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Vertigo Causes and Cures

Diagnosing dizziness and vertigo is not an easy touch and go process. These symptoms can be arising from a variety of causes. Potential causes of dizziness and vertigo can include, the inner ear, brain, muscles, infection, mental health issues such as depression and anxiety, and other very serious medical conditions. It is important to determine whether the patient’s symptoms are a result of gait disturbances or vertigo. In fact, one of the most important information of a patient’s dizziness is the length of the patient’s dizzy episodes. With good history, clinical investigation and physical testing, the practitioner is able to more clearly understand and diagnose the dizziness complaint. 

Benign Paroxysmal Positional Vertigo BPPV

Benign Paroxysmal Positional Vertigo (BPPV) is the result of tiny crystals of calcium oxalate detaching from the gelatinous membrane in the utricle or saccule. These crystals are a normal part of the inner ear anatomy, but become abnormal when they attach from their correct anatomical location. When this happens, the crystals migrate to one or more of the ear’s six semicircular canals. These canals should be free of any crystal or debris and are important for sensing head movement. When you move your head, these crystals shift and can cause an error message to the brain. This disruptive crystal can cause abnormal flow of the inner ear’s endolymphatic fluid. This false signal to the brain can produce symptoms of vertigo. It is very important for the brain to process a lot of information of balance, and where you are in space. Any disturbance to this process can cause symptoms of dizziness and vertigo.

Typically, disruptive signals to the brain can cause something called nystagmus, which is abnormal eye movement. This abnormal eye movement is how clinicians are able to diagnose your vertigo and allow them to tap into the cause of the symptoms and how to effectively treat.  Dizziness, and vertigo is a very common complaint and BPPV is also very common. This type of vertigo or dizziness is reported to occur with changes in head position and episodes of vertigo last for seconds to minutes. Symptoms can normally be improved by keeping the head still, or preventing lying down in the positions that causes the vertigo. 

Cure for BPPV

Typically positional vertigo treatment techniques can move the crystal to the correct location. This type of treatment may improve symptoms within 1-3 treatments. Sometimes, residual dizziness or off balanced is reported and this can be improved with vestibular retraining techniques. 

Meniere’s Disease

Meniere’s disease is also called idiopathic endolymphatic hydrops. This disease involves the excessive buildup of fluid in your inner ear. It's characterized by sudden episodes of vertigo lasting as long as several hours. You may also experience fluctuating hearing loss, ringing in the ear (tinnitus) and the feeling of a plugged ear. In most cases only one ear is involved, but both ears may be affected but more rare. Overall, excessive inner ear fluid may accumulate either due to excess production or inadequate absorption. The cause of this conditions is believed to include hereditary and or autoimmune factors. Meniere’s disease can cause complaints of vertigo, fluctuating tinnitus and hearing loss. These symptoms are seen to last hours to days. Sometimes, patients can become chronically dizzy due to permanent damage caused to the inner ear. However, the primary finding could be hearing fluctuation associated with episodes of dizziness.. 

Cure for Meniere's 

Medical management is an important aspect of therapy. Here your doctor may send you for testing of hearing and the vestibular system. It is important to follow of of your recommended appointments and see a specialist in some cases. Typically medications are used to ease the symptoms and reduce the pressure in the ear. Vestibular physiotherapy can help with symptoms of dizziness and off balanced and help retrain the system. In some cases, surgical intervention is necessary. 

Central Vestibulopathy

Central Vestibulopathy involves patients that have dysfunction involving the central processing and integration of visual, somatosensory, and vestibular information coming from the ear into the brain. 'Central' typically means brain, and damage to the brain can arise from a variety of causes.  Some causes include: stoke, tumours, autoimmune disease, cortical and brainstem lesions, hydrocephalus, traumatic brain injury resulting in bleeding, and concussion. Patients present with complaints of chronic balance and dizziness issues that go up and down while sitting or standing. Balance disturbances and other visual disturbances can also occur. 

Cure for Central Vestibulopathy 

Medical intervention is necessary to determine the cause. Once the initial cause has been treated, medical management is occurring, vestibular rehab therapy can improve balance, gait disturbances, dizziness and vertigo. In regards to concussion, management of the initial concussion can include concussion physiotherapy, and then vestibular therapy as well to help with symptoms improve. 

Peripheral Vestibulopathy

There are causes of chronic peripheral vestibulopathy. This is typically dizziness with no relief. Some diagnosis may include: viral syndromes causing permanent damage, Acoustic Neuromas, Semi Circular Canal Dehiscence,  autoimmune inflammatory disorders. The patient will report a chronic daily sensation of dizziness that may improve and worsen throughout the day. Symptoms can cause dizziness, off balance, vertigo. Patients will have difficulty while sitting or standing, and symptoms will worsen with head accelerations. Patients will also have severe difficulty tracking with their eyes and a loss of targeted gaze. 

Cardiovascular, Cardiogenic, & Cardiac Arrhythmias

Cardiogenic dizziness occurs as a result of an sudden decrease in blood flow to the brain. Causes can include abnormal heart beats that decrease the available blood to the brain. Sometimes, certain smaller arteries in the brain can loose flow due to dissection or restriction. Many people can feel dizziness when they stand up too quickly. This is known as orthostatic hypotension. This is the inability of the heart to provide blood flow to the brain as it fights gravity. Sometimes, dizziness of the above related companies can be accompanied with chest pain and the sensation of heart palpitations and shortness of breath, 

Gait Difficulties and Gait Ataxia

These patients have gait or balance complaints that occur while walking and performing normal daily actives. Sometimes, symptoms are not observed during  sitting. Some common causes of this can include severe central spinal stenosis, brain pontine ischemic disease, and peripheral neuropathy. Patients may walk with a wide based unsteady gait, have multiple falls or near falls. 

Severe Migraine

The severe migraine variant is the term applied to a migraine that has more symptoms than simply a bad headache. This means that patients can experience tinnitus, hearing loss, and even visual disturbances. This may be caused by changes in blood vessels and pressure and blood flow to the cortex. These patients report episodes of vertigo that may last hours to days.