical procedures may also be preferred in the treatment of vertigo when other treatment options do not work. BPPV and acoustic neuroma are two conditions for which surgery is appropriate to treat.

Loss of balance and dizziness complaints in vertigo patients can lead to serious injuries. Therefore, vertigo is a condition whose diagnosis and treatment should not be neglected. Finding and treating the underlying cause of vertigo protects the person from possible risks such as falling and improves the person’s quality of life.