Vertigo Treatment
Keep pace with life, don't lose your balance.
What is Vertigo?
Looking at the origin of the word vertigo, we see that it means “to turn” or “to spin.” It is a Latin word. Although it is commonly used to describe dizziness, vertigo is not defined as a disease on its own; rather, it is considered a symptom. Vertigo is a sign of various disorders occurring in the inner ear and nervous system. However, in some cases, it can occur as a standalone condition and is then referred to as “vertigo disease.”
The causes of vertigo include all disorders related to the auditory balance system and the ear’s balance function. These conditions can be listed as follows:
- Meniere’s disease
- Vestibular neuritis: Viral infection of the balance nerve
- Cerebrovascular conditions: Brain hemorrhage
- Labyrinthitis: Viral or bacterial infection of the inner ear
- Migraine
- Perilymphatic fistula: Leakage of fluid from the inner ear to the middle ear
- Anxiety
- Superior canal dehiscence: Vertigo triggered by loud sounds, coughing, or sneezing
- Side effects of various medications (e.g., gentamicin, streptomycin, chemotherapy drugs)
- Alcohol use: Affects the inner ear fluid and disrupts the balance system
- Acoustic tumor: Usually develops on the balance nerve and grows slowly
- Benign positional vertigo: Related to inner ear crystals
What are the Symptoms of Vertigo?
Vertigo, as its Latin meaning suggests, is a disorder associated with dizziness. Therefore, cases of dizziness can easily be interpreted as vertigo. The patient complains of circular dizziness. If the severity of vertigo increases, the person may be unable to move and may experience nausea, falling, and vomiting in addition to dizziness. There is a feeling of being pushed forward, backward, or to the side.
Symptoms include blurred vision, imbalance, lightheadedness, a desire to walk while holding onto something, a feeling of people closing in on you in crowded places, and easy fatigue.
These conditions can also be related to other disorders. However, imbalance, a feeling of intoxication, and a feeling of being about to faint are among the most prominent features of vertigo. In advanced stages, vertigo can cause serious problems such as falls and broken arms or hips. Therefore, it is essential to consult a specialist doctor if you experience any of the symptoms mentioned. Diseases like vertigo generally fall within the purview of the Ear, Nose, and Throat (ENT) department. This is because 80-90% of ear-related health problems manifest as vertigo.
What is the Balance-Related Part of the Ear That Causes Vertigo?
We can define the ear parts as the outer, middle, and inner ear. The outer ear includes the auricle and the outer ear canal up to the eardrum. You can examine the outer ear canal with cotton swabs.
The middle ear is located deeper than the eardrum. Middle ear inflammation, as we call it, wakes children up in the mornings with fever and often pain. Some middle ear diseases affect the inner ear, which is located further inside, and can cause vertigo. If there is a serious problem in the middle ear, it can be said that vertigo originates from this condition.
The deepest part of the ear, the inner ear, is a structure that provides balance and orientation. This mechanism is called the vestibular organ. It is located at the base of the cochlea, which is related to hearing, in the back half of the inner ear. To make an analogy, the vestibular organ is like a spirit level used by carpenters. It contains a fluid-filled chamber and has tube-like canals.
When the head moves, these fluids are in motion, and this tells our brain where the head is located within its environment. For example, if we are in a car, it tells us whether the car is moving forward or backward. There are two vestibular organs. One is in the right ear and the other is in the left ear. As a result of a disease, the vestibular organs become asymmetrical or unequal, with one side being more dominant, which causes vertigo.
How is Vertigo Diagnosed?
Vertigo is diagnosed through comprehensive examinations and tests performed by an Ear, Nose, and Throat (ENT) specialist. The specialist attempts to make a diagnosis by considering all relevant risk factors, symptoms, and findings. Ear examination is crucial at this stage. If the problem is thought to originate from the ear, an audiogram (hearing test) is appropriate. Additionally, examinations of the middle ear (tympanogram), videonystagmography (balance test) involving 10-14 consecutive tests, and acoustic reflex tests are necessary.
If the source of the problem is thought to be the vestibular nerve (balance nerve), an MRI using gadolinium is appropriate. If these tests yield no results, a clinical diagnosis from an ENT specialist is required.
How is Vertigo Treated?
The most successful and effective treatment for vertigo is vestibular rehabilitation. Vestibular rehabilitation is a branch of physical therapy and rehabilitation. It would be accurate to call the treatment of vertigo symptomatic; it aims to eliminate symptoms. In cases where the exact cause is not understood, clinical treatment by an ENT specialist is sought.
Vertigo treatment is particularly important for improving the quality of life of patients and preventing falls and fractures in elderly patients due to vertigo. The appropriate treatment methods for vertigo can be listed as follows:
Medication: In emergency situations, it is applied to prevent vomiting during the first 3-5 days when vomiting is most likely to occur.
Vestibular Rehabilitation: This method corrects and improves balance system disorders that can trigger vertigo problems.
Surgical Method: This can only be preferred in cases of perilymphatic fistula and superior canal dehiscence.
