Vertigo is a symptom wherein a patient describes a feeling of spinning or revolving or that the world around the patient
is spinning or revolving. When you feel as though you are spinning, itís known as subjective.
When it seems the world around you spinning, itís objective. Either way, the feeling is scary, disturbing, and distressing.
The patient can break out in a cold sweat, become nauseated and vomit. These sensations often come about suddenly and without warning.
At times, there can a sensation that something is going to happen. For this reason, some doctors think vertigo may be a migraine variant
since quite often migraines start similarly and act in a spell-like manner striking the patient suddenly and leaving after a period
of hours or days with an aftermath sensation. These same sensations are similar to some epileptic seizures.
This is of historical importance; since over 150 years ago, Dr. Prosper Meniere, a French physician, described several patients with Vertigo
as secondary to inner ear problems as opposed to illnesses that affect the brain, such as a stroke or epilepsy. People then, as today,
feared their Vertigo was a sign of a brain tumor or an impending stroke, which is caused by a vascular insufficiency of the brain.
The name Meniere's Disease or Syndrome today describes to any symptom complex of dizziness, lightheadedness or similar feelings
of Vertigo or imbalance. However, the name Menieres Disease is a misnomer since it really is not a true disease entity
but rather a symptom of some, often unknown, reason for Vertigo. Generally, Vertigo stems from the inner ear,
but may be caused by a brain tumor, which emphasizes the need for a diagnosis by a qualified Otologist.
Sometimes the patient's blood pressure Ė hypertension -- causes the dizziness. The Otologist will perform hearing testing
and other ear and neurological evaluations. Often a Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) of the brain
is ordered by the physician to rule out vascular insufficiencies -- strokes and tumors. These imaging tests can be performed
with or without contrasting chemicals injected into the patientís vein prior to the tests. When the CT or MRI reveals no evidence
of brain tumor or stroke the cause of the patient's Vertigo is presumed to be the inner ear.
Often the imbalance becomes more severe when the patient moves his/her head in a specific direction or manner.
This particular form of Vertigo is called Benign Positional Vertigo (BPV), in which case, there are generally
no abnormalities on the audiogram, CT or MRI of the brain. For BPV, physical therapy often is prescribed.
Occasionally, these exercises or head movements can cause more symptoms. The theory behind this is that
these exercises somehow retrain the brain to compensate for the Vertigo. Some physical therapists have theorized
that tiny particles in the inner ear portion having to do with balance get lodged in the semicircular canals
and that violent movement of the patient's head will sometimes jar or loosen those particles thereby alleviating
the Vertigo. However, the specific treatment must be tailored to the patient based on the cause of the dizziness.
Occasionally ear infections (mastoiditis) and/or benign tumors (cholesteatoma) cause dizziness and imbalance.
Those problems, on the list of potential causes, need to be ruled in or out.
As you can see, having a qualified Otologist diagnose the cause is imperative to providing effective treatment.