Carenotes > Vertigo

Vertigo

GENERAL INFORMATION:

What is vertigo? Vertigo (VER-ti-go) is a type of dizziness. It is a false feeling that you are moving or that everything is spinning around you. Vertigo is a symptom that may be caused by diseases or conditions that affect the vestibular system. This system helps keep you in balance, even while you are moving, and includes the inner ear, nerves, and brain. The inner ear contains the nerve of the ear and small organs that help you hear and maintain your balance. The inner ear is filled with fluid that acts as a sensor when you change the position of your head.

What causes vertigo? Vertigo may be caused by conditions affecting the part of the ear or brain that controls balance. These conditions may be any of the following:

• Benign paroxysmal positional vertigo: This is also called benign postural vertigo or benign positional vertigo. It happens when small particles, that float in the inner ear fluid, get out of place and cause irritation.
  
  
• Meniere's disease: This disease happens when the pressure in the inner ear increases because of too much ear fluid.
  
  
• Vestibular neuritis: This is an inflammation (swelling) of the nerve in your ear caused by an infection.
  
  
• Other causes:
  
  
  • Ear trauma: Ear trauma may form a perilymphatic fistula (abnormal connection between the inner and middle ear). Injuries to the head and neck area, side effects of medicines, and chemicals may also cause ear trauma.
    
    
  • Infections: Inner ear infections may cause swelling, eardrum thickening, or abnormal skin growth in the ear.
    
    
  • Neurologic conditions: Neurologic (brain and nerve) conditions, such as multiple sclerosis, migraine, tumor, or stroke may cause vertigo. Behavior problems, such as mood, panic, and anxiety disorders, may also cause vertigo.
    
    
  • Alcohol: People who drink alcohol too much and too often may have vertigo. Alcohol may be found in beer, liquor (vodka or whiskey), and other adult drinks.

What are the signs and symptoms that come with vertigo? You may feel that you or everything around you is moving or spinning. You may also feel like you are being pulled downwards toward the floor or toward your side. Symptoms may occur after changing positions, such as turning over in bed or moving your head or neck. You may have nausea (upset stomach) or vomiting (throwing up). You may also have trouble with your balance, which may cause you to fall down. Other signs and symptoms may also be present and may help point to the disease or condition that is causing your vertigo. These signs and symptoms may include the following:

• Being highly sensitive to light or sound.
  
  
• Body weakness, slurred speech, problems seeing, increased sleepiness, or problems while moving.
  
  
• Facial weakness and headache.
  
  
• Hearing loss, ear fullness or pain, or hearing ringing sounds.
  
  
• Nystagmus (abnormal fast movement of the eyes). You may not feel or know this movement is happening.

How is vertigo diagnosed?

• Health history: Your caregiver will take a detailed health history from you. This may include information on what triggered your vertigo, when it started, and how long it lasted. You may also be asked to provide information about your past diseases, travels, activities, trauma, and medicines you have taken now and in the past.
  
  
• Physical exam: Your caregiver will do a complete physical exam on you. He may do positional testing by moving your head in different directions. This test will check to see if a problem in the inner ear is causing your vertigo. You may be asked to do some exercises that could make you dizzy.
  
  
• Tests: Different tests may be done depending on the disease or condition that your caregiver thinks may be causing your vertigo. This may be based on your health history, the pattern of your vertigo, and other signs and symptoms. It may also be based on the findings he may get from your physical exam. You may have any of the following:
  
  
  • 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
    
    
  • Auditory brainstem response (ABR) test: This test plays a series of clicks through headsets on your ears. A special machine is used to measure how your cochlea and nerves react to the clicks.
    
    
  • Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. It is tested to see how your body is doing. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
    
    
  • C-spine x-rays: You may need cervical spine (c-spine) x-rays to check for broken bones or other problems in your neck. Several pictures may be taken of the bones in your neck. These neck bones are called vertebrae.
    
    
  • CT scan:
    
    
    • This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your brain. It may be used to look at bones, muscles, brain tissue, and blood vessels.
      
      
    • You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.
    
    
  • Electronystagmography: This test is also called an ENG. An ENG is done to test for problems you may have with balance or dizziness. Sticky pads with wires are placed on the skin around your eyes. The wires are connected to a special machine that records information during your ENG. Warm and cool air or water is put into your ears while your eye movements are recorded. Do not drink alcohol or eat a heavy meal before this test. You may feel dizzy or sick to your stomach after the test.
    
    
  • Lumbar puncture: This procedure may also be called a spinal tap. During a lumbar puncture, you will need to lie very still. Caregivers may give you medicine to make you lose feeling in a small area of your back. Caregivers will clean this area of your back. A needle will be put in, and fluid removed from around your spinal cord. The fluid will be sent to a lab for tests. The tests check for infection, bleeding around your brain and spinal cord, or other problems. Sometimes medicine may be put into your back to treat your illness.
    
    
  • MRI: This test is called magnetic resonance imaging. During the MRI, pictures are taken of your head. An MRI may be used to look at the brain, muscles, joints, bones, or blood vessels. You will need to lay still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

How is vertigo treated? Treatment will depend on the condition causing the vertigo. Your caregiver may suggest bed rest, avoiding certain activities, and changing your diet, such as decreasing salt intake. If you are using medicines that may be causing your vertigo, they may need to be decreased or stopped. You may also have any of the following:

• Medicines: Medicines may be given to relieve your vertigo. You may also be given medicine to relieve symptoms caused by vertigo, such as nausea, dizziness, vomiting, and headache. If a bacterial infection is causing your vertigo, your caregiver may give you antibiotics.
  
  
• Surgery: Surgery to correct certain problems in the ears or brain may be done.
  
  
• Therapy: A form of exercise therapy may be used to help decrease your dizziness, improve your balance, and prevent injuries.

When the cause is found and treatment begins as soon as symptoms begin, your vertigo may be resolved and further problems prevented.

Where can I find support and more information? Having vertigo may be life-changing for you and your family. Accepting that you have vertigo may be hard. You and those close to you may feel sad or frightened. These are normal feelings. Talk to your caregivers, family, or friends about your feelings. You may also want to join a vertigo support group. This is a group of people who may also have vertigo. Contact the following for more information:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• American Hearing Research Foundation
  8 South Michigan Avenue, Suite 814
  Chicago, IL 60603-4539
  Phone: 1-312-726-9670
  Web Address: http://www.american-hearing.org
  

• Vestibular Disorders Association
  P.O. Box 13305
  Portland, OR 97213-0305
  Phone: 1-503-2297705
  Phone: 1-800-8378428
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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