Learn more about vertigo, which is usually closely related to the inner ear.
Vertigo is defined as the sensation of movement of the environment or of oneself turning, or of precipitation into the void which does not actually exist. It is a very uncomfortable feeling that is usually accompanied by nausea, loss of balance (dizziness) and a feeling of imminent fainting.
Dizziness and vertigo should not be confused. While in vertigo a fictitious movement is perceived, (it is not actually taking place), dizziness is a broader feeling of lightheadedness or disorientation.
Vertigo is almost always related to an alteration of the vestibular system, located inside the inner ear, which coordinates our balance, as well as our posture, and can be momentary or last hours or even days. This disorder can affect anyone, although in children it presents in the form of spontaneous and temporary crises and in the elderly it can evolve into chronic instability.
One of the most common causes of vertigo is alterations in the nerve connection from the ear to the brain or in the brain itself, but there are many more, such as:
The most frequent clinical sign that shows if you are suffering from vertigo is the sensation that the room you are in is spinning or that the body itself is in motion. However, there are also other symptoms of vertigo:
To perform a diagnosis for vertigo, the first step will always be to determine the nature of the problem and its cause. To do this, the ENT doctor will have the patient fill out a questionnaire to understand the symptoms that accompany the dizziness, its duration, possible triggers or what might produce relief.
The specialist will then proceed to vestibular testing, analyzing the ears, nose, oral cavity, nasopharynx and larynx. The vestibular tests are a series of diagnostic tests to learn more about the status and possible involvement of the inner ear, the vestibular labyrinth and the semicircular canals. Among these tests, the most common are electronistagmography or rotation tests , among others. It may be necessary to study nystagmus, a reflex disorder that manifests itself with rapid and uncontrolled movements of the eyes (either side to side, up and down or rotating) and is justified by the connection between the brain, vestibular system and nuclei of eye movements. The physician will attempt to stimulate nystagmus by jerking the patient's head or alternately introducing drops of hot and cold water into the ear canal.
Likewise, a computed tomography or an MRI of the head may be required, which would show, if present, bone alterations or tumors in the facial or acoustic nerve. In case your doctor suspects a meningeal infection, he will perform a lumbar puncture and, to confirm an insufficiency in the blood supply, he might order an angiography. These tests offer the specialist the information they need to determine how to deal with episodes of vertigo.
The treatment of vertigo depends on what causes it, so it will not be the same in all cases. Several drugs exist to treat is, which are always suggested depending on each patient's case:
It is very common for all these drugs to cause drowsiness, especially in the elderly, so these prescriptions must be accompanied by a low-salt diet, a combination that is effective in 70% of cases.
If this first option is not effective, treatment with intratympanic gentamicin, an antibiotic that is injected through the eardrum, passes into the middle ear and acts on the balance cells. If this does not solve the problem either, the only possible way is to go under the knife to undergo a vestibular neuroctomy, where the balance nerve is cut while maintaining the patient's hearing, or a labyrinthectomy, which involves the removal of all sensory receptors for balance, with consequent hearing loss.
BPPV is triggered by sudden movements and it originates in the deposit of calcareous-type remains ("ear crystals") in one of the semicircular canals of the inner ear. In this case to treat it, the said material must be extracted from an area where it should not be.
Do you want to know how to reduce the risk of vertigo? Some recommendations to achieve this would be to avoid or rapid movements or extreme positions of the head, as well as to minimize the circumstances that can trigger this condition, such as anxiety, the use of substances that cause allergies or stress.