By Dr Ananya Mandal, MD
Vertigo or dizziness is a symptom in itself rather than a diseased condition. It is usually a symptom of an underlying condition affecting the inner ear or the brain.
Manifestations of vertigo include dizziness, problems with balance and so forth. (1-5)
This may last for a few seconds or minutes to hours or even days.
In Benign paroxysmal positional vertigo (BPPV) for example, vertigo episodes last for around 30 seconds to a minute.
The surroundings appear to move vertically or horizontally or may appear to spin.
Relief of symptoms on keeping a still position of the head is common in BPPV.
Another symptom related to dizziness is that patients may feel light headed or disoriented.
Problems with balance
The inner ear maintains posture and balance of the body. In diseases of the inner ear there is vertigo and accompanying problems with balance.
There may be difficulty in standing up or walking. Vertigo may occur even when in bed or lying down in some cases.
Nausea or vomiting
During episodes of vertigo there may be feelings of nausea or sickness and in rare cases there may be vomiting.
Duration of vertigo
The duration of vertigo may vary depending on its cause. For example in late stages of Ménière’s disease or in vestibular neuronitis, the episode lasts a few seconds.
In BPPV an episode may last from several seconds to a few minutes.
Vertigo lasts for hours in early stages of Ménière’s disease, migraine or due to injury or surgery.
In stroke, migraine, multiple sclerosis etc. vertigo may last for days and in psychological feelings of vertigo episodes last for weeks without improvement.
Associated symptoms like ear pain and deafness and tinnitus or ringing of the ears may be seen in some conditions like Ménière's disease.
Associated fever usually means vertigo is caused due to infection of the inner ear. Associated pain usually signifies middle ear disease or damage to the bones of the ear etc.
- In vertigo due to stroke, brain tumors or multiple sclerosis there may other symptoms such as weakness, changes in hearing or vision, difficulty speaking, paralysis, unconsciousness etc.
- Those with migraine may have symptoms of throbbing, one sided headache, nausea, vomiting, sensitivity to light or loud sounds.
- There may be symptoms of nystagmus along with vertigo. This is uncontrolled usually side to side movement of the eye balls.
- Slight symptoms may cause minor discomfort. Severe episodes of vertigo may affect a person’s normal activities and ability to perform everyday tasks.
What activities bring on vertigo?
Activities that bring on vertigo, especially in patients with BPPV, include sudden change in position of the head.
This could be due to sudden head movement, rolling in bed, sudden looking up, standing or bending over etc.
Cause of vertigo
The trigger of the vertigo episode is often determinant of the cause of the condition.
For example, a change in position of the head brings about vertigo in BPPV, acute labyrinthitis, some tumors of the back of the brain.
Vertigo without any triggering factors may be seen in Ménière’s disease, migraine, multiple sclerosis and stroke.
Vertigo occurring after an episode of viral respiratory tract infection signifies vestibular neuronitis while episodes brought about by stress signify a psychological cause or vertigo or migraine.
Edited by April Cashin-Garbutt, BA Hons (Cantab)
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