Vertigo Clinic

Vertigo is of two main types:

• Peripheral vertigo
  It occurs when there is an issue with the inner ear.
• Central vertigo
  It happens when there is a problem with the brain. Its causes include brain tumours, infection, stroke, or traumatic brain injury.

While both vertigo and dizziness are considered to be problems related to loss of balance, there are distinct differences between the two. Vertigo is a feeling of moving or feeling that your environment is spinning. On the other hand, dizziness is an overall sensation of feeling unbalanced.

Vertigo affects people of all ages. However, it is more common in those above 65 years of age. Women are more likely to experience the condition compared to men. Some females even experience it as a side effect of normal pregnancy

A vertigo attack can last for several seconds to minutes, on average. However, in severe cases, people can experience an episode for hours, days, or even weeks and months.

Vertigo is sometimes compared to motion sickness. It can make you feel like you are rocking, spinning, or tilting. The feelings of loss of balance may worsen on walking, standing, moving the head, or changing positions.

Even though the feeling of vertigo can be scary, it is itself not considered to be a serious condition. It is, however, associated with other potentially serious medical conditions. Therefore, if you are experiencing recurrent or prolonged vertigo attacks, you must talk to a healthcare provider. If you are located in Indore, you can visit the Vertigo clinic at Kokilaben Dhirubhai Ambani Hospital, Indore and seek an appointment with an expert who will guide you to the next step.

Even though vertigo is not a hereditary condition, it can indicate a range of medical conditions, some of which can be hereditary. Therefore, genetic factors could be involved in more frequent vertigo attacks.

Certain different types of conditions or syndromes can lead to vertigo, including:

• Benign paroxysmal positional vertigo (BPPV)
  It is the commonest cause of vertigo and occurs when there is a change in head position. People suffering from the disease typically experience vertigo when sitting up, lying down, or turning over in bed.
• Meniere’s disease
  This condition is characterised by buildup of fluid inside the ear that causes vertigo attacks. The condition may also present with a sensation of ringing in the ears called tinnitus, feeling of fullness in the ears, or fluctuating hearing loss.
• Labyrinthitis
  If the labyrinth of the inner ear becomes infected or inflamed, the condition is called labyrinthitis. The labyrinth has the vestibulocochlear nerve that transmits information regarding position, sound, and head motion to the brain. People with the disease often experience ear pain, headaches, tinnitus, vision changes, or hearing loss.
• Vestibular neuritis
  It refers to the inflammation of the vestibular nerve that causes vertigo. It is quite similar to labyrinthitis. However, it does not affect hearing. People with vestibular neuritis may experience vertigo accompanied by blurred vision and nausea.
• Cholesteatoma
  Recurrent ear infections can lead to the development of a noncancerous skin growth in the middle ear. This condition is called cholesteatoma and it can lead to vertigo, dizziness, and hearing loss.

Many different factors can lead to vertigo attacks. Following are some common causes for vertigo:

• Certain medications.
• Head injuries.
• Arrhythmia
• Migraine headaches.
• Prolonged bed rest.
• Stroke.
• Diabetes.
• Ear surgery.
• Shingles in or near the ear.
• Low blood pressure (orthostatic hypotension) – a condition in which your blood pressure decreases when you stand up.
• Perilymphatic fistula (when inner ear fluid leaks into the middle ear).
• Hyperventilation.
• Otosclerosis (a bone growth problem affecting the middle ear).
• Multiple sclerosis (MS).
• Ataxia, or muscle weakness.
• Syphilis.
• Brain disease.
• Acoustic neuroma.

Many patients with migraine also experience vertigo during the attacks. It may occur during a headache, before the onset of a headache, or during a headache-free period. Some people even have vertigo as the primary symptom of migraine instead of headache.

Even though vertigo doesn’t occur due to stress itself, it can contribute to dysfunction of the inner ear. This can result in vertigo attacks in some individuals.

As mentioned above, vertigo can occur as a symptom of a wide range of medical conditions. However, it can also happen in combination with other symptoms, such as balance problems, nausea and vomiting, headaches, tinnitus, motion sickness, nystagmus which is characterised by the eyes moving uncontrollably from side to side, or a feeling of fullness in the ear.

Your doctor will carry out a physical examination and ask certain questions about your symptoms. He may also recommend you to undergo a few tests so that the diagnosis is confirmed.

Vertigo can be diagnosed on the basis of investigations performed by the healthcare provider, which may include:

• Romberg’s test
  For this test, you will be directed to close your eyes while you stand with your feet held close together and your arms placed to your side. If you feel unsteady or unbalanced, it could mean that you have a problem with your CNS.
• Fukuda-Unterberger’s test
  Your healthcare provider will ask you to march in a place with your eyes closed for around 30 seconds. If you lean or rotate towards one side, it could indicate an issue with the labyrinth of your inner ear. This could cause vertigo.
• Head impulse test
  Your healthcare provider will move your head gently towards each side which you are asked to focus on a stationary target. He will be checking to see how the balance system of the inner ear is working to control the eye motion while the head is moving.
• Vestibular test battery
  This test includes certain other investigations performed to help identify a problem with the inner ear. Goggles are placed over the eyes of the patient so that the eye movement responses can be monitored while the eyes are moved to follow a target, when cool and warm water is placed into the ear canal, and when the head and body is moved.

Apart from the tests mentioned above, your doctor may also request some radiographs including an MRI Magnetic resonance imaging and CT (computed tomography) scans.

Vertigo resolves spontaneously in many cases. However, several treatment methods are available to successfully manage the condition.

The treatment of vertigo that is right for you depends on many different factors, including what the root cause of your symptoms is. Following are some of the most notable treatments for vertigo:

• Medication
  Treatment of the cause of the vertigo can relieve the symptoms. For example, if vertigo is happening due to an infection, your doctor can prescribe you some antibiotics. Medications can also relieve some other symptoms linked with vertigo such as motion sickness or nausea.
• Vestibular rehabilitation
  If vertigo is occuring due to an inner ear problem, vestibular rehabilitation may help relieve some of the symptoms. This physical therapy also helps strengthen other senses so that there is some compensation for the vertigo episodes.
• Canalith repositioning procedure (CRP)
  If you are suffering from Benign paroxysmal positional vertigo (BPPV), canalith repositioning manoeuvres can help mobilise the calcium deposits into the inner ear chamber from where those can be absorbed by the body.
• Surgery
  When there is a serious underlying issue responsible for causing vertigo like a neck injury or a brain tumour, surgery may be needed.

Following are the steps you can take to decrease your risk of getting vertigo attacks:

• Take your time when you are standing up, turning your head, or performing other vertigo-triggering movements.
• Sleep on two pillows with your head elevated.
• If you feel dizzy, sit down as soon as possible.
• When picking something up, squat instead of bending over.

If vertigo becomes recurrent or severe, you might need to see your healthcare provider. He might diagnose an underlying health problem causing the symptoms.

Vertigo can occur suddenly, without any warning signs. Even though the attacks may feel scary, they resolve unexpectedly most of the time. If you are experiencing recurrent, prolonged, or severe vertigo attacks, you might be having another underlying condition. Your healthcare provider can identify the underlying cause of your vertigo and formulate a tailored treatment plan to help you return to normal life.

If you are looking for the best vertigo clinic in Indore, you have found it! The Vertigo Clinic under the Department of ENT at Kokilaben Dhirubhai Ambani Hospital, Indore houses advanced medical equipment and experienced doctors, making it a clinic of excellence. The clinic is equipped with top-notch blood banks, laboratory, and radiology services and state-of-the-art operation theatres. The specialists of the clinic work in collaboration with those of other departments like Neurosurgery, Dental Surgery, and Plastic Surgery to provide personalised treatment and care to patients.