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 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

Benign paroxysmal positional vertigo is among the common causes of vertigo. It is the sudden sensation of the spinning of your head which occurs with the change of position of your head. It is a disorder of the inner ear. It occurs when calcium carbonate crystals accumulate in large numbers in any one of the ear canals and stimulate abnormal fluid movement in the inner ear. This sends false signals of head movement to the brain. This can also crop up post head injury. Rolling over the bed or quick head movements like when sitting up in bed can also trigger this condition. 

The common symptoms of benign paroxysmal positional vertigo are as follows: 

Vomiting and nausea. 
Vertigo Blurred vision
Intense dizziness 
Loss of balance 
Benign paroxysmal positional vertigo may be treated in the following manner: 

Medication to get relief from the spinning of your head. 
Epley's Maneuver involves transportation of the calcium particles to a different part of the ear which will no longer cause any problems. 
Brandt-Daroff exercises. 
Sometimes watchful waiting can help a person to recover without having to undergo any other treatment but it is a long process and often involves risk factors. 
Surgery: This option is used rarely when other treatments fail. 
A very important thing to remember is that vertigo can lead to falls and driving should be avoided. The patient will need support during an episode to avoid injuries.

All About Benign Paroxysmal Positional Vertigo

Dizziness, vertigo and balance issues are common symptoms and most of us may have experienced momentary symptoms. It is a sensation of feeling a movement even after the movement has stopped. For example the sensation we feel when we get off a merry-go-round or feeling butterflies in the stomach when we are on a roller coaster ride. Imagine if these symptoms are constant and start affecting our day to day activities. Even a simple task of walking can be bothersome as we may feel like our body is drifted and we cannot balance properly. We may feel a severe spinning sensation when we change position from lying down to sitting or rolling over in bed. It can also cause fear, anxiety and make us limit our movements and activities. These may cause more complications such as neck pain, headaches, body pains and depression. It is therefore very important to find out the root cause of vertigo and treat it immediately.

Dizziness is a sensation of light-headedness or unsteadiness. It can be caused heart disease, brain related causes like stroke, prolong illness, psychological issues, side effect of certain medications, blood pressure fluctuations and many other conditions. Neck stiffness, pain and weakness can also cause dizziness called Cervicogenic dizziness or Cervical Vertigo.
Vertigo is a spinning sensation or a feeling of motion when we are not moving. Its a common symptom in inner ear disorders. Some of the conditions that cause vertigo are: BPPV or Positional Vertigo, Meniere's, Labrynthitis, Vestibular Migraines, Vestibular neuritis, mal de barquement syndrome, perilymph fistula, toxicity of ears due to certain antibiotics, acoustic neuroma etc.
Balance problems or Disequilibrium means unsteadiness, imbalance or loss of equilibrium. It can occur as a primary symptom or with vertigo and dizziness.
You need to consult a Vestibular Therapist or Vertigo specialist who can diagnose your problem correctly. If you have Positional Vertigo known as BPPV then specific tests and manevers can help cure it completely. If there is inner ear disease such as Menieres disease, ear infections, labrynthitis or vestibular neuritis then proper medications prescribed by ENT specilialist and Vestibular Therapy can help you get rid of vertigo. In case the symptoms are related to Central nervous system (Brain) then promt treatment from Neurologist and Vestibular Therapist can help decrease vertigo and improve daily activities. If the symptoms are related to the neck called Cervical Vertigo or Cervicogenic Dizzienss then proper treatment of neck by a Vestibular Physiotherapist can help. Also making sure the posture is good when working on computer/laptops for prolong periods can prevent strain and reduce dizziness related to neck and back muscle tightness.

Vertigo & Dizziness - How You Can Get Rid Of It With Physiotherapy?

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?

Vertigo is that sensation when a person feels that the world is spinning around him. It is a feeling of off balance.

While having a Vertigo, people often complain about feeling dizzy, basic daily activities like walking or moving becomes really intense for them. These episodes can impact everyday life.

Is Vertigo common?

Experiencing Vertigo at least once during a lifetime is quite common. It is often seen in older people, but it can happen to anyone at any age. Women are a little more prone to experience an episode of Vertigo than men.

Types of Vertigo:

There are two major types of Vertigo:

Central Vertigo: Central Vertigo occurs when there is a sudden and temporary malfunction in the brain, precisely in an area called the cerebellum.

Peripheral Vertigo: Peripheral Vertigo occurs due to a problem in areas of vestibular nerve or the inner ear. This area connects the inner ear and the brain. Peripheral Vertigo is the most common type of Vertigo.

According to the American Institute of Balance, Peripheral Vertigo is generally a more serious and dangerous problem compared to Central Vertigo.

Recurrent Spontaneous Vertigo with Head-Shaking Nystagmus:

Recently, researchers discovered a new type of Vertigo called  Recurrent Spontaneous Vertigo with Head-Shaking Nystagmus  or (RSV-HNS).

To diagnose RSV-HNS, the patients need to sit in a room without lights. The examiner changes the position of their heads, first in forward direction, then in side to side direction for about 15 seconds. The camera records the patient s eye motions. It results in those who have RSV-HSN making an eye movement which lasts longer than the others. This movement is known as  nystagmus .

Compared to other types of Vertigo, RSV-HSN shows a more severe sensation of motion sickness. People with RSV-HSN experience things like nausea, headaches, vomiting, and an unwillingness to head motions. These symptoms can be experienced anywhere from a couple of times a week to once a year.

The reason behind RSV-HSN is still unknown. Doctors recommend that proper medication helps to improve the condition.

Treatment for Vertigo:

A major part of the treatment of Vertigo depends on the cause of the Vertigo. Often, Vertigo goes away without any treatment. The reason behind Vertigo curing itself is that people adapting to the inner ear changes and finding different mechanisms to maintain balance.

Why a neurologist is the right choice to consult for vertigo?

The patient of vertigo should not visit an ENT doctor and must consult a good neurologist as basically it's either a problem of brain or of abnormal signals from the vestibular nerve from the ear. In no way it is a problem of ear per se. A neurologist has the training and expertise to deal with it, not an ENT doc. Also, it's important to consult urgently as sometimes it can be a sign of brain stroke (specially if associated with imbalance). Importantly, to rule out brain lesions like cyst, tumor, clots and nerve infections, consulting a neurologist is the best option available.

Apart from this, these are a few treatments:

Medicines: Medication tends to give relief to symptoms like motion sickness associated with Vertigo.

Vestibular Rehabilitation: Under this treatment, doctors try to aim at the patient s vestibular strengths which send the signals to the body movement and head related to  gravity.

Canalith Repositioning Manoeuvres: In this treatment, a physical therapist suggests different head and body movements, which help to release the deposit out of the canal and into an inner ear which can be absorbed by the body. This treatment is quite effective to treat Vertigo.

Surgery: If the reason behind causing Vertigo is some serious internal problem like tumor or a head injury, then, in such circumstances, surgery is highly recommended.

Conclusion:

There are many treatments and medicines available for Vertigo. They are totally dependent upon the cause, symptoms, and condition of the patient. This is why it is important to consult a doctor or specialist for the best treatment option.

Vertigo - Know The Types & Treatment Of Them!

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