What is vertigo?
Vertigo is a condition in which the sufferer feels as if the surrounding environment is spinning or floating. This condition will also make the sufferer lose balance, making it difficult to just stand or even walk. The best way to describe vertigo is to rotate your body several times and feel the conditions produced.
Keep in mind, vertigo is not the name of the disease. However, a collection of symptoms can occur suddenly or last for a certain period of time.
Signs & symptoms
What are the symptoms of vertigo?
The common symptoms of this disease are dizziness, a spinning head sensation and loss of balance. These signs will trigger the sufferer to experience the sensation of nausea, vomiting, excessive sweating, headaches, sometimes even accompanied by nystagmus (abnormal eye movements), ringing in the ears (tinnitus) and the sensation of feeling about to fall. Usually, this condition will disappear and can last for several minutes, hours, or even days.
Please consult a doctor if your condition does not improve. The doctor will usually ask for your symptoms, do a simple examination, and recommend further examination. Especially if the frequency of you experiencing this disease includes often.
What are the causes of vertigo?
The actual cause of vertigo depends on the type of vertigo experienced. In general, there are two types of vertigo that are grouped according to the cause. Each condition also has its own causes.
1. Peripheral vertigo
This is the type of vertigo that is most often experienced by most people. The cause of peripheral vertigo is caused by a disturbance in the inner ear which functions to regulate the body's balance.
When you move your head, the inside of the ear will tell you where your head is and then send a signal to the brain to maintain balance. However, if there is a problem in the inner ear, you will feel pain and dizziness. This can occur due to inflammation in the inner ear or because of a viral infection.
In addition, this type of vertigo is caused by several other things such as:
Benign paroxysmal positional vertigo (BPPV)
BPPV is the most common cause of vertigo, a condition in which the inner vestibular ear is disrupted and triggered by sudden changes in position and head movement. For example:
- Change the position of the head from an upright position to a sudden bow
- Wake up suddenly from sleep
- Movement of looking up head
The condition of BPPV is also more susceptible to people who have had surgery on their ears, have a history of head injuries, have ear infections, and are currently in a period of healing and bedrest.
Experts suspect that the BPPV occurs due to the presence of kabonate crystal fragments which are released from the inner ear canal wall. So this way, in the middle ear, there is a crystal of carbonate which functions to create the illusion of motion. When a change in head position occurs suddenly, these crystals will enter into the part of the ear containing the balance fluid.
The entry of these crystals stimulates abnormal fluid movements when you move a particular head. Well, this is what makes a person become unbalanced and the world around him is spinning.
This condition usually occurs in a short time and is often experienced by people aged over 50 years. However, it is also possible if younger people can experience this condition.
History of head injury
Other causes of peripheral vertigo are due to the impact of a history of head injury. People who have had a head injury before, may experience inner ear disorders which then cause vertigo.
Experiencing labirintitis
Labirintitis is inflammation and infection that occurs in the inner ear, especially on tortuous and fluid channels. This inner ear plays an important role in controlling one's hearing and balance. Inner ear infections are usually caused by viruses and bacteria, for example in people with flu or colds.
If you experience this disease due to labirintitis, other symptoms that will also arise are nausea, vomiting, loss of hearing ability, pain in the ear, and fever.
Vestibular neuronitis
Vestibular neuronitis is inflammation that occurs in the nerve part of the ear that is directly connected to the brain. Inflammation is caused by a viral infection that usually occurs suddenly without accompanying symptoms or other signs, there is even no problem with hearing ability.
This condition can occur for several hours a day. Symptoms of loss of balance, headache, nausea, and even munta. Although this inflammation occurs in the nerve part of the ear, this condition usually does not make the sufferer experience hearing loss.
Ménière's disease
Ménière's disease is a rare disease that attacks the inner ear. Although Ménière's disease is rare, this condition can be a very severe cause of vertigo. Even in some cases, symptoms include ringing in the ears, and hearing loss over a period of time.
If you experience Ménière's disease, the symptoms that appear will be experienced for several hours or even days. This disease is also accompanied by symptoms of severe nausea and vomiting. Although quite dangerous, experts have not been able to ascertain what is the cause of Ménière's disease.
2. Central vertigo
Unlike peripheral vertigo caused by disturbances in the ears and balance organs, central vertigo occurs due to problems in the brain. The part of the brain that most influences the occurrence of this disease is the cerebellum or cerebellum.
The following are some of the conditions that cause vertigo central:
- Migraine, which is the next headache, is unbearable accompanied by throbbing pain and is often experienced by young people. Migraine is usually experienced by young people and is considered as one of the common causes of this disease. Avoiding triggers and treating migraines can usually relieve this disease.
- Multiple sclerosis, is a nerve signal disorder that occurs in the central nervous system - the brain and spine - which results from errors in a person's immune system.
- Acoustic neuroma is a benign tumor that grows in the vestibular nerve, the nervous system that connects the ear to the brain. So far the acoustic neuroma is caused by a genetic disorder.
- Brain tumors that attack the cerebellum or cerebellum, resulting in impaired body movement coordination.
- Stroke, which is a blockage of blood vessels that occurs in the brain.
- Take several types of drugs that can cause vertigo side effects.
How to diagnose vertigo?
Just like the initial diagnosis of the disease in general, the doctor will ask everything related to the headache that you feel in detail. Starting from the sensation of vertigo experienced (float, shake, or spin), the trigger for the emergence of vertigo, frequency of appearance, duration, and so forth.
In addition, your doctor will also ask about your medical history, including a history of migraines, head injuries or ear infections in the near future, and medications that you regularly consume.
If needed, the doctor will do a further physical examination. This examination is intended to see hearing function, eyeball motion, and brain function. Some of the inspection methods include:
Head impulse test
The patient is asked to focus on the tip of the doctor's nose while the head is moved quickly to one side. If the patient's eyes remain focused on the doctor's nose during this movement, the test results are negative rather than vertigo.
Romberg Test
The patient is asked to stand with both feet tightened, first his eyes open then the doctor will tell him to close his eyes for some 20-30 seconds. Positive test results if the patient loses balance or falls after closing his eyes.
Unterberger Test
The patient stands with both legs straight forward and walks in place by lifting the knee as high as possible for 30 seconds with eyes closed. If he is positive for vertigo, he will spin the side, towards the problem side.
Nystagmus test
Examination is performed to determine uncontrolled eyeball movements (nystagmus) by instructing the patient to perform rapid maneuvers that can trigger vertigo. When the test takes place, the patient will be monitored using an Electronystagmography (ENG) and Videonystagmography (VNG) device which serves to record eye movements using special glasses.
Hearing examination
This examination uses a tuning fork and audiometry test performed by an ENT doctor, especially if you experience tinnitus (buzzing ears) or hearing loss.
Supporting investigation
In addition to the several tests mentioned above, to ensure further doctors will also conduct a series of other supporting tests such as blood and urine tests, x-rays, CT scans, and MRI.
How to treat vertigo?
Often the symptoms of vertigo will improve over time even without treatment, one of which is to rest. This happens because your brain can adjust to changes in the inner ear, in an effort to maintain the balance of the body.
Even so, there are various treatments that are determined based on the causes and severity of vertigo experienced by patients, including:
1. Vertigo caused by Benign Paroxysmal Positional Vertigo (BPPV)
Following a few simple head maneuvers can be a way to deal with the sensation of dizziness you experience.
Epley maneuver
- Sit up straight on the edge of your bed with your legs hanging. Turn your head 45 degrees to the left. Place a pillow under you, so when you lie down, the pillow will rest between your shoulders and not under your head.
- Immediately lie down, head towards the bed (fixed at a 45 degree angle). The pillow must be under your shoulder. Wait 30 seconds.
- Turn your head 90 degrees to the right without lifting it. Wait 30 seconds.
- Turn your head and body from the left side to the right side, so you can see the floor. Wait 30 seconds.
- Slowly sit again, but stay on the bed for a few minutes.
- Repeat the movement instructions from different sides and do this movement three times before going to bed every night, until you don't get dizzy for 24 hours.
Foster / Half Somersault Maneuver
- Sit down and lean your head up to the ceiling for a few seconds.
- Touch the floor with your head (prostration). Slide the chin into the chest so that the head touches or enters the knee. Wait for about 30 seconds.
- Still in a prostrate position, turn your head towards the troubled ear (if you feel dizzy on the left side, turn your face to your left elbow). Wait 30 seconds.
- Then with a quick motion, lift your head until it is aligned horizontally with your back. Keep your head fixed at a 45 degree angle. Wait 30 seconds.
- After that, with a quick movement, also lift your head and sit up straight, but keep your head facing the shoulder in the same position as the problematic ear. Then, slowly slow down.
You can repeat it several times to reduce dizziness. After the first round, rest for 15 minutes before continuing to the second round.
After doing some of the maneuvers mentioned above, try not to move your head too far up or down in a few moments.
If you don't feel better for a week after trying the exercise, talk to your doctor immediately, and ask what you should do next. You might not do the exercise correctly, or maybe something else causes your headache.
2. For vertigo caused by Ménière's disease
If your vertigo is caused by this disease, there are a number of things you can do to help alleviate both symptoms, namely:
- Limit consumption of salt and diuretics to reduce the volume of fluid stored in the body
- Avoid caffeine, chocolate, alcohol, and cigarettes
- Perform physiotherapy to overcome balance disorders
- Acupuncture and acupressure for some people can reduce both symptoms, but until now there has been no scientific evidence that this is effective.
3. Take certain drugs
To reduce symptoms, your doctor can give vertigo medication to make you feel more comfortable. Some drugs commonly used to relieve symptoms of this disease such as headaches, nausea and vomiting include: meclizine, promethazine, diphenhydramine, dimenhydrinate, and lorazepam.
Doctors will also consider giving antibiotics or steroids that function to reduce swelling and cure infections. As for Ménière's disease, diuretics (water pills) can be prescribed to reduce pressure from fluid buildup.
Information about dosages and other types of drugs, always consult your doctor or pharmacist before starting treatment.
4. Therapy of vestibular rehabilitation (VRT)
This therapy is done if the complaint is experienced is dizziness and difficulty maintaining body balance. This is a type of physical therapy to strengthen the vestibular system. Functionally, the vestibular system plays a role in maintaining balance, coordination, and control of body movements.
5. Operation
If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain or neck, surgery can be done to help alleviate and even cure this disease.
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