Vertigo symptoms, causes & treatment

What is vertigo?

Vertigo is characterized by a lack of balance and the person feels that the environment or himself is constantly moving. It looks more like a symptom than a condition the body is dealing with.

It can be difficult to perceive or even lead to sudden dizziness and unsteadiness, which makes it difficult to carry out daily tasks. Many feel a “heavy” head and often feel dizzy when lying down or when bending the head.

This results in difficulty standing or even walking, while at the same time you constantly feel dizzy or sick. [1]

Symptoms

The most common symptoms that many people with vertigo experience are the following:

1. Bend
2. Oscillation
3. We lean in one direction when we walk
4. Feeling nauseous
5. Vomiting
6. Abnormal or jerky eye movements (nystagmus)
7. Headache or “heavy” head and dizziness
8. Sweat
9. Tinnitus (ringing in the ears, ringing or other sounds in your ears) or hearing loss
10. Balance problems or falls [2]

Often, when the feeling of spinning and nausea coexist, this is also described by patients as stomach vertigo, although in reality this definition does not exist as a condition.

In the case of central vertigo, the following may also appear:

• Swallowing problems
• Double vision
• Facial paralysis
• Weakness in arms
• Abnormal eye movements [3]

How long does it last?

Vertigo can last from a few seconds to days. Its duration always depends on its type, since it is divided into two categories:

1. regional vertigo and
2. central vertigo

Peripheral vertigo is associated with issues involving the inner ear while, conversely, central vertigo is associated with neurological issues. Both the symptoms, as well as its duration and severity, depend on its respective cause.

There are cases in which a feeling of dizziness may occur. This can happen either because you have suddenly changed position, been on a boat or plane, or there has been a change in altitude. Usually, such a situation lasts from a few seconds to 1 minute.

Peripheral vertigo, also called benign positional vertigo (BPPV), occurs when the inner ear canal sends more messages than usual to the brain.

However, there are cases where such incidents occur during the year, regardless of whether the duration is short and this concerns about 15-20% of people, according to research. In peripheral vertigo, symptoms usually go away without treatment in up to 3 months. [4]

People who have chronic conditions may experience central vertigo, while also experiencing intermittent vertigo symptoms, as occurs in people with multiple sclerosis [5].

Causes

There are several reasons that can lead to vertigo, as it is a symptom of many different conditions.

Causes of peripheral vertigo:

1. Benign Paroxysmal Positional Vertigo (BPPV)

It is perhaps the most common cause of vertigo. It can occur when bending or standing, certain head movements, or even when changing positions in bed. It is characterized by repeated bouts of vertigo, relatively intense which may lead to persistent nausea.

The symptom of dizziness or loss of balance is a common phenomenon and may last a few minutes. Through research that has been carried out, it has been shown that it results from small fragments (of calcium carbonate crystal), which are detached from the inside of the ear.

Benign paroxysmal positional vertigo occurs more often in people over the age of 50, for no particularly obvious reason. It may be due to:

• an ear infection
• a surgical procedure
• head injury
• prolonged bed rest, e.g. recovery from an illness.

2. Head injury

In cases where vertigo results from a head injury and leads to symptoms of dizziness, it is recommended to consult your doctor.

3. Labyrinthitis

This is an infection inside the ear that leads to inflammation. The auditory labyrinth is responsible for hearing and consists of fluid-filled canals. When there is inflammation, it sends different information to the brain compared to the information sent by the unaffected eye or ear.

This results in dizziness. It is often accompanied by nausea, vomiting, hearing loss, tinnitus and sometimes ear pain. [1]

4. Vestibular neuronitis

It is a condition that causes inflammation of the nerve that connects the labyrinth to the brain. It usually results from a viral infection and can cause unsteadiness, nausea and vomiting. However, there are no hearing problems. It can last from a few hours or days but can reach up to 6 weeks. [6]

5. Ménière’s disease

This particular disease affects the inner ear and can cause vertigo, hearing loss, tinnitus and auditory fullness (feeling of pressure). The cause is unknown however, it can be treated with proper diet and treatment. [7]

6. Taking certain types of medication

Vertigo can be caused as a side effect of certain medications taken. Of course, this does not mean stopping the treatment prescribed by the doctor, but talking with him if you are worried about the side effects. [6]

Causes of central vertigo

As for the causes of central vertigo, which basically results from neurological problems (eg encephalitis), the most common are:

1. Migraines
2. Multiple Sclerosis
3. Transient ischemic/stroke

Important note: Very often people with vision disorders (eg myopia or presbyopia) often have dizziness or imbalance that looks like vertigo, when in fact it is due to the fact that they have not noticed it or have not visited an eye doctor. There are not a few cases when someone wears the wrong glasses, either because over the years the degrees have changed, or because of a wrong diagnosis.

How to cure vertigo

The treatment of vertigo depends on the factors that cause it. There are cases where it is treated without treatment. This happens when the brain adapts to the changes inside the ear.

1. Pharmaceutical treatment

In some cases, special treatment is needed in order to reduce the symptoms of vertigo, which is usually nausea. The most common cases of treatment are when vertigo results from inflammation or infection and from Ménière’s disease. [7]

2. Repositioning maneuvers & vestibular rehabilitation

These are forms of treatment, with specific movements, where the advice and direction of a doctor or physiotherapist is needed.

3. Gymnastics

Usually the exercises used are aimed at strengthening balance and maintaining specific positions. Such are [10], [14]:

• Familiarization exercises
• Gaze stabilization
• Balance training
• Yoga
• Tai chi

Yoga and tai chi are particularly beneficial for people with anxiety, especially if this is a cause of vertigo.[14]

4. Acupuncture

5. Surgery

It is used as a method of rehabilitation in certain cases, such as a head injury.

6. Essential oils

Essential oils such as lavender seem to help with dizziness or nausea. However, there is no official research to prove this. [11]

7. Sleep

Some research has shown that vertigo has a two-way relationship with sleep status. A very general rule is to avoid changing positions and movements in bed as they can worsen the dizziness. More specifically:

• Make slow movements, with gradually low head acceleration when lying down or getting out of bed.
• Lift the head. Sleeping with the head elevated by 45° contributes effectively to the reduction of benign paroxysmal positional vertigo (BPPV). To achieve this position, try using pillows.
• If one of the two ears is affected, avoid sleeping on that side and find a sleeping position that helps you.
• Avoid activities that aggravate the condition, such as reading or watching TV in bed. [12] [13]

8. Hydration

Vertigo can occur even in cases where the body is dehydrated. One method of coping is to reduce sodium (salt) intake, in addition to drinking plenty of water. [15]

9. Food supplements

There are nutritional supplements, which seem to relieve the symptoms of vertigo and can be combined either with some treatment, or taken individually, always in consultation with the attending physician. Such are:

• Magnesium

Magnesium appears to contribute to several cases of vertigo. Studies have shown that many people who suffer from migraines have low levels of magnesium in the brain and spinal fluid.

A daily dose of between 400-800 mg of magnesium is recommended by most clinics, including Johns Hopkins, for migraine prevention. Magnesium oxide is the most recommended form and has been used in many studies. An even more easily absorbable form is magnesium glycinate, which may be better tolerated. [17]

• Riboflavin (Vitamin B2)

A similar example is taking riboflavin, which appears to help reduce migraine associated with vertigo.[18]

• Coenzyme Q10

Coenzyme Q10 appears to help prevent migraines as well as symptoms that may be associated with vertigo. The studies proving this may be small, but they are just as important. The doses of Q10 in two studies were 150mg and 100mg per day, respectively, daily. [19]

• Ginger

In 2015, a study carried out showed that ginger has a similar – if not the same – interaction with treatments given in cases of migraine, but also in the symptoms of vertigo, as it proves to be particularly effective when taken in cases of repositioning manipulation, such as the Epley maneuver . [20]

• Vitamin D

Low levels of vitamin D have been found in people with benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and vestibular neuritis. However, the dosage depends on the patient’s symptoms and is determined by the attending physician. [21] [22]

• Ginkgo Biloba

It has been proven through research that this specific herb helps with vertigo and is effective in cases of vestibular disorder. It is recommended to be taken in a dose of 120-140 mg per day. Its main action seems to be to thin the blood and this has the effect of improving blood flow to the brain. [23] [24]

Conclusion

Vertigo is a condition that is likely to happen to anyone. Follow the above changes in your daily life and consult a specialist if you do not see a reduction in symptoms.