The vertigo is a specific type of dizziness that often usually described as a sense of movement and turns (National Institutes of Health, 2010).
In many cases it is not comparable to the feeling of dizziness of traditional dizziness in itself, since people with vertigo tend to feel as if they are really moving, shaking or turning (National Institutes of Health, 2010).
Symptoms of vertigo usually occur in the form of nausea, loss of balance, or a sense of imminent loss of consciousness (DM, 2016).
On the other hand, the causes of vertigo can be diverse, usually related to aspects of the inner ear or brain. Some of these causes may be benign or more serious, while others may even threaten the individual’s survival (Furman et al., 2016).
In addition, depending on the etiological cause, we can distinguish several types of vertigo: peripheral vertigo (affecting the inner ear and the vestibular nerve) and central vertigo (due to neurological alteration) (DM, 2016).
The treatment for vertigo and dizziness will depend so much on their causes, type, as on the symptoms that the person presents. In general, the methods used are effective for symptomatic treatment (Mayo Clinic, 2015).
What is vertigo?
Vertigo is defined by the presence of sensations of movement, balance, inclination or twist (Cleveland Clinic, 2015) In many cases, people with vertigo describe feelings of instability, lightheadedness, as if they are floating or as if everything around them and these sensations occur even when they are in rest, standing or lying down (Cleveland Clinic, 2015).
Dizziness, dizziness and a feeling of imbalance are symptoms that are reported very often by adults when they go to primary care services (Vestibular Disorders Association, 2016).
All these sensations (dizziness, vertigo and imbalance) can result from both a peripheral vestibular disorder (dysfunction of the different structures of the inner ear) and central vestibular disorder (dysfunction of one or more central nervous system areas that are essential for the processing of signals and spatial information) (Vestibular Disorders Association, 2016).
Although these three conditions may be linked by the underlying cause or by the associated sensations, they may have different meanings:
- Dizziness: is a feeling of instability, imminent loss of consciousness or fainting.
- Vertigo: Unlike dizziness, it is characterized by the presence of a movement component. The person may feel that he is moving or spinning or that instead, things around him are doing so.
- Imbalance: This term generally describes as the sensation of instability that is often accompanied by spatial disorientation.
What are the symptoms of vertigo?
The most frequent symptoms and signs of vertigo usually include some or several of the following sensations (Furman et al., 2016):
- Sensation of rotation and rotating movements.
- Sensation of oscillation and inclination.
- Loss of balance.
Patients are usually described as follows: “I feel like everything is spinning?” The room and everything is spinning around me ?? Everything moves and I feel nauseous.
Generally, the symptoms are alternating, they can appear and disappear. They can last from seconds to hours and days. On the other hand, these sensations can also be aggravated by sudden movements with the head or a change of position (Furman et al., 2016).
In addition, we must also take into account that when a person suffers from vertigo it is possible that he develops some of the following conditions (Furman et al., 2016):
- Nausea and vomiting.
- Headache, sensitivity to light or noise.
- Double vision or difficulty focusing the field of vision.
- Difficulty or inability to speak or swallow.
- Feeling of weakness, fatigue and tiredness.
- Difficulty breathing normally.
- Intense sweating.
- Feeling of palpitations.
- Hearing loss or ringing in the ears.
This wide variety of symptoms will also have repercussions at the cognitive and psychological level, mainly due to the mental fatigue that cause the constant symptoms of instability and dizziness.
- Cognitive alterations: difficulty concentrating; distracted attention; forgetfulness and short-term memory lapses; confusion and disorientation; difficulty understanding orders or simple directions; difficulty following instructions, difficulty in following conversations, etc. (Vestibular Disorders Association, 2016).
- Psychological repercussions: loss of self-sufficiency, self-confidence and / or self-esteem; anxiety, panic and social isolation (Vestibular Disorders Association, 2016).
Is vertigo very frequent?
Both dizziness and vertigo are two very recurrent conditions in primary and inpatient medical consultations (Batuecas-Caletrío, 2014).
In general, this pathology can affect any person; however, it is more frequent in the adult population (Vestibular Disorders Association, 2013).
In spite of this, when it develops in the infantile population it usually appears in the form of spontaneous and temporary crisis. In the case of the older population, the elderly, feelings of dizziness and dizziness may evolve into chronic instability (DM, 2016).
Although there are few statistical data on this medical condition, different National Institutes of Health in the United States have estimated that about 90 million citizens have attended a medical visit on occasion due to the sensation of vertigo and dizziness (Vestibular Disorders Association, 2013).
Therefore, approximately 42% of the population has performed some kind of medical consultation regarding problems related to dizziness and vertigo (Vestibular Disorders Association, 2013).
Types of vertigo
The vertigo of can classify in different ways. The most usual categorization is based on its causes (Clinical Universidad de Navarra, 2016):
- Peripheral vertigo: occurs as a consequence of an alteration of various structures of the inner ear and vestibular nerve. It is the most prevalent type of vertigo in which patient’s usually present symptoms such as tinnitus, pressure and / or earache (Clinical Universidad de Navarra, 2016).
- Central vertigo: occurs as a consequence of a significant alteration of the neurological mechanisms of the vestibular system. In this type of vertigo, gait alterations, postural alterations, severe instability, double vision, intense headache and even swallowing alterations are frequent (Clinical Universidad de Navarra, 2016).
In addition, vertigo may be subjective or objective depending on the perception of the sensations of movement (MD, 2016).
Vertigo is a type of pathology that will imply dysfunction and / or alteration of the vestibular system, either at the central level or at the peripheral level.
The vestibular system consists of a set of structures that are going to be essential for postural and balance maintenance. It consists of both peripheral systems (inner ear, vestibular nerve) and central systems (coulometer nuclei, motor neurons of the spinal cord, cerebellum, and vestibular centers of the cerebral cortex).
On the one hand, peripheral vertigo can occur due to different conditions (National Institutes of Health, 2010):
- Benign postural vertigo
- Drugs: antibiotics, diuretics, silicates, etc.
- Injuries in peripheral areas due to cranial trauma.
- Inflammatory processes of the vestibular nerves.
- Various diseases and pathologies, such as Meier’s disease.
- Tumor processes that press the vestibular nerves.
On the other hand, central vertigo can develop due to different conditions (National Institutes of Health, 2010):
Disorders and strokes.
Use of various drugs: acetylsalicylic acid, alcohol, anticonvulsants, among others.
Development of convulsive episodes and epilepsy.
In general, the conditions that can produce vertigo are summarized in (DM, 2016):
- Dizziness: individuals who are prone to the sensations of sudden movements, swings, etc., in which the inner ear is especially sensitive to movements.
- Infections: Some viral or bacterial infections can affect the functionality and structure of the inner ear.
- Poor or abnormal regulation of blood pressure (hypertension or hypotension).
- Neurological pathologies: cranioencephalic disorders, brain tumors, stroke, demyelinating diseases, etc.
Age is considered an important factor for the suffering of vertigo. Older adults are more likely to develop pathologies than health that may be the etiological cause of dizziness and vertigo. On the other hand, they usually also ingest medications that can cause this clinical condition (Mayo Clinic, 2015).
In addition to age, previous episodes of dizziness may have a greater sensitivity for this type of pathology (Mayo Clinic, 2015).
When a person comes to a medical appointment with a set of symptoms that can be diagnosed as vertigo, specialists usually perform a physical examination to determine the possible underlying cause (Health line, 2016).
A vision and hearing test is usually done. Physical examination of the eyes and hates is essential. In addition, a postural analysis and tests are performed to determine the patient’s balancing ability (Health line, 2016).
Depending on the most probable cause (peripheral or central), neuroimaven tests such as TAC or RMF will also be necessary (Health line, 2016).
When it is a benign situation without a significant physical cause, dizziness and dizziness usually improve without therapeutic intervention (Mayo Clinic, 2015).
When vertigo becomes a more serious situation, with an identified cause and also significantly interferes with the daily life of the person will require a medical intervention.
Normally, the type of treatment used will depend on both the severity of the symptoms, the type of vertigo, and the etiological cause.
An intervention can therefore be performed at the symptomatological level or on the cause that causes the development of dizziness and vertigo.
Drugs (Mayo Clinic, 2015)
- Diuretics: Specialists can prescribe the intake of diuretics when the presence of Meier’s disease is identified. Diuretics along with a low salt diet can help reduce episodes of dizziness and instability.
- Drugs that reduce the sensation of dizziness: anti-steroids, anticholinergics.
- Drugs that reduce nausea.
- Drugs used for the treatment of anxiety: benzodiazepines may be prescribed for symptomatic treatment but may lead to addiction and somnolence.
Non-pharmacological intervention (Mayo Clinic, 2015)
Head Position Maneuvers: Duple acicular or jugular replacement can help relieve the symptoms of positional vertigo. It should be performed by a specialist (doctor, audiologist or physiotherapist) and is usually effective after two or three reversals.
Balance therapy: Various exercises can be used to learn to adopt a position that minimally alters the body balance system. One of the therapies that have this objective is vestibular rehabilitation.
Other interventions (Mayo Clinic, 2015)
Interventions can also be performed at the level of the inner ear (injections or surgical procedures) to deactivate areas or removal of the sensory organ.
These techniques are not often used; it is only done if the person has a severe additive loss and if the dizziness and dizziness have not responded to any type of treatment.