Vertigos

Types of vertigo and our ears

Who has not experienced this unpleasant feeling of vertigo at least once? The feeling that the room is spinning, nausea, blurry vision, dizziness, a heaving or falling sensation… Mostly benign, vertigo can be so intense in some people that it seriously affects their quality of life.

Keeping one’s balance is a complex job that requires participation from the vestibular (ear), visual and somatosensory (tactile feelings) systems. The central nervous system is the conductor whose role is to integrate the information coming from all the systems.

Vertigo and balance problems are among the most frequent complaints heard by health professionals and affect 20 to 30% of the general population. Approximately 40% of the vertigo and balance problems are caused by a problem in the inner ear. The others are caused by problems in the central nervous system or other medical or psychiatric issues.

Types of vertigo caused by inner ear disorders

Benign paroxysmal positional vertigo (BPPV)

BPPV is the most common cause of vertigo and is caused by  movements of the head, or “positional” movements. Even though the feeling can be very strong, it usually subsides within seconds and only comes back when the person gets up or turns over in bed. This type of vertigo is benign and not serious. In most cases, a session of vestibular reeducation with a health professional is all it takes to make the problem go away.

 

Aging

Normal aging of the inner ear and the central nervous system occasionally cause instability and balance problems. Vestibular reeducation done via exercises at home can help reduce the symptoms of vertigo from aging.

 

Vestibular neuritis and labyrinthitis

Vestibular neuritis is caused by a problem in the vestibular nerve resulting from a viral or vascular condition. It appears first with an acute phase that lasts 42 to 72 hours, causing severe vertigo, nausea and vomiting. Once this phase ends, the symptoms gradually decrease (from several days to months).

Labyrinthitis is a viral or bacterial infection of the inner ear that causes symptoms that are similar to vestibular neuritis but that include hearing loss and tinnitus (ringing of the ears). As with neuritis, medication may help reduce the symptoms during the acute phase; vestibular reeducation exercises help reduce the residual symptoms of vertigo.

 

Ménière’s disease

This is a chronic disorder of the inner ear that generally manifests in people between 20 and 50 years old and that affects less than 1% of the population. Caused by an imbalance of fluid pressure in the inner ear, the usual symptoms are episodes of vertigo, fluctuating deafness usually in low frequencies, tinnitus and a feeling of fullness in the ear. Some of the treatments for this condition are a low-sodium diet, diuretic medication, anti- vertigo drugs or surgery.

 

Superior canal dehiscence

This is the thinning of the bony wall of the inner ear caused by aging, a congenital condition, a bone illness or trauma, often caused by loud noises. Surgery is often necessary to correct the condition.

 

Side effect of some medication

Several medication note vertigo as a possible side effect. Some of these drugs are ototoxic, meaning they can damage the vestibular system, while others may affect blood pressure or the central nervous system. Ask your pharmacist or doctor for more information.

 

Types of vertigo from other medical conditions

Vestibular migraine

Migraines affect 10% of the population and have a strong heredi- tary prevalence. More women than men suffer from migraines. The typical symptoms are headaches, photophobia, phonophobia and abnormal visual perceptions (ophthalmic auras). A vestibular migraine is a neurological disorder whose symptoms resemble those of inner ear problems. For example, the person may feel motion sickness and rotational or positional vertigo, lasting from several seconds to several days. Treatment includes avoiding migraine triggers like stress and certain foods along with preven- tative or therapeutic medication.

Unlike the types of vertigo caused by a problem in the inner ear, the symptoms resulting from problems in the central nervous system, other medical conditions or psychiatric disorders are often chronic, continuous and without specific triggers. They cause a feeling of light- headedness and walking on cotton or on ground that gives way underneath your feet. Cardiovascular diseases, a stroke, hypoglycemia, anxiety, stress, depression and visual problems can also cause vertigo.

 

Be aware

Despite the fact that most types of vertigo and balance problems are often benign, they sometimes signal a health issue that needs to be treated. It is vital to pay attention to vertigo, as it may also cause falls and fractures. If you have the least question about the cause of dizziness, see a general physician, otorhinolaryngologist or an audiologist.

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