Vertigo: Treatment, symptoms, advice and help
Abnormal perception of movement of the environment is called vertigo, but may be used to mean a feeling of faintness, some other alteration of consciousness, or unsteadiness.
Vertigo: Incidence, age and sex
Recurrent dizzy spells affect at least 30% of people aged over 65 years.
Signs and symptoms of Vertigo: Diagnosis
Benign paroxysmal positional vertigo occurs in older patients with paroxysms of vertigo occurring with certain head movements due to the presence of degenerative material affecting the free flow of endolymph in the labyrinth. This is the most common cause of severe vertigo, and may be accompanied with vomiting often coming on when waking. During the attack, nystagmus may be present.
Causes and prevention of Vertigo
Vertigo may be caused by labyrinthine disorders ( usually short-lived, though it may recur) or from central (brain-stem) disorders (often persistent and accompanied by other signs of brain-stem dysfunction).
Causes of vertigo due to labyrinthine dysfunction include infection, benign positional vertigo, Meniere’s disease, ischaemia / infarction, Trauma, perilymph fistula and drugs .
Causes of vertigo due to central disorders include demyelination , migraine, posterior fossa mass lesion and vertebro-basilar ischemia.
Secondary hyperventilation attacks and associated depressive features are common.
The vertigo can then be treated with vestibular exercise. Drug treatment of labyrinthine vertigo can be achieved with “vestibular sedative” (e.g. cinnarizine, prochlorperazine, betahistine). Patients with intractable symptoms should be referred to an ENT specialist for assessment.