What is vertigo?

Vertigo is a symptom of an underlying disease rather than a disease in itself. It is commonly felt as though the environment around is moving in spite of standing still. It is also termed dizziness by most patients.

Symptoms of vertigo

Common symptoms associated with vertigo are feeling nauseous or sick, vomiting and difficulty in maintaining a standing posture.

There may be loss of balance in severe cases and this may interfere with daily activities.

Vertigo and fear of heights

Unlike common misconception, vertigo is not associated or related to fear of heights.

How long does vertigo last?

Depending on the cause a single episode of vertigo may be short lasting several seconds or minutes or may be long lasting 12 to 24 hours or even days.

Causes of vertigo

Vertigo has its basics in the balance mechanisms and tiny organs that lie within the ear. (1-4)

Normally when the head moves, a complex organ within the inner ear called the vestibular labyrinth and vision aid in maintaining the balance and posture of the body.

When the head is turned the tiny tube like organs called the semicircular canals sense it.

Straight movements of the head are detected by inner ear organs called utricle and saccule.

In addition, posture is detected by muscles and joint receptors present in the neck, spine, and limbs.

When the labyrinth detects a change in the position of the head, it sends the information superior and inferior vestibular nerve to the base of the brain.

There are further branching networks of nerves some of which travel to the front part of the brain or the frontal cortex. The sense of rotation is felt at the frontal cortex.

The information regarding the position travels along the spine to the limbs to maintain balance of the body.

This whole network is assisted by vision. Eyes send in signals about motion and posture as well to the brain.

Both the ear’s vestibular organs and the visual system work in synergy with the central nervous system to maintain balance and their derangement may lead to vertigo.

Vertigo and disease

Vertigo is commonly caused by diseases of the inner ear. Diseases of the brain may also cause vertigo.

Causes of vertigo include –

• Benign paroxysmal positional vertigo (BPPV) – this is the commonest form of vertigo especially among the elderly where any movement triggers a spell of dizziness
• Labyrinthitis – infection of the inner ear commonly occurring after an infection of the upper respiratory tract or middle ear.
• Ménière's disease is a condition with a triad of features including hearing loss, tinnitus or ringing of ears and vertigo.
• Severe headaches or migraines
• Inflammation of the vestibular nerve that carries messages from the inner ear to the brain regarding posture and balance.
• Other conditions that may cause vertigo include head injury, after ear surgery, as side effects of some medications, recreational drugs or alcohol etc.

Diagnosis of vertigo

Most cases of vertigo are mild and not serious. However since vertigo signifies an underlying condition is some cases, all cases should be evaluated in detail and appropriate diagnosis should be made.

Treatment of vertigo

Recurrent vertigo may need to be treated with medications, certain head manoeuvres or exercises and rarely surgery.