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Vertigo

A false sensation of movement often combined with nausea and vomiting

  • Age, genetics, and lifestyle as risk factors depend on the cause
  • Gender is not a significant factor

People with vertigo feel as if they or their surroundings are moving. These false sensations are often accompanied by a feeling of spinning and may be associated with nausea and, sometimes, severe vomiting. Vertigo may result from disturbance affecting the organs of balance in the inner ear (the vestibular apparatus), the nerve that connects the inner ear to the brain, or the areas of the brain concerned with balance. Rarely, it is a sign of a serious underlying condition and needs urgent medical attention.

Vertigo often develops suddenly and may last from a few seconds to several days, occurring either intermittently or constantly. The condition can be very distressing and, in severe cases, may make it impossible to walk or even to stand. In most cases, vertigo disappears on its own or following treatment of the underlying disorder.

What are the causes?

Vertigo is often associated with arthritis in the neck (see Cervical spondylosis), a disorder that mainly affects older people. In this condition, vertigo occurs when the head is turned or tilted, thereby compressing blood vessels that supply the parts of the brain involved with balance.

Another common cause of vertigo is an infection of the vestibular apparatus (see Labyrinthitis). The infection usually begins as a viral infection of the respiratory tract, such as a common cold or influenza or, less frequently, a bacterial infection of the middle ear (see Otitis media). This type of vertigo usually starts suddenly and lasts for 1–2 weeks.

Recurrent vertigo combined with hearing loss and sounds in one or both ears (see Tinnitus) may be due to the inner-ear disorder Ménière’s disease. Vertigo may also be a side effect of certain antibiotics, due to excessive alcohol consumption, or be a symptom of food poisoning or heatstroke (see Heat exhaustion and heatstroke).

Vertigo is sometimes caused by calcified material moving around in the inner ear and causing dizziness when the head is moved. This condition often improves over a few weeks or months.

Rare causes of vertigo include a tumour affecting the nerve connecting the inner ear to the brain (see Acoustic neuroma), a stroke, a head injury, or multiple sclerosis. These serious conditions may also cause other symptoms, such as speech or vision problems or weakness in a limb. If vertigo is accompanied by symptoms of this type, you should seek immediate medical attention.

What can I do?

You may relieve vertigo by lying still and avoiding sudden movement. If you have been vomiting, take small sips of water every 10 minutes to avoid dehydration until the symptoms subside.

If the vertigo persists for more than a few minutes, or if it becomes recurrent, you should consult your doctor.

What might be done?

Your doctor may examine your ears, eye movements, and nervous system to look for a cause. Tests may include a caloric test, in which air at different temperatures is blown into the ear to check the function of the vestibular apparatus. A neck X-ray may be done to look for cervical spondylosis. If you also have tinnitus, you may have CT scanning or MRI to rule out a tumour pressing on the brain.

Your doctor may recommend drugs to relieve the symptoms of vertigo (see Antiemetic drugs, and Antihistamines). If vertigo is a side effect of an antibiotic, you may be given an alternative drug. Other treatment will be aimed at the underlying cause. For example, vertigo caused by a bacterial infection of the vestibular apparatus may be treated with antibiotics.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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