When the brain takes you for a spin

Vertigo is a sudden internal or external sensation, often triggered by moving your head quickly. It’s a sensation of feeling off-balance.

CHENNAI: Imagine you are standing in the balcony of a high-rise building. You look down and feel dizzy. While this is common when standing at heights, what if you feel the same when you are just sitting or going about doing your daily chores? That is vertigo. “Is the world spinning, or are you feeling lightheaded?” — This could be the first question your doctor could ask when you visit him, narrating your stories of feeling dizzy.

Vertigo is a sudden internal or external sensation, often triggered by moving your head quickly. It’s a sensation of feeling off-balance. “Almost 10 per cent of adults report symptoms of vertigo and it increases to 40- 50 per cent in the elderly. It’s also a common causal factor for a fall in elderly people,” says Dr Sivarajan Thandeswaran, senior consultant, stroke and neurovascular medicine, Kauvery Hospital. He walks us through the general symptoms, treatment and preventive measures.

Causal factors
There are two categories of vertigo — peripheral vertigo and central vertigo. Peripheral vertigo occurs as a result of a problem in the inner ear or the vestibular nerve that connects the inner ear with the brain. Central vertigo occurs when there is a problem in the brain, particularly the cerebellum — the part of the hindbrain that controls the coordination of movements and balance.

Conditions that can trigger vertigo

• Benign paroxysmal positional vertigo (BPPV) is vertigo brought on by specific changes in the position of your head. It’s caused by calcium crystals floating in the semicircular canals of the ear.
• Meniere’s Disease is an inner ear disorder that affects balance and hearing.
• Labyrinthitis is an inner ear disorder. The two vestibular nerves in your inner ear send information to your brain about spatial navigation and balance control. When one of these nerves becomes inflamed, it creates a condition known as labyrinthitis.

Symptoms
Vertigo is often triggered by a change in the position of your head. Symptoms can last a few minutes or a few hours or may come and go. People with vertigo typically describe it as spinning, tilting, swaying, and pulled to one direction. Some other symptoms include migraine, vomiting, nausea, ringing in the ears or hearing loss, and abnormal or jerking eye movements. 

Treatment
The treatment for vertigo depends on what’s causing it. Vestibular rehabilitation: This is a type of physical therapy aimed at helping strengthen the vestibular system. The function of the vestibular system is to send signals to the brain about head and body movements relative to gravity.

Dix-Hallpike test: While on an examination table, you’re quickly lowered from a seated position to a supine position with your head pointed either slightly right or slightly left. A doctor will look at your eye movements to learn more about your vertigo.

CT and MRI scanning Preventive measures

• If you are prone to migraine, it must be kept under control.
• Low salt intake will keep fluid compositions in the ear intact.
• Reducing the volume of what you listen to is healthy for the ear.
• Sugar and blood pressure must be kept under control as that can prevent stroke.
• Regular use of earbuds must be avoided as it can damage the eardrums.
• Switch positions while using gadgets.