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Understanding Vertigo Symptoms, Severity and Treatment.

September 6, 2024

What are the Symptoms of Vertigo?

Vertigo causes dizziness that makes you feel like you are spinning when you are not. It most commonly occurs when there is an issue with your inner ear. But you can also develop it if you have a condition affecting your brain, like a tumor or stroke. Treatments vary and can include repositioning maneuvers, exercises, medication or even surgery.

The symptoms that occur with vertigo are different from simple dizziness. With vertigo you experience the sensation that you are moving, or that objects around you are moving, when they are not. Often it feels like spinning or swaying. Dizziness is a more lightheaded feeling.

Assessing the Severity of Vertigo is Important.

Dr. Waseem Ahmad, Hammond Henry neurologist (Geneseo Medical Group - 600 N. College Avenue, Geneseo) explains that there are specific signs or symptoms that should prompt you to seek immediate medical attention for vertigo:

  • Vomiting
  • Double Vision
  • Facial Droop
  • Facial Numbness
  • Arm or Leg Weakness

If vertigo comes on suddenly, accompanied by difficulty with speech, weakness on one side of the body, or confusion, go to the Emergency Room to get checked for a stroke.

Vertigo is diagnosed by performing a clinical exam, including discussing symptoms and medical history. Clinical tests and observations are also helpful, which include head impulse testing or the Dix-Hallpike maneuver (patients are quickly lowered from a seated position to lying down). Additional testing may be needed to diagnose vertigo, including imaging, hearing exams, and balance tests.

Neurologists use diagnostic tests to identify the cause of vertigo:

  • A videonystagmography (VNG) test evaluates eye movements and is helpful for diagnosing vertigo causes. VNG looks for a specific type of eye movement called nystagmus, which happens when eyes move uncontrollably up and down or side to side. Movements may be rapid or slow. Nystagmus can happen briefly when moving your head in certain directions. But if you get nystagmus when you’re sitting still or for long periods, it could point to an inner ear (vestibular) disorder.
  • A Magnetic Resonance Imaging (MRI) scan of the brain (with internal auditory canal protocol) may be used to help your medical provider identify possible causes for your vertigo symptoms and rule out others. It uses a magnetic field and radio waves to create images of the inside of your brain. An MRI may show fluid buildup, inflammation in the inner ear, or a growth on the nerve.

Treating the Underlying Cause is Critical for Decreased Discomfort and Long-Term Relief.

Peripheral Vertigo is the most common type of vertigo, resulting from a problem in the inner ear, or the vestibular nerve, which controls balance.

  • Benign Paroxysmal Positional Vertigo (BPPV). The most common cause, BPPV creates an intense, brief sense of spinning/moving. Episodes are triggered by a rapid change in head movement, such as a blow to the head or simply rising from bed quickly. Although bothersome, it is rarely serious, except for increased falling risk. BPPV symptoms include:
    • Dizziness - Feeling you or surroundings are spinning/moving, unsteadiness or a loss of balance.
    • Nausea - Sometimes with vomiting
    • Increased sweating
    • Headache
    • Ringing or Buzzing in Ears
    • Hearing Loss
    • Involuntary Eye Movements
    • Learn more about BPPV
  • Medications - Some can cause vertigo, along with hearing loss, and tinnitus (ringing in the ears).

Central Vertigo occurs due to a problem in the brain caused by a variety of different conditions, such as:

  • Meniere’s Disease – Excessive fluid builds up in the inner ear, resulting in sudden vertigo episodes lasting several hours.
  • Migraine – Vertigo can last minutes to hours.
  • Traumatic Brain Injury – Vertigo is common after a traumatic injury to the head or neck, especially if there is damage to the vestibular system.
  • Infection – A viral infection of the vestibular nerve, called vestibular neuritis or labyrinthitis, can cause intense, constant vertigo.
  • Brainstem Stroke
  • Brain Tumors
  • Multiple Sclerosis
  • Inner Ear Disorders

Treatment Options

Treatment depends on the underlying cause. Vestibular rehabilitation therapy as well as medications, such as meclizine (Antivert), have been effective in reducing symptoms.

BPPV repositioning maneuvers

The canalith repositioning maneuver, aka Epley maneuver, can relieve symptoms of BPPV. Specific head maneuvers help displace canalith crystals (small particles causing vertigo) from inner ear canals. Treatment session requires the patient to hold four positions for 30 to 60 seconds each, repeating each position several times. A healthcare professional guides you through each movement during the session, providing guidance on how to perform the procedure at home.

Medication

Meclizine is an antihistamine, a class of medication often used to treat allergies, which is effective in treating motion sickness or vertigo. (Caution: Can lead to confusion/amnesia in older adults.)

Exercises

Several exercises help alleviate vertigo symptoms, typically involving marching in place or holding specific positions to improve balance. The exercises are similar to vestibular rehabilitation therapy (VRT), which involves exercises designed for each patient’s symptoms.

Three main methods (selected per patient post clinical assessment):

  • Habituation - Improves dizziness.
  • Gaze Stabilization - improves control of eye movements so vision can be clear during head movement.
  • Balance Training - Improves steadiness.

There are home remedies and home exercises for vertigo, such as Brandt-Daroff exercises, the Semont maneuver, and the Foster maneuver. If you have severe vertigo - reach out to an experienced physical therapist for guidance, instead of simply performing exercises on your own. 

Surgery

Certain underlying conditions that cause vertigo, such as a brain tumor or head injury, may require surgery.

What Impact Can Vertigo Have on Your Daily Activities or Quality of Life?

Vertigo can impact your daily activities, including work – cognitively and physically. Even your mental health can be impacted. Both work and personal activities are impacted by the struggle to maintain equilibrium, balance, and strength. Even visual perception can be impacted.

We’re Here to Help You Understand the Symptoms, Severity and Treatment of Vertigo. Talk to your primary care provider or visit the Hammond-Henry Neurology Department website. To make an appointment with Dr. Waseem Ahmad, call Geneseo Medical Group at 309.944.9197.