Treatment of Vertigo

About the disease

Vertigo is a disease, during which a sensation of spinning appears without a person moving quickly or looking down from a height. Most often vertigo is caused by pathology, originating either in brain or in ears. It happens because of the loss of balance in special parts of the brain or in the middle ear. Rarely vertigo appears as a result of sensory nerves disruption. In 80% of cases of vertigo there is some kind of damage in the central nervous system, meaning that actual case of vertigo is simply an indicator of some disease, which needs to be identified and treated. Very often vertigo is accompanied by hearing loss and condition known as tinnitus.

Tinnitus is a ringing and noise in the ears, which can be permanent or last short periods of time. There are two main types of vertigo: peripheral and central one. Peripheral vertigo develops if there is a problem in the middle ear. It can be caused by head injury, previous ear surgery or some kind of ear infection. Central vertigo happens, if parts of the brain, responsible for the interaction between senses of balance and vision, become disrupted. Central vertigo most often is caused by long-term migraine. 40% of patients with migraine develop vertigo a long-term. 

Symptoms

• Dizziness
• Nausea
• Sensation of spinning
• Hearing loss
• Fatigue

Diagnosis

• During physical examination a doctor will examine your ears to determine if vertigo was caused by ear infection.
• CT scan and MRI are ordered to determine if there is a problem with parts of the brain.
• Head impulse test is performed to understand how vertigo affects the eyes of the patient. Patient is asked to move head quickly looking at specific spots. Reaction of the eyes helps the doctor determine the type of vertigo. 

Treatment

• Conservative treatment is the most often used method of curing the vertigo. Special drugs are administered to restore the balance in the brain or middle ear to cure the patient. It may take some time for all symptoms to subside.
• The Epley maneuver is used in cases of peripheral vertigo. During this procedure patient`s head is positioned in different directions to allow the fluid from one part of the middle ear move to a special open place, where it will not cause spinning in the head. Such maneuver needs to be done repeatedly to cure the cause of vertigo.

Most often vertigo subsides over time and it rarely causes any real serious medical conditions. 

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko