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Vertigo-Associated Disorders

Overview

Vertigo is a sensation of motion or spinning that leads to giddiness and uneasiness.

Vertigo is different from light-headedness. People with vertigo get sensation of actual spinning or movement, or that the environment itself is spinning.


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Causes

There are two types of vertigo:

  • Peripheral vertigo occurs if there is a problem with the part of the inner ear that controls balance (vestibular labyrinth or semicircular canals) or with the vestibular nerve, which connects the inner ear to the brainstem.
  • Central vertigo occurs if there is a problem in the brain, particularly in the brainstem or the back part of the brain (cerebellum).
     

Vertigo related to the inner ear may be caused by:

  • Benign positional vertigo (also called benign paroxysmal positional vertigo)
  • Drugs called aminoglycoside antibiotics
  • Injury (such as head injury)
  • Labyrinthitis
  • Ménière's disease


Vertigo related to the vestibular nerve may be caused by:

Inflammation (neuronitis)
Nerve compression (usually a noncancerous tumor such as a meningioma or schwannoma)

Vertigo related to the brainstem may be caused by:

  • Blood vessel disease
  • Drugs (anticonvulsants, aspirin, alcohol)
  • Migraine
  • Multiple sclerosis
  • Seizures (rarely)

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Signs & Symptoms

The primary symptom is a sensation that you or the room is moving or spinning. With central vertigo, there are usually other symptoms from the circumstances causing the vertigo. Symptoms can include:

  • Difficulty in swallowing
  • Double/ Blur vision
  • Problems in Eye movement
  • Facial paralysis
  • Slurred speech
  • Weakness of the limbs

The spinning sensation may cause nausea and vomiting in some people.

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Prevention

Avoiding head positions that cause vertigo can help prevent the condition. Taking caution in situations such as driving, walking, or operating heavy equipment. Even short episodes of vertigo may be dangerous.


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Treatments
Medications Modern Medicine

Medications to treat peripheral vertigo may include:

  • Anticholinergics (such as scopolamine)
  • Antihistamines (such as meclizine)
  • Benzodiazepines (such as diazepam or lorazepam)
  • Promethazine (to treat nausea and vomiting) 
  • Benign positional vertigo is most often treated with physical maneuvers that help reposition small structures in the semicircular canals of the inner ear. This reduces or stops the vertigo.

The cause of central vertigo should be identified and treated as appropriate.

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