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!

Are you feeling lightheaded, unbalanced or woozy lately? Are you having strange sensations in the ears and eyes? These indicate that you are suffering from dizziness, a condition affecting the body s sensory organs. It can cause fainting at times as well. It is not a disease, but a symptom of several disorders. Dizziness is caused by inner ear disturbances, effects of medication, motion sickness and underlying health conditions, such as poor blood circulation, infections or injuries.

Test and diagnosis
If you feel dizzy for a prolonged period of time or if the dizziness occurs and reoccurs, a special treatment is required. This is because dizziness may make you prone to several risks in everyday life. Several tests are carried out to find out the cause of the dizziness. If a stroke is suspected, an MRI scan or CT scan is carried out. A physical examination is undertaken in which the way you walk and balance are observed and the nerves of the central nervous system are checked. Hearing and balance tests may also be required, which are as follows:

Eye movement testing in which the path of the eyes is observed while tracking an object in motion. An eye motion test may be given where cold and warm water is placed in the ear canal.
Head movement tests are carried out when benign paroxysmal positional vertigo is suspected.
Treatment
Treatment of dizziness includes medicines, therapies and balance exercises.

Medicines

Water pills are prescribed when a patient has Meniere s disease, which helps in reducing dizziness.
Antihistamines provide temporary relief from dizziness.
Therapy

Head position maneuvers: A technique known as canalith repositioning helps in resolving dizziness quickly. It can be performed by a doctor, therapist or audiologist. The position of the head is maneuvered in the process.
Balance therapy: Several exercises help in making the body s balance system lesser sensitive to motion. This technique, known as vestibular rehabilitation, is used for people suffering from dizziness due to inner ear conditions.
Psychotherapy: This therapy may be used for patients who experience dizziness because of anxiety disorders.
Use of antibiotics: An antibiotic by the name of gentamicin may be injected in the inner ear for disabling the balance function. The unaffected ear performs that function.
Other procedures: A procedure known as labyrinthectomy may be used for disabling the vestibular labyrinth in the affected ear.
If you experience dizziness continuously, it is important for you to visit an ENT specialist. An ENT specialist deals with problems related to the ear, nose and throat and will be able to provide you with the best diagnosis and treatment for dizziness.

Dizziness - Can it be a Sign of Ear Disturbance?

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

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?

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

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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