Dizziness is usually described as variety of sensations, which comprise of a feeling of faintness, unsteady, weak, light headed, giddy or woozy. When dizziness causes a false feeling of spinning and the moving surroundings is known as vertigo.

Dizziness can be one of the most common reasons for a visit to the doctor. However, constant feeling of dizziness can affect a person's life drastically, but it is rarely life threatening. The treatment of dizzy sensation and dizziness mostly depends on the symptoms.

Causes of dizziness
The common causes of dizziness are medication, motion sickness and ear problems, especially disturbances of the inner ear. An injury, infection or poor blood circulation can also lead to dizziness. The triggers of dizziness and the sensations it provides are used to evaluate the cause. Also, the duration of the dizziness and the symptoms lead to a clue towards the cause of the same.

Dizziness caused by the inner ear problems
The balance of the body depends on the combined effort of many parts of the sensory system. These are:

1. Sensory nerves: these send messages to the brain in regard to the body positions and its movements
2. Inner ear: the inner ear has the organ of corti which are responsible for detecting the motions and thereby help in the balance of the body.

In vertigo a person might feel that the things around them are moving, thus creating a swaying or a spinning motion. Vertigo is usually caused by the problems of the inner ear. 

The common causes are:

1. Benign paroxysmal positional vertigo (bppv), this happens when the calcium particles accumulate in the inner ear canals. The inner ear is responsible for the body movements and balance.

2. Meniere's disease, a problem of the inner ear mainly caused by the build up of the fluids, thereby leading to a change in pressure. This causes vertigo along with hearing loss and tinnitus.

3. Vestibular neuritis is the problem of the inner ear and is largely due to infection. Infection leads to swelling of the nerves of the inner ear which affect the body movements.

Treatment of vertigo includes:
1. Rehabilitation of the vestibular system by physical therapy in order to strengthen it.
2. Canalith repositioning by suggesting some body and head movements basically for bppv. These movements help to move the calcium deposits from the inner ear canals to one of the chambers, which are further absorbed by the body. When the canaliths (calcium deposits) move, it might give rise to vertigo.
3. Medicines are given to relieve symptoms of motion sickness and nausea. Antibiotics can be taken in case of infection and swelling.
4. Surgery in some cases.

Dizziness and Ear Problems

Vertigo refers to dizziness, or spells of dizziness, or rotational dizziness, which can be short term or long term. It is a general symptom for a variety of conditions of the brain, inner ear, sensory nerve pathway, and other sensitive organs. Vertigo has the capability of hampering the day to day functioning of the person. Furthermore, due to these reasons, it has the potential to cause anxiety and depression.

Types of Vertigo & Diagnosis:

Vertigo can be categorized into two major types based on the underlying cause:

1. Peripheral Vertigo: It is said to occur if it is related to the problems of the inner ear, such as its inflammation or an infection in its tiny parts or displacement of tiny particles present in the inner ears.

2. Central Vertigo: It is said to occur if it is related to the problems of the brain (the Central Nervous System) or the sensory nerve pathways.

Vertigo can be diagnosed by physical examination, assessing the medical history followed by undergoing a CT scan or an MRI, as required.

Treatment:

It is important to essentially understand the root cause of the condition and then treat that accordingly for best results.

1. A bacterial infection can be addressed through antibiotics.

2. Nausea and motion sickness can be reduced by using anti-emetics and antihistamines.

3. Sometimes, for patients with intractable Benign Paroxysmal Positional Vertigo (BPPV), surgery is performed to block the area triggering Vertigo.

4. Exercises can also help in managing the milder symptoms of Vertigo without visiting to the doctor for the same.

5. Most of the time, in case of BPPV, physiotherapy is the recommended treatment.

6. Certain lifestyle changes and precautions can be adopted to avoid conditions that trigger Vertigo.

7. Vestibular Rehabilitation Therapy goes a long way in managing Vertigo.

Vestibular Rehabilitation Therapy (VRT) for Managing Vertigo:

Vestibular Rehabilitation Therapy, abbreviated as VRT, is a program based on exercise that promotes the retraining of the Central Nervous System and repositioning of the free flowing particles in the fluid present in the inner ear. This helps in treating the condition of the inner ear for managing Vertigo. Its application is based on scientific research and evidence. The major goal of this type of treatment is to let the brain establish coordination again with the inner ear, with eye, and with the proprioceptive system for processing information.

The proprioceptive system consists of the sensory receptors which respond to pressure and stretch. Hence, VRT is effective in improving the diminishing quality of life due to Vestibular Disorders like Vertigo, by addressing both, the primary as well as secondary consequences of the condition. Over a period of time, when the patient becomes sufficiently trained under professional guidance, VRT can then be carried out at home at prescribed intervals based on the specific requirement.

Methods for VRT-

Depending on the clinical examination, the three major methods of exercise for Vestibular Rehabilitation Therapy can be prescribed, as described below:

1. Habituation exercises are prescribed for those patients who experience dizziness by movement and by visual stimulation.

2. Gaze Stabilization exercises are prescribed for those patients who experience uncontrolled eye movements leading to unclear vision.

3. Balance Training exercises are prescribed for improving steadfastness, to prevent falling, and to restore balance during performing activities like bending, standing and turning, reaching, walking, and running for helping patients return to their daily lives confidently.

Take Away:

Vertigo is the vestibular condition of dizziness that can be managed through methods like Vestibular Rehabilitation Therapy for re-training the brain to coordinate with the affected organs. It helps in restoring the quality of life. VRT is mainly practiced through habituation exercises, gaze stabilization exercises, and balance training exercises.

Managing Vertigo Through Physiotherapy And VRT!

Vertigo is a feeling that your head or your surrounding is spinning. It is an illusion of movement. People with vertigo cannot bend down to pick up stuff, as they may feel the spinning sensation.
There are two types i.e. objective and subjective. Vertigo is said to objective when the surrounding seems to be spinning; subjective is when the person feels their head is spinning. Vertigo can be slightly mysterious to diagnose. There are, however, some causes which can help you understand it better. There are two main types of vertigo: Central and Peripheral. Central vertigo is when there is an issue in the brain that is causing vertigo. Middle ear problems leading to vertigo is known as peripheral vertigo.

Central vertigo:

Paroxysmal positional vertigo (BPPV): Also known as, Benign paroxysmal positional vertigo (BPPV). These episodes are benign and occur in paroxysms or spurts. The person will feel the attack with simple actions like turning over in bed. They do not last long, often about 20 to 30 seconds.
Migraine: Known for the severe headaches, migraine can also cause vertigo.
Head trauma: This type of vertigo usually subsides with time as the person recovers from trauma.
Neck injuries: Injury to nerves and blood vessels in the neck can also lead to vertigo.
Health conditions: General health issues like arteriosclerosis, multiple sclerosis, and diabetes lead to vertigo.
Stroke or blood flow blockage: When blood does not reach the base of the brain, it can result in vertigo.
Peripheral vertigo:

Middle ear infections: Labyrinthitis (either bacterial or viral) a middle ear infection can cause vertigo. Common viruses include herpes, influenza, measles, rubella, hepatitis, and EBV.
Meniere s disease: Another ear problem causing vertigo is Meniere s disease. This is known for its 3 symptoms   vertigo, ringing in the ears (tinnitus) and hearing loss. This can be caused by various factors, some of which can include ear infections, head injuries, or heredity. The exact cause of the condition is not established clearly.
Acoustic neuroma: A tumor of the nerve tissue in the inner ear may cause vertigo. The person can also have hearing loss and ringing sensation.
Other causes of vertigo include:

Pregnancy: During the first trimester, in particular, the various hormonal changes can cause vertigo. The expanding uterus puts pressure on the blood vessels, leading to reduced blood supply to the brain, which can also induce vertigo. As the baby continues to grow, lying on the back can put pressure on the blood vessels to the heart, causing vertigo.
Stress: It is known to worsen vertigo, which a person may already have. Anxiety and panic attacks are known to worsen vertigo.
Travelers: Be it ship, air, or train, some people experience a spinning sensation with any form of travel.


Vertigo In Adults - Why It Happens?

BPPV or Benign paroxysmal positional vertigo is a major cause of vertigo. This is a condition that gives a sensation of head spin all of a sudden. It also results in dizziness in brief episodes. The severity level can vary from intense to mild. BPPV is triggered with certain changes of the head position. Although BPPV is bothersome, it isn t serious unless there is a chance of a person falling abruptly because of the head spin. There are ample treatment options available to address this problem.

Symptoms of BPPV
BPPV includes some of the following symptoms:
a. Loss of balance
b. Dizziness
c. Feeling of the surrounding spinning
d. Vomiting and nausea
e. Rhythmic movement of the eye

When to seek medical attention?
If dizziness is accompanied with one of the below-mentioned symptoms, it is time to urgently seek medical attention and get vertigo addressed for good:

Hear loss
Tingling or numbness
Fever accompanies with severe headache
Arm or leg weakness
Problems with vision
Difficulty in walking
Becoming unconscious
Causes of BPPV:
If there is on known cause associated with BPPV, the condition is termed as idiopathic BPPV. In most of the cases, though, BPPV is associated with a severe to minor blow to the head. Other causes include an injury to the inner ear, prolonged sitting position in a fixed posture, even migraine pain is at times associated with BPPV.

What are the risk factors?
Benign paroxysmal positional vertigo is likely to occur in the age group of 50 and above, this being said it can happen at any age in case of any injuries. Statistically, it is found that the likelihood of BPPV is more in women than men. Head injury of any sort is by far the most likely reason of BPPV.

What are the tests and diagnosis involved?
A doctor is likely to perform a physical examination followed by a series of tests. Some typical signs that a doctor looks for include the following:
Ability to control eye movement- especially side to side movement

Symptoms of dizziness
In case it is difficult to spot the symptoms, a doctor might suggest video- nystagmography or electronystagmography. It helps to track irregular eye movement. An MRI can also be prescribed to study the cross-sectional images of the body and the head.

Treatments associated with BPPV:
BPPV mostly go away within months or weeks on its own. If however, it still persists, a doctor can suggest Canalith Repositioning- series of small movements that helps to counter BPPV. For extreme cases, a doctor might advise a surgery for blocking the portion of the inner ear that might be causing the problem. It guarantees close to a 100 percent fix to BPPV.

Vertigo / Dizziness - When To Seek Medical Attention?

Acoustic neuromas are tumors that develop on the nerves connecting the ear to the brain. Being non-cancerous in nature, they do not spread to other parts of the body. However, they are characterized by symptoms such as gradual or sudden hearing loss, more pronounced with either of the ears, a ringing sensation in the affected ear, weakness, facial numbness and dizziness.

Causes:

Acoustic neuroma can be of two types: one is sporadic in nature and the other is associated with a condition known as neurofibromatosis type II (NF2). NF2 is basically an inherited disorder identified by benign growth in the nervous system. NF2 being a rare disorder, makes the sporadic type the dominant one. Although the causes behind this type of neuroma are still unknown, long term exposure to radiations, especially around the neck and the head, could be one of the most important triggering factors.

Treatments:

Once the diagnosis is done, treatments for acoustic neuroma depend on the growth and size of the tumor.

Diagnosis with the help of monitoring: Small tumors exhibiting no such symptom or slow signs of growth need to be monitored with the use of hearing tests and regular imaging. In case, the MRI scans are able to trace any sort of development on the part of the tumor or if the tumor poses subsequent difficulties, opting for treatment becomes the need of the hour.

Stereotactic Radiosurgery: Also known as Gamma Knife, radiosurgery is a treatment method wherein controlled radiations are used to treat tumors, thus doing away with the need of making any incision.

Surgical Removal: Surgery performed under general anesthesia is directed towards removing the tumor; that helps to preserve the facial nerve and thus inhibit facial paralysis and hearing loss. The tumor is usually removed either through the ear or through the skull.  

Experiencing Dizziness? It Could Be A Sign Of Acoustic Neuroma

Vertigo is a medical condition where the affected person feels that the world or surrounding environment is spinning or moving. It is accompanied with nausea, vomiting, sweating and having problems in walking steadily. Moving your head worsens this condition. An illusion of movement is observed.

Vertigo arises from several conditions. There are mainly two types of Vertigo-

Peripheral Vertigo: This is the most common vertigo and is caused often due to a problem in the balance mechanism of the inner ear. The causes include:

Benign Paroxysmal Positional Vertigo: Being one of the common causes of vertigo, BPPV occurs due to certain head movements when standing up or bending over. The attacks are short, powerful and recurrent in nature. Nausea is also accompanied. A feeling of lightheadedness and despaired balance is observed after the attack. Fragments of calcium carbonate crystals are broken off from the channel linings present in the inner ear. These fragments cause the problem by getting into the ear fluid canals, and certain head movement sweeps them across the canal causing vertigo.

Head Injury: Vertigo develops due to head injuries, and the symptoms are similar to that of dizziness.
Labyrinthitis: It is an infection in the inner ear, which causes the labyrinth of the ear to get inflamed. The labyrinth controls our hearing and balance. An inflammation causes it to send different information than the other, normal ear. This conflict causes vertigo. Such vertigo can be accompanied by nausea, vomiting, loss of hearing and ear pain.

Vestibular Neuronitis: This is a condition pertaining to the inner ear, which causes inflammation of the nerve which connects the labyrinth to the brain. The condition arises from viral infections. Nausea and vomiting are observed, and this condition leads to vertigo.

Meniere's Disease: This rare condition in the inner ear causes severe vertigo along with hearing loss and aural fullness. Meniere's disease prompts sudden vertigo attacks with nausea and vomiting.
Central Vertigo: Central vertigo arises from problems in the cerebellum of the brain and brainstem. Causes include:

Migraines.
Sclerosis, a condition which affects the central nervous system.
Acoustic neuroma, a type of brain cancer growing on the acoustic nerve.
Brain tumors, stroke or transient ischemic attack.
Certain medications.
Treatment-
Treatment of vertigo depends on the cause and on the extent of symptoms. Labyrinthis and vestibular neuronitis are cured by vestibular rehabilitation and medication. BBVV is treated using a process called the Epley maneuver. Meniere's disease is cured by modes of dietary restriction, medication, treating tinnitus and treating hearing loss. Generally, curing the cause of vertigo helps in healing the disorder.

Vertigo is caused by different reasons and factors and rectification of these factors helps in the treatment of vertigo.

Vertigo: Causes and Treatment

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