In 1958, James Stewart starred in the Alfred Hitchcock film Vertigo and from then on Americans have had the wrong idea about the disorder after which the movie was named. Stewart’s character did not, in fact, suffer from any form of vertigo, but instead a profound fear of heights.
True vertigo accounts for about 5 percent of dizzy spells suffered by patients each year. If you are suffering from moments of dizziness you may be referred to an audiologist for testing because vertigo is often caused by problems with the inner ear. The following is a breakdown of the possible causes, symptoms, and treatments associated with this sometimes debilitating condition.
Vertigo has been placed into two main categories of causes referred to as central and peripheral. Peripheral vertigo is a problem with inner ear while central vertigo causes arise in the brain or spinal cord. Patients are usually sent to an audiologist for a hearing test if one of the following peripheral causes is suspected to be responsible for their dizziness.
Benign paroxysmal positional vertigo (BPPV) is the most common reason for dizzy spells. It is believed to be caused by a mechanical malfunction of the inner ear which occurs when loose calcium carbonate debris has broken off and causes a sensation of movement. Next, Ménière’s disease is a chronic condition that usually affects only one ear with symptoms beginning between 20 and 50 years of age. It can increase the amount of fluid present and lead to feelings of pressure or fullness inside the inner ear. Finally, labyrinthitis is a viral infection of the inner ear that causes inflammation in the inner ear around nerves that help the body sense balance.
The symptoms associated with vertigo will depend on its underlying cause. Patients usually seek treatment because they have moments in which they feel as if they are spinning, tilting, swaying, or being pulled in one direction. They may also experience and often complain of abnormal or jerking eye movements, headaches, or sweating.
BPPV attacks usually end within one minute of onset. Patients will usually report sensations of motion when they make changes in their position. Vertigo caused by Meniere’s can result in recurrent spontaneous attacks and hearing loss. Both Ménière’s disease and labyrinthitis can cause a ringing in the ears (tinnitus) and a feeling of pressure or fullness in the ear. Nausea, vomiting, and a lack of balance are also common.
Just as with the symptoms, the treatment given for vertigo will depend largely on the medical reasons for it. Repositioning movements such as the Epley or the Semont maneuver are the most common treatments for BPPV. These movements are used to shift the calcium deposits out of the ear canal and into the inner ear chamber so they can be absorbed by the body.
Sufferers of Ménière’s disease may be put on a low-salt diet and given intratympanic injections of the antibiotic gentamicin. Many are also given diuretics to reduce fluid buildup or surgery is performed in order to place a shunt or remove tissue. Vestibular rehabilitation is a form of physical therapy used to strengthen this system’s ability to send signals to the brain about head and body movements in relation to gravity. Medications may include antihistamines, corticosteroids, or anticholinergics that inhibit the nerve impulses responsible for involuntary movement.
The first step to treating the symptoms and causes of chronic dizziness will be to see your primary physician. He or she will be able to determine if you should see an audiologist for testing or another specialist if needed.