Vertigo
Last Edited: April 10th, 2012

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Vertigo

What is Vertigo?

Vertigo is a condition in which the sufferer feels the sensation of movement even though he or she knows that they are standing, sitting, or lying still. Medical practitioners recognize three “subtypes” of vertigo based on how the sufferer perceives motion relative to his or her environment:

  • The victim feels that they are motionless while it is their environment that is moving
  • The victim feels as if they are moving and their environment is standing still
  • Both the sufferer and the environment are standing still but the sufferer senses a psychological felling of motion

What Are the Causes of Vertigo?

Vertigo is among the most frequent complaints to confront medical practitioners. It is a relatively rare complaint in children but seems to increase with age. The most common causes of vertigo are simple positional vertigo (vertigo that occurs when abruptly changing from a lying or sitting position to standing) and the vertigo associated with the common cold. Less common causes of vertigo include vestibular migraine, a form of migraine headache; vestibular neuritis, an inflammation of the auditory (hearing and balance) nerve and Ménière's disease, a rare condition that causes almost continuous periods of disabling vertigo.

How is Vertigo Diagnosed

Vertigo is usually diagnosed based on the sufferer's reported symptoms. If, however, the vertigo is recurrent or unusually persistent, the health care provider may order a series of diagnostic tests and examinations to rule out medical conditions that may induce vertigo. These tests and/or examinations may include:

  • CBC and Biochemical profile
  • Glucose Tolerance Testing to exclude hypoglycemia
  • ”Tilt-Table” Testing
  • EKG
  • EEG, to exclude atypical or petit mal seizures
  • MRI, to exclude organic brain disease such as tumors, nerve lesions, or enlarged ventricles

What is the Prognosis of Vertigo

Vertigo is best thought of as a symptom rather than a disease. As such, many sufferers will either simply “outgrow” their symptoms or have such symptoms disappear when the underlying cause is successfully treated. The rarer conditions, being more difficult to treat, carry a less-favorable prognosis.

How is Vertigo Treated?

In most cases, the cause of vertigo is apparent and will usually resolve of its own accord (“it will go away over time”). The most common medications used in simple, uncomplicated, vertigo are antihistamines (Benadryl, etc), anticholenergics (Dramamine), as well as anti-nausea/anti-vomiting medications such as Compazine and Emetrol. Antibiotics may be indicated if an infection involving the middle ear is suspected.

As to the rarer conditions that may cause vertigo, in addition to the above-mentioned medications vestibular neuritis and vestibular migraine may respond to Non-Steroidal Anti-Inflammatory Drugs such as ibuoprofin or even low-dose oral steroids. Ménière's disease is much more difficult to manage, although avoidance of alcohol and tobacco have been proven to reduce the number and severity of episodes of this condition. There have been some reports that allergy desensitization may be of value in Ménière's disease.

Summary

Vertigo is, in the majority of cases, an annoying symptom rather than a disease. Although there are serious conditions that may be associated with vertigo, these are relatively rare and their diagnosis is best left to qualified medical practitioners. The various medications used in the treatment of vertigo are mentioned, and the prognosis is discussed as being favorable in the majority of cases.