07/05/2023
Vertigo
POSITIONAL VERTIGO
is an alarming symptom. It is often due to an inner ear dysfunction. It is scaring as loss of balance is the prime feature of this problem. As you wake up and begin to get of the bed the whole world is spinning around you. The coat, the walls of the room, the roof and every thing in the room is rotating around you. There may be associated nausea and even vomiting . Vertigo can happen any time. It may occur while sitting and working or standing, bending or resting and lying on a bed.
There are many definitions for vertigo. Loss of balance is one among them. False sensation of movement, Loss of space orientation, rotation of objects around, feeling of falling are other definitions . Some people describe these symptoms as giddiness . Difficulty to hold head and neck steady, blurring of vision, heaviness of head are often described as giddiness.
Posture and equilibrium of body is maintained by the inner ear vestibular system, the visual inputs and the feed from proprioceptive impulses from muscle spindles of the musculoskeletal organs. They function in harmony. Any aberrations in the harmonious function of these three lead to loss of balance.
Vestibular system consist of three semicircular canals, utricle and saccule. These are parts of the inner ear. These have an active participation in informing orientation of body and its posture relative to the surrounding. Linear and angular acceleration of head and body is informed by this system.
Benign Paroxysmal Positional vertigo is often precipitated by bending body to stoop down or turning head to sides. It occurs while getting up from bed or tilting head forward backward or to sides . Classically vertigo last for few seconds and disappears . But recurs each time on tilting head to sides either right or left. Very short duration and fatigability is the characteristic feature of this disease . Sometimes it is very dangerous as patient may fall down. Dislodgement of otoconia crystals from utricle into one semicircular canal(posterior semicircular canal )is considered as the cause of vertigo.
The symptoms such as vertigo can be controlled with Betahistine hydrochloride or cinnarizine , or promethazine. But these should be used under the supervision of a medical expert as these drugs can cause serious sides effects .
Epley’s maneuver is a procedure by which the dislodged otoconia debris is brought back to the utricle. It is a very simple procedure done in Out Patient department. By a successful correction by this procedure drugs can be avoided.
There are some simple head neck exercises with which the positional vertigo can be controlled .
Vertigo is only a symptom .So it should be investigated to exclude brain tumors or other demyelinating or degenerating neurotological diseases .
