Contrary to some popular song lyrics, feeling the earth move around you may not be love but vertigo. Vertigo is a feeling of lightheadedness and the sense of moving when you’re standing still. Sometimes, you feel well grounded but everything around you moves.
Vertigo isn’t a disease, but instead, it’s a symptom. While the symptom may be of something as simple as seasickness or a tipple too much hooch, it also could be from something as serious as a cerebral hemorrhage.
Dizziness
Some people mistake dizziness for vertigo. Vertigo is dizziness but not all dizziness is vertigo. Vertigo is the feeling you’re moving or the room about you is moving. When you think about the last time you were on a boat all day, when you went to bed, you experienced the room moving with the same up and down movement of the boat. That’s vertigo. If you’ve had too much to drink and lay in bed with the room spinning, that’s vertigo. If you stand up and get a “head rush” where you think you’re going to pass out, that’s dizziness.
The difference is minor and you can see why most people clump them together. However, the reasons for dizziness, because it tends to be an umbrella term, vary far more than the reasons for vertigo.
You can classify dizziness into four categories
The first is vertigo where the earth spins. The second is disequilibrium where the person with it has problems with balancing and their legs don’t seem to function properly. The third is (pre)syncope. This comes right before you pass out. Finally, there’s a category called lightheadedness. That’s a catch all for everything else.
Statistics show that if you talked to five Americans, at least two of them went to the doctor for dizziness or vertigo. While many times the cause is benign, sometimes the vertigo comes from serious illnesses such as a stroke or tumor so getting the appropriate tests is important to rule these possibilities out of the picture.
Benign Paroxysmal Positional Vertigo (BPPV)
Most of the time vertigo comes from problems in the inner ear. One of the most common causes of vertigo is benign paroxysmal positional vertigo (BPPV). This one is easy to diagnose and treat but often doctors don’t use the simple technique to diagnose the syndrome and instead, subject the patient to hours of expensive tests.
The simple test for BPPV, vertigo that occurs when a patient leans forward, rolls over in bed or sits up after being in a supine, lying-down, position is the Dix Hallpike maneuver. The doctor starts with the patient in a sitting position and turns the patient’s head 45 degrees to the right. Then he moves from sitting to lying on their back with the head approximately 20 degrees lower than the body, continuing to maintain the 45-degree turn of the head.
During this time, the patient must leave his eyes open. Eye movement is one of the key indications of this type of vertigo. If the test is positive for BPPV, the patient feels vertigo in about 10 seconds or less. It often lasts approximately 30 seconds. During that time, the doctor sees the patient’s eyes move up and down or “twisting” known as nystagmus. When the patient returns to sitting position, the nystagmus sometimes change direction and the patient again feels vertigo.
Octonia in the Ear Canal
The cause of BPPV, responsible for 20 percent of vertigo, is literally rocks in your head. Okay, they’re calcium carbonate crystals called octonia in the ear canal, not really rocks. When they move out of their position and into the semicircular inner ear canals, they float. When you move your head in a certain way, they create vertigo.
In order to find the side affected, the doctor performs the test twice. If the patient is dizzy when the head turns and the right ear is toward the floor, the problem is in the right ear.
Treatment for BPPV may include doing nothing, since this is a self-limiting problem and disappears in weeks to a few months. An alternative is using the Semont maneuver or the Epley maneuver to clear the “ear rocks” away. Both involve moving the head briskly to reposition the octonia to a different area. You’ll find information on both movements at the bottom of the page on Dizziness-and-balance.com
Other causes of vertigo can include an in infection or inflammation in the inner ear. The inflammation of the nerve, called vestibular neuritis, comes from an infection and causes vertigo. Ear infections cause swelling and sometimes abnormal skin growth on the eardrum that can cause vertigo.
Meniere’s disease
Meniere’s disease is another frequent cause of vertigo. While not all people with Meniere’s disease have the same symptoms, the most typical ones are vertigo and dizziness, hearing loss in one or both ears, ringing in one or both ears and a feeling of pressure in one or both ears.
Doctors call Meniere’s disease idiopathic endolymphatic hydrops. If you break the term down, it isn’t nearly as difficult as it seems. Idiopathic means they don’t know the cause. Endolymphatic is one of the fluids in the cochlea that’s in the inner ear. Hydrops means build up or swelling. When you put the terms together, it means there’s a build-up of endolymphatic fluid in the inner ear and the doctors don’t know why.
Meniere’s disease can come from a number of occurrences. It might be delayed trauma from an accident, which medically changes its name to delayed endolymphatic hydrops, but the result is the same. It can come as a secondary problem to a previous illness or disease.
No matter how you develop Meniere’s, there’s no cure, just ways to make the disease less debilitating. Treatment with drugs, hearing aids, surgery, physical therapy, middle ear injections and a new device called a Meniett are all some of the maintenance treatments.
Other causes of vertigo
Ear trauma from a blow to the head, injuries to the neck, side effects from chemicals or medicine can also cause vertigo. Neurological conditions, those that affect the brain and nerves, such as stroke, tumor, migraine and multiple sclerosis can also cause vertigo.
Problems with panic attacks, anxiety disorders and mood disorders may give the patient vertigo. One of the major causes of vertigo that is easy to cure is too much alcohol. The recommended cure for this is time and to say “no” the next time you’re offered one too many.