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Vertigo : Cause, Symptoms and Treatment

Vertigo is a symptom with a sensation of yourself or around a spin that occurs suddenly. There is a condition of vertigo that is mild and not too pronounced and there is a severe condition that blocks the routine.

Vertigo attacks can vary, ranging from mild dizziness and appearing periodically to severe and lasting. Severe attacks can continue for several days so that the sufferer cannot move normally.

Symptoms of Vertigo

A common symptom is that the object around it runs around in circles with the ears buzzing. As a result, nausea and want to vomit can not be avoided. If the vertigo disease continues, usually the sufferer can fall because it is not strong standing. Even if you have stretched out and closed your eyes, the person will still feel his body spinning and the feeling of pounding can cause fainting.

The initial attack of vertigo usually lasts only a few hours. But if it is not immediately addressed, vertigo will always recur and recur, and if it can repeat it can cause a stroke.

Some of the common disorders that cause vertigo are:

Benign paroxysmal position vertigo

A person suffering from benign paroxysmal position vertigo (BPPV) will usually feel symptoms when moving the head.

Not yet known exactly the cause of this condition. However, it is suspected that BPPV is the effect of the medical actions that the patient has taken, and the presence of the body's natural crystals that enter the inner ear.




In the inner ear, there is an organ called the vestibular labyrinth. Inside the vestibular labyrinth there are semicircular and otolitic channels. Otolit acts as a monitor of head movements, while semicircular channels act as sensors for special head movements in circular motions. Inside the otolite there are also crystals that make the ears sensitive to gravity.

When the crystal is released from its place and enters the semicircular channel, it will cause the semicircular channel to be more sensitive to movements that occur in the head. As a result, vertigo will appear when the head is moved.

Labyrinthitis

Basically, the ear has two balance nerves that function to send signals to determine the direction and control of balance in the brain. Labyrinthitis is a condition in which one of the nerves experiences inflammation. When inflammation occurs, it will trigger vertigo.

In addition to vertigo, labyrinthitis can also cause other symptoms, such as:

  • Nausea and vomiting.
  • Lost balance.
  • Ears buzzing.
  • Uncontrolled eye movements.

Meniere's disease

Vertigo can appear in people with Meniere's disease, a condition in which there is damage to the inner ear. The cause of Meniere himself is not yet known. However, the researchers suspect that this condition is caused by the amount of fluid in the inner ear being abnormal.

Abnormalities in the amount of inner ear fluid can be affected by:

  • Abnormal immune response.
  • Viral infection.
  • Allergy.
  • Head injury.
  • Genetic / hereditary abnormalities.
  • Migraine.
  • Abnormalities of the inner ear structure.
  • Blockage occurs.

 

Basically, vertigo arises because of a disturbance in the ear or brain. Therefore, some of the conditions below can also cause vertigo:

  • Cholesteatoma, a condition in which abnormal skin growth occurs in the ear, precisely behind the eardrum. This condition is caused by ear infections that continue to recur.
  • Otosclerosis, a condition in which abnormal bone growth occurs in the ear.
  • Stroke, a disorder of the blood supply to the brain caused by bleeding or blood clots.
  • Perilymphatic fistula, which is a condition in which a tear occurs in the dividing wall of the inner ear and middle ear. This tear causes fluid in the inner ear to move to the middle ear.
  • Acoustic neuroma, which is a benign tumor in the connecting nerve of the brain and inner ear.
  • Multiple sclerosis, a condition in which the immune system mistakenly attacks the protective layer of the brain and spinal cord. A damaged protective layer will disrupt the process of sending signals from the brain throughout the body.
  • Parkinson's disease, a condition characterized by abnormal movement and balance of the body, due to interference with brain function.
  • The condition in which the sufferer experiences a headache on one side.
  • Diabetes can cause complications such as hardening of the arteries and decreased blood supply to the brain. As a result, brain function is disrupted.
  • Vertigo can appear in pregnant women. Generally, it is caused by hormonal changes, decreased blood sugar levels, and narrowing of blood vessels during pregnancy.
  • Chiari malformation, a condition in which brain tissue descends to the spinal canal. This causes interference with brain function.
  • Syphilis is a sexually transmitted infection caused by bacteria. This infection can cause symptoms of hearing loss, dizziness, and trigger vertigo.
  • Anxiety disorders. Anxiety and panic can trigger vertigo, and stress can potentially worsen vertigo.
  • Brain tumor. Tumors in the cerebellum can cause vertigo.
  • Air pressure. Changes in air pressure, such as when diving, can cause damage to the ear. Damaged ears are a common cause of vertigo.
  • Vertigo can be one of the symptoms that appears when a person has an allergy.
  • Vertigo can appear as a side effect of a drug. Some drugs that can trigger vertigo are anticonvulsants, antidepressants, sedatives, and antihypertensive.
  • Head and neck injuries. This condition can also cause vertigo, if a collision causes damage to the brain or inner ear.

Risk Factors for Vertigo

Some of these factors can increase a person's risk for vertigo. Among others are:

  • Aged over 50 years.
  • Got an accident.
  • Have a history in the family.
  • Experiencing severe stress.
  • Drink alcohol.
  • Smoke

Vertigo diagnosis

The doctor will review the medical history and physical examination. The doctor will ask the patient what triggers the spinning dizziness, for example when moving the eyes, head, or when the patient is lying in a certain position. Doctors will also make observations on eye movements.

To see abnormalities of eyeball movements when the head position is different, the doctor will do a test using a special tool in the form of electronystagmography or videonystagmography.

In addition, other tests also need to be done to find out the cause of this condition. The test can be:

  • Electroencephalography (EEG). One of the main causes of vertigo is a disorder of the brain. This test uses a small disk placed around the head (electrode), which serves to observe electrical activity in the brain.
  • Hearing test. In the hearing test, the patient will be asked to listen to the sound played on the earphone. The volume and tone of the voice will be arranged differently. The hearing test serves to detect any disturbance in the ear, which can cause symptoms of hearing loss or vertigo.
  • Blood test. The doctor will measure the number of red and white blood cells in the patient's body. If the number of blood cells is not normal, it can indicate a disturbance in the body, such as inflammation or infection that can be a cause of vertigo.
  • This test uses a special tool, where the patient will stand on the device, barefoot, and use safety equipment. Next, the tool will run a simulation to detect the problematic part of the body, which triggers vertigo.
  • Scanning In certain cases, the doctor will recommend a CT scan or MRI, to detect problems in the brain.

Causes of Vertigo

Vertigo is generally caused by a disruption in the inner ear, which triggers the problem of the body's balance mechanism. Other causes of vertigo are:

  • Change in certain head position.
  • Migraines or headaches are unbearable.
  • Meniere's disease is a disorder that attacks the inner ear.
  • Vestibular neurons, namely inflammation of the vestibular nerve in the inner ear.
  • Disorders of the brain, such as tumors.
  • Certain drugs that cause ear damage.
  • Trauma or head and neck injuries.

Vertigo treatment

Vertigo actually falls into the category of symptoms and not diseases. Therefore, how to deal with vertigo depends on the disease that causes it. Some cases of vertigo can heal without treatment, because the brain manages to adapt to changes in the inner ear.

Vertigo requires special treatment steps if caused by:

  • Epley's maneuver to handle BBPV.
  • Drugs, such as prochlorperazine and antihistamines. However, these drugs are usually only effective for the initial stages and should not be used long-term.
  • Therapy for vestibular rehabilitation to help the brain adapt to confusing signals from the ear that are the cause of vertigo, so the frequency decreases.

Even though many cases of vertigo can heal on their own, it would be better if this condition was examined by a doctor, especially if vertigo occurs repeatedly.

Basically, treatment of vertigo must be adjusted to the cause. The following are treatment methods tailored to the causes of vertigo:

BPPV

The action in dealing with BPPV can be in the form of repositioning canal, which aims to transfer crystals in the semicircular tract to other organs. This action is done by asking the patient to make special movements or maneuvers. The doctor will also teach movements in repositioning the canal in patients to be practiced at home.

In dealing with BPPV, doctors can also perform surgery if the canal repositioning procedure is unsuccessful. This operation aims to clog the bones in the inner ear. The clogging device that is used serves to inhibit the semicircular channel in response to head movements, so that it can prevent the symptoms of dizziness that can trigger vertigo.

Labyrinthitis

Labyrinthitis will be treated with drugs such as desloratadine, diazepam, or prednisone. Doctors can also recommend follow-up in the form of therapy for vestibular rehabilitation or vestibular rehabilitation therapy (VRT).

Vestibular rehabilitation therapy aims to train the brain to balance signals coming from the vestibular nerve. Some methods used include:

  • Coordinate hand and eye movements.
  • Stimulates dizziness so the brain gets used to it.
  • Train your body balance.
  • Train fitness and body strength.

Meniere's disease

To overcome vertigo in Meniere's disease, the doctor will give medicines to relieve symptoms. Example:

  • Diazepam, to relieve dizziness.
  • Promethazine, to relieve nausea and vomiting.
  • Giving gentamicin or corticosteroids directly into the ear.

 

If vertigo caused by Meniere's disease is classified as severe, the doctor can recommend patients to undergo a surgical procedure. Among others are:

  • Surgical endolymph pocket. In this procedure, some parts of the bone in the endolymph bag will be removed. In certain cases, the doctor also places a special tube on the ear. This procedure aims to reduce the production of fluid that occurs in the ear.
  • Vestibular nerve surgery. This procedure works by cutting the nerve (vestibular) that connects the balance and movement sensors that are in the inner ear and brain.
  • This procedure works by removing the organ that functions to regulate balance and hearing. Labyrinthectomy is only performed on Meniere sufferers who have lost their hearing completely.

Prevention of Vertigo

Vertigo can be caused by many conditions, so prevention must be adjusted to the risk factors that are owned. For example, if a person is diving, make good adjustments to the body's pressure. There are also several attempts that can be made to prevent worsening or recurrence of vertigo. Among others are:

  • Avoid sudden movements so as not to fall.
  • Seated immediately if vertigo attacks.
  • Use a few pillows to make your head position while sleeping higher.
  • Move your head slowly.
  • Avoid head movements looking up, squatting, or bending your body.
  • Get to know the triggers for vertigo and do exercises that can trigger vertigo. The brain will become accustomed and actually reduce the frequency of recurrence of vertigo. Do this exercise by asking someone for help.
  • For those who also suffer from Meniere's disease, limit salt consumption in the daily menu.



References

References

Swartz, R. Longwell, P. (2005). Treatment of Vertigo, American Academy of Family Physicians.

Marks, J. Everyday Health (2018). What Are the Causes and Risk Factors for Vertigo.

NIH (2017). MedlinePlus. Vertigo-Associated Disorder.


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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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