Vertigo: Treatment, Procedure, Cost and Side Effects

Vertigo may cause a person to feel that he/she is rotating or rocking or as if the world is spinning even when he/she is perfectly still. Sound waves enter through the outer ear canal and reach the ear drum. There the sound is converted to vibrations and when these vibrations reach the vestibular nerve, it carries these signals to the brain. This mechanism together with the collection of semi-circular canals in the inner ear helps to provide real-time feedback regarding a person’s position in space. Vertigo implies a dysfunction in any part of this entire procedure.

There can be different causes of vertigo and the causes can be differentiated into peripheral or central. Central causes of vertigo have their roots in the brain and the spinal cord while the peripheral vertigo occurs due to some problem in the inner ear. However, vertigo in most cases occurs due to problems in the inner ear. Vertigo can occur if the inner ear gets inflamed due to illness or if the small hair cells within the semicircular canals get irritated. In this scenario, a person suffers from benign paroxysmal positional vertigo (BPPV). Meniere’s disease is a disorder of the inner ear that is caused due to fluid build-up and pressure changes in the ear. Vestibular neuritis or labyrinthitis is an inner ear problem that is often related to infection.

The treatment for vertigo depends on what is causing the problem. The various methods of treatment include vestibular rehabilitation, canalith repositioning maneuvers and medications. Sometimes, surgery may be needed if vertigo is caused due to tumor or injury to the brain or neck.

Aa to the current research in medical science, there are three types of Vertigo that can be found amongst the patients, they are:

1. Benign paroxysmal positional vertigo (BPPV): One of the most common types, this type of Vertigo often causes short episodes due to certain head movements. The sudden movement of the head causes the breaking of anatomical debris in your inner ear causing confusing stimulation in the small hair which gives you the sensation of dizziness.
2. Labyrinthitis: If you go through Vertigo with an underlying cause of ear infection, then labyrinthitis is the type. The infection often makes you feel like you are moving due to the confusion caused In the inner ear sensory by the external pathogen. This may also cause fever, earache, loss of physical control.
3. Vestibular neuronitis: Also known as vestibular neuritis, is mainly caused by a severe ear infection that has started to infect the vestibular nerve ( responsible for balance control). This Vertigo causes severe earache, nausea, and vomiting which can be frequent and sudden in its nature of occurrence.
4. Meniere’s disease: This Vertigo is quite rare amongst the patients. One of the most serious cases of Vertigo causes a sudden episode of Vertigo which can last up to 24 hrs.

Common causes of Vertigo are associated with the ear and its nearby organs, some of them may include:

• Paroxysmal positional Vertigo.
• Labyrinthitis.
• Vestibular neuronitis.

Ten common signs of Vertigo include:

• Fatigue
• Difficulty focusing vision
• Hearing loss
• Head spinning
• Balancing problem
• Sweating
• Nausea
• Vominging
• Dizziness
• Ringing in the ears

Labyrinthitis and vestibular neuronitis can be treated by vestibular rehabilitation. Vestibular rehabilitation involves carrying out some exercises that encourage a person’s brain to adapt to the ear’s abnormal messages. During this therapy, a person keeps moving despite feelings of dizziness and vertigo. This unique procedure trains a brain to avoid the confusing signals coming from inner ear and to rely on the signals coming from the other parts of the body. This method helps the brain to minimize any dizziness and helps the person to maintain balance.

BPPV is usually treated with a procedure called Epley maneuver. This is a procedure four different head movements are performed to move the fragments that cause vertigo to a position where they cannot produce any more symptoms. A person may experience vertigo during the movements. Although this procedure may provide some immediate relief, total recovery can be achieved only after 2 weeks. Brandt- Daroff exercises are recommended if the Epley maneuver does not work.

If vertigo is caused due to Meniere’s disease, a person will need to adopt a low-salt diet, take medications, treat tinnitus- ringing in the ears- with sound therapy, treat hearing loss, undergo physiotherapy to regain balance and also have to get treated for the secondary symptoms of this disease. Sometimes medications can be used to treat various forms of vertigo. Two of the most commonly used medicines are prochlorperazine and antihistamines. Betahistine is recommended for long-term treatment of Meniere’s disease.

Vertigo refers to a sense of dizziness. This condition may develop due to a range of reasons. A person is eligible for treatment of vertigo if he/she experiences some or all of the symptoms associated with it. The symptoms are: dizziness, problems with balance, lightheadedness, a sense of motion sickness, tinnitus, feeling of fullness in the ear and nausea and vomiting. A doctor will determine whether a person is suffering from vertigo or not by means of a physical examination and checking the patient’s medical history. A person may also be advised to undergo an MRI or CT scan. Thus, a person will only be eligible for treatment after he/she has been properly diagnosed by a doctor.

A person who does not suffer from the symptoms of vertigo are not eligible for treatment. A person affected by Benign Paroxysmal Positional Vertigo is not suited to undergo the vestibular rehabilitation. Epley manouevre requires some head exercises to be done. A person who has a serious head/neck injury is not eligible for this treatment. A person needs to consult a doctor before understanding whether he/she is eligible to take medications like antihistamine and prochlorperazine.

The side-effects of vestibular rehabilitation therapy include dizziness, muscle fatigue, sedation, weakness, and unsteadiness and falls that may sometimes amplify the disorder. Epley manoeuvre does not have any serious side-effects. However, a small fraction of the patients who have undergone his treatment have experienced transient nausea while fewer people have experienced vomiting. Prochlorperazine has a number of side-effects like dizziness, drowsiness, sleep disorders, constipation, swelling of breasts, weight gain and missing of menstrual period for women. Antihistamine’s side effects include drowsiness, dizziness, vomiting, nausea, vision problems, confusion and problems in urination.

There are a number of post-treatment guidelines that a person can follow to ensure that this condition does not recur. A person can reduce the risk of developing central vertigo by controlling the risk factors for stroke. A person should not drive a car or a motorbike even after he has undergone treatment. There is always a risk of a mishap. If a person has undergone treatment for peripheral vertigo, he/she should continue with vestibular rehabilitation exercises. A person should also avoid operating large machineries or climbing the stairs.

The Epley maneuver to treat Benign paroxysmal positional vertigo shoe positive results almost immediately after the treatment. However, a person with BPPV will take about 2 weeks to recover completely. The Brandt-Daroff exercises, which are recommended to a person who doesn’t benefit from the Epley maneuver also takes about 2 weeks to get the patient cured fully. Surgery is recommended if the symptoms of vertigo persist for years. If central vertigo is caused due to a migraine, a person will recover as soon as the migraine is dealt with. Medicines usually cure a person suffering from vertigo within 3-14 days, depending on the severity of the condition.

The cost of prochlorperazine is around Rs 646 while antihistamines are available within a price range of Rs 1800 – Rs 2000. A CT Scan can cost something around Rs 70,000 – Rs 80,000.

It is believed that vertigo can be totally cured. Treatment of vertigo generally depends on treating the symptoms. Vertigo can be of two types: central and peripheral. Central vertigo can be cured by treating the accompanying migraine. Sometimes central vertigo is caused due to brain tumors. Surgery may be required to treat the brain tumor. This can, in most cases, permanently cure central vertigo. Meniere’s disease, which can also cause vertigo, can be treated by making some lifestyle changes and by treating some problems of the ear. Thus, as long as the inflammation inside of the ear is treated, vertigo can be permanently cured.

Food does not trigger Vertigo in an individual, but it can worsen the symptoms if one is going through it. Here are some of the food items that can worsen your Vertigo:

• Refined sugar.
• Food with extra or processed salt.
• Caffeinated drinks.
• Sodium enriched foods.
• Nicotine (smoking).
• Alcohol.
• Processed food & meat.
• Bread and pastries.
• Fried foods.
• Pickles and fermented foods.

Gingko Biloba is one of the most researched herbs that help to increase blood flow to the head and brain and thus can act as a natural cure for vertigo. Ginger, which helps to treat nausea, can also act to contain vertigo. Almonds and milk also help to treat vertigo. Other natural ingredients that help to contain vertigo are lemon balm, fruits and vegetables rich in Vitamin C, vitamin D, and garlic, and sesame oil.

Summary: Vertigo can be described as the sensation of one spinning or the surrounding spinning. The cause of Vertigo can be small as headrush drowsiness due to medication to a serious medical condition like labyrinthitis.