Vertigo: Symptoms, Causes and Treatment
When a patient has vertigo, he may use different terms to describe his sensations like dizziness, feeling faint, head spinning, giddiness, or unsteadiness of gait. Usually, a careful history can differentiate between these symptoms. It is important to distinguish between presyncope (fainting) and vertigo (illusion or sense of movement of body/surroundings).
Symptoms of Vertigo
Feeling faint can be accompanied by a feeling of lightheadedness, visual blurring, increased salivation, and nausea. The usual causes of fainting are an insufficient supply of oxygen or blood or in rare cases due to decreased blood glucose. Lightheadedness is also a feature in some forms of seizures, and chronic depression.
Causes of Vertigo
While the causes of syncope can be due to cardiovascular, cerebrovascular, disorders of vascular tone, situational (as in cough or micturition), anxiety attacks, psychogenic and seizures, vertigo is usually caused by a disturbance in vestibular, visual, or somatosensory pathway. It can be associated with nausea, vomiting, or gait disturbances. Head or postural movements can commonly precipitate an attack of vertigo.
Distinguishing between central causes of vertigo and peripheral causes of vertigo are important. Central causes could be due to vascular lesions, demyelinating lesions or neoplasms in the brain. Peripheral causes are due to labyrinthine dysfunction as in BPPV (benign paroxysmal positional vertigo), labyrinthitis, vestibular neuronitis, or Meniere's disease.
Peripheral vertigo is characterized by postural disturbances, nausea, vomiting and peculiar eye movements (nystagmus) noted by a clinician during attacks of vertigo. The appropriate diagnosis can only be made by consulting a doctor. Sometimes, consultation with ENT specialist becomes necessary.
Central vertigo is usually accompanied by signs of cerebellar and brainstem dysfunction. Headache may be an accompanying feature.
Treatment of Vertigo
- Treatment of acute vertigo consists of bedrest and vestibular suppressant drugs.
- The treatment of BPPV is a repositioning procedure done by the clinician.
- Meniere's disease might respond to low salt diet and diuretics.
- Central vertigo needs to get investigated to rule out space-occupying lesions in the brain.
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