Common causes of vertigo

Some of the most common causes of vertigo are as below

Benign paroxysmal positional vertigo (BPPV)

In this condition, patients complain of vertigo on change of position or up and down movements of the head. It is caused by the collection of calcium particles (otolith) in the inner ear, which irritate the nerve that maintains the body’s balance when in a particular position. The patient experiences attacks

of severe spinning on turning the head into a particular position. Vertigo usually lasts for less than a minute. Treatment consists of repositioning manoeuvres under VNG guidance like Epley, Semont’s, or Barbeque Maneuver depending on the position of the otolith.

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Labyrinthitis

Labyrinthitis is caused by bacterial infection of the balance and hearing nerve in the inner ear leading to intense vertigo, hearing loss and ringing in the ear.

Mal de Debarquement Syndrome (MdMS)

This condition usually starts after sea or air travel with the patient feeling a rocking or floating sensation. The unsteady feeling usually decreases during driving and alcohol consumption. Patients suffering from MdMS require vestibular rehabilitation.

Meniere's Disease

This is caused by increase in the pressure of the fluid present in the inner ear. The patient has spells of vertigo, ringing in the ear and hearing loss, usually in one ear.

Ototoxicity

Sometimes, some medicines may damage the nerves of balance or hearing causing dizziness and hearing loss. Some commonly used drugs, which are ototoxic, are aspirin, anti-malarial

and anti-TB drugs, and antibiotics ending with – mycin. Early diagnosis of ototoxicity is done by Dynamic Visual Acuity(DVA) testing and Audiometry.

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Vestibular Migraine

Patients usually identify migraine with headaches. But migraine may also present in the form of vertigo or dizziness. These patients often complain of spinning or unsteadiness, sound intolerance and motion sensitivity. Lifestyle changes and medical treatment are the mainstay of treatment.

Vestibular Neuritis

Vestibular neuritis is caused by the infection of the nerve of balance; the patient complains of intense nausea and vomiting along with vertigo. It may last a few days leading the patient to be confined to bed.

Early diagnosis and vestibular rehabilitation help in faster recovery.

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Acoustic Neuroma

Acoustic Neuroma, also called Vestibular Schwannoma, is a slow growing non-cancerous tumour of the Vestibulocochlear nerve. This nerve is responsible for conducting impulses regarding hearing and balance from the ear to the brain.

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Multiple Sclerosis

Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system. It has an auto-immune origin in which the body’s own immune system attacks the myelin sheath of nerve fibers. This myelin sheath is a protective cover of the nerve and facilitates nerve conduction.

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Superior Semicircular Canal Dehiscence

Superior semicircular canal dehiscence or SSCD is a condition which has only recently been identified; it was first described by Lloyd Minor in 1998. This condition affects the inner ear leading to auditory and vestibular symptoms.

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Tinnitus

Tinnitus is the sensation of sound heard by the patient, which may be described variously as ringing, buzzing, hissing, etc. McFadden defined sound as the conscious experience of sound that originates within the head of its owner, in other words without any external source.

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Vestibular Paroxysmia

In this condition, the patient suffers from short spells of vertigo which occur recurrently. It is due to compression of the vestibular or balance nerve.

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