Vertigo(Dizziness): Causes, Treatment & Types

Dr. Raman Abrol, a senior  ENT consultant, at Abrol Institute and Research Centre. He talks about a very general problem that people usually call dizziness, vertigo. 

What is Rotatory Vertigo? 

Vertigo, which people often mistake for dizziness, is a very common problem. It is an age-related problem. But nowadays, it is also seen in certain professions. There are two classified types of vertigo, the first one being rotatory vertigo. In this, the person feels dizzy and feels like he’s spinning. And the other type would be general dizziness, imbalance, or not being stable, vertical shaking, etc. Patients usually use vague terms to describe their condition. This is non-rotatory vertigo. 

Cervical Vertigo and what causes it?

We will now focus mainly on rotatory vertigo as it is a bit of a severe condition and requires an ENT specialist to treat it. Cell phones are becoming a problem for young as well as middle-aged people. Being on the phone for long hours can prove harmful in many ways. When you use the phone, you bend your neck a certain way, and this posture can put a strain on your spinal cord. We have a name for this condition, cervical vertigo.  The cervical area on your neck is abnormally stretched when you look at your phone in a particular posture for long hours. The spinning in this condition is not very different from rotatory, they are also momentary spinning, but they only occur when you change the positioning of your neck. For example, you will experience spinning if you move your head from side to side or right to left. If there is a pain in the neck, spasm, shoulders, and arms and spinning, and dizziness, it is called cervical vertigo.  

Not going into detail, I would focus on the primary symptoms and the common problems people face to spread awareness about them and help them diagnose and treat them accordingly. 

How to treat Cervical Vertigo? 

So cervical vertigo is basically because of bad posture, but what should we do to fix this? 

Laptop and mobiles on eye-level:

Make sure to place your mobile phone or laptop at your eye level. Put the computer on a stand or table where the screen is at your eye level. This will help improve your posture and lessen the strain on your neck. 

Pain killers: 

For pain and spasm, the doctor prescribes painkillers, and for vertigo, Stugeron, Vertin, Stemetil, etc., these pills are usually not required unless the doctor feels the need to prescribe them to the patient. 

Physiotherapy:  

The other way to treat this is cervical physiotherapy. So for people who do not have a proper posture or are always bend over a screen should work on strengthening their neck muscles. They can even go through youtube and find neck muscle strengthening exercises. There are many physiotherapy videos to choose from. You can pick one of 10-15 min that suits you. 

What is BPPV?

Now, coming to rotatory vertigo. The patients who come to me with this problem suffer from BPPV, Benign paroxysmal positional vertigo. It is not a severe condition, as the name suggests. It’s benign, but it causes excessive spinning and dizziness. The patient panics, thinking it is something serious as if they are dying, telling that the spinning was so extreme. 

This condition is majorly positional, which means if he is lying down and turn to one side, he will experience spinning. So with this, we can conclude that if he turns on the left side and experiences dizziness and spinning, then the problem is with the balance organ of his left ear. And same goes for the right side as well. 

How does an ENT specialist diagnoses BPPV? 

80% of the patients suffer from rotation vertigo, BPPV. An ENT specialist can easily diagnose this. A DST is done. An ENT specialist would twist the person’s neck from left to right while he’s sitting. The patient might experience extreme dizziness and excessive spinning on any side. The direction in which the eye is spinning is also noted. This is how it is diagnosed. 

Why does it happen? 

With growing age, the balance organ degenerates. The tiny particles detach themself and settle on some sensitive area causing irritation in the balance organ. 

The particles settle in a particular place. This is why the person only experiences vertigo when he moves his head on any one side. 

How is vertigo treated?  

It is not very difficult to treat vertigo as it is not a life-threatening disease. Therefore, it is easy to treat. 

Epley maneuver:

As ENT doctors, we treat it using an Epley maneuver. This helps in fixing the positioning of the head. Mostly the patient recovers without medicines. But in some cases, the doctor prescribes Stugeron, Vertin, Stemetil for 5-7 days, as they experience excessive spinning. 

Vestibular Exercises 

The other thing that the doctor would suggest is adaptation exercises. Vestibular adaptation exercises are recommended to regain balance. These exercises are to be started as quickly as the person experiences vertigo. 

The primary purpose of these exercises is to make the brain relearn and regain its’s balance. In addition, it trains the brain to comprehend the false signals coming from the dysfunctioning balance organs. These adaptation exercises are proven to be very effective. The patient regains their balance and gets relief within a week. Not only this, these exercises prevent this condition from resurfacing again. 

Bad posture and balance organ dysfunction are the two most common causes of vertigo. However, other reasons are not as common, and I will discuss these sometime later. 

Now, coming back to the symptoms. If there are other symptoms than dizziness, like paralysis, hearing loss, tinnitus, or the duration of spinning has increased, the head is spinning the entire day, also vomiting and nausea. Then these should be investigated thoroughly. An MRI test is to required as these are severe symptoms. The other test is needed, such as hearing tests.  

We would talk about this in another video. My purpose for today was to make you aware of the two major causes, i.e., cervical vertigo and BPPV.