What is vertigo?

Vertigo as a symptom of dizziness

Vertigo is a sensation of false movement, mostly described by patients as a sensation of spinning in the head but sometimes as tilting. Vertigo can be accompanied by imbalance, presyncope, and lightheadedness¹. Presyncope means lightheadedness or the sense of impending collapse¹. Because vertigo provokes a loss of balance, one of its most likely consequences is a fall.

Disequilibrium that describes a sense of imbalance, unsteadiness, and postural instability is an important trigger of vertigo¹.¹.

Vertigo can have many forms²:

• Some patients experience a brief spinning episode, lasting for only a few seconds.
• Some patients experience less frequent vertigo, but the attacks are moderately severe regarding the symptoms.
• For some, vertigo can be severe and occur frequently, affecting their daily activities.

Most patients experience a vertigo attack that only lasts for a few seconds, but even a short spinning, shaking, or falling sensation, can be terrifying. The fear that it might re-occur can prevent people from carrying out routine tasks, such as driving a car and crossing the street.

Causes of vertigo

Vertigo is most often caused by disturbances in the inner ear. If vertigo arises from a disorder of the ear and the structures surrounding it, it is called peripheral vertigo³. The most common types of peripheral vertigo are as follows⁴:

• Benign paroxysmal positional vertigo—where specific head movements cause vertigo.
• Labyrinthitis—an inner ear infection triggered by a cold or flu virus.
• Ménière’s disease—a rare inner ear condition that sometimes involves ringing in the ear (tinnitus) or loss of hearing.

What factors can trigger vertigo ?

Vertigo can also be a symptom of many conditions, some of which can be dangerous. If you experience vertigo, the first and most important step is to discuss this issue with a doctor. He or she will be the best person the find the cause of your vertigo and help you prevent future attacks!

Symptoms of vertigo

Usually, vertigo manifests itself with the following symptoms⁵:

• Dizziness or a sensation of spinning
• Feeling light-headed
• Balance problems
• Nausea—sensation to vomit
• Migraine

Many exercises can help manage vertigo and reduce the frequency of attacks. Sitting, standing, and walking exercises involving head and eye movements can help prevent vertigo⁶.

Exercises for preventing vertigo

In case of more serious symptoms, such as

• double vision
• ringing in the ears (or even. deafness)
• difficulty to speak, walk or swallow

you should urgently seek medical help.

Vertigo can result in psychological difficulties

Because of the risk of falling, vertigo has a significant psychological impact on people. Vertigo may cause considerable distress, anxiety due to fear of falling, and fatigue, driven by its unpredictability and inability to be controlled. Vertigo can create a fear of public and open places and being in these situations can induce panic attacks and depression⁷. Consequently, chronic vertigo can result in difficulties in all aspects of social life, be it professional or personal environment.

Patients can have a fear of vertigo itself and the associated medical constraints. Patients suffering from vertigo may avoid activities such as going out alone to meet friends, drive to their relatives, which results in a sense of social isolation and withdrawal from social situations⁷. For example, one patient can feel stressed and experience panic when taking his/her children or grandchildren to a park or playing sports with them. People suffering from vertigo avoid events, such as going to the theatre, the cinema, or concerts. Patients lose their valued activities and can become fearful of being disliked or stigmatized, which may further drive anxiety and depression.

In case of psychological experiences like these, it is important that patients speak up and discuss their thoughts with doctor, family, and friends to get support.

References

1. Salvinelli F, Firrisi, M Casale, M Trivelli, L D’Ascanio, F Lamanna, F Greco, Costantino S. “What is vertigo?” Clin Ter. 2003; 154 (5): 341-348.
2. Bateman K, Rogers C, Meyer E. An approach to acute vertigo. S Afr Med J. 2015;105(8):694.
3. RACGP – An approach to vertigo in general practice. https://www.racgp.org.au/afp/2016/april/an-approach-to-vertigo-in-general-practice/. Published 2020. Accessed October 28, 2020.
4. NHS. Vertigo. nhs.uk. https://www.nhs.uk/conditions/vertigo/. Published 2020. Accessed October 14, 2020.
5. Victoria State government. Vertigo (BPPV). https://www.bettersafercare.vic.gov.au/sites/default/files/2019-07/Vertigo.pdf. Published 2020. Accessed October 28, 2020.
6. Umc.edu. Vestibular exercises. https://www.umc.edu/Healthcare/ENT/Patient%20Handouts%20-%20ENT/Otology%20Handhouts/vestibular-exercises-2016.pdf. Published 2020. Accessed October 29, 2020.
7. Yardley L, Todd A, Lacoudraye-harter M, Ingham R. Psychosocial consequences of recurrent vertigo. Psychol. Health. 1992;6(1-2):85-96.