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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