The vestibular system is one of three sensory systems that help with spatial orientation and posture. The other two are the visual system (retina to occipital cortex) and the somatosensory system, which relays information from skin, joints, and muscle receptors. The three stabilizing systems overlap enough to compensate (partially or entirely) for each other’s shortcomings.
According to studies, 85 per cent of patients with inner-ear problems benefit from vestibular rehabilitation or physiotherapy at home, and 30 per cent recover completely.
Types Of Vertigo
Physiologic Vertigo:
This occurs in healthy people when
- The brain faces an intersensory mismatch between the three stabilizing sensory systems.
- Such as those experienced during seasickness.
- Unusual head/neck positions include excessive extension when painting a ceiling.
- Following a spin, another type of physiologic vertigo is space sickness, which is a common transient effect of active head movement in a weightless zero-gravity environment.
Pathologic Vertigo:
This is caused by damage to the visual, somatosensory, or vestibular systems. As well as the sudden onset of extraocular muscle paresis with diplopia.
Vertigo can also be classified as Central or Psychogenic Vertigo based on its cause.
Causes of Vertigo
Causes of diseases affecting the vestibular apparatus include-
- Benign paroxysmal positional vertigo- BPPV is the most common cause of vertigo. After identifying the involved semicircular canal.
- Vestibular neuronitis- Vestibular neuronitis is managed by vestibular sedatives like Beta-Histines or Cinnarizine and rest.
- Meniere’s disease- Meniere’s disease is managed by the reduction of fluid intake and diuretics.
Central vertigo is-
- Stroke
- Demyelinating diseases
- Vestibular migraine
Central causes are more serious and necessitate hospitalization with an MRI scan for imaging. They need more intensive treatment for strokes or high-dose steroids for demyelinating illness.
Thus, vertigo necessitates an expert evaluation by a neurologist to determine the cause and plan a treatment strategy.
The signs and symptoms of vertigo
- Dizziness
- A feeling that you or your surroundings are spinning or moving (vertigo)
- Unsteadiness or loss of balance
- Nausea
- Vomiting
Treatment:
- A detailed history focused on the patient’s interpretation of “dizziness” is the most important diagnostic tool. Rapid rotation and abrupt cessation of movement in a swivel chair is the most basic provocative test for vestibular dysfunction. This always causes vertigo, which patients can compare to symptomatic dizziness.
- A final provocative and diagnostic vestibular test requires using Frenzel eyeglasses (self-illuminated goggles with convex lenses that blur the patient’s vision but allow the examiner to see the eyes greatly magnified), is vigorous horizontal head shaking for about 10 seconds.
- In cases of recurrent monosymptomatic vertigo with a normal neurologic examination, such an examination is rarely helpful.
- Acute vertigo is treated with maximum bed rest of 1–2 days and vestibular relaxant drugs such as antihistaminics, tranquillizers with GABA-ergic effects, phenothiazines, or glucocorticoids.
- If vertigo lasts more than a few days, most doctors recommend ambulation to try to induce central compensatory mechanisms, despite the patient’s short-term discomfort. A systematised vestibular rehabilitation program can treat chronic vertigo of labyrinthine origin.
- Prophylactic measures to prevent recurrent vertigo are ineffective in some cases. A diuretic or, more effectively, a very low salt diet (1 g/d) may help with Meniere’s disease.
- Cognitive-behavioural therapy is the most effective treatment for psychogenic (“phobic postural”) vertigo.
Conclusion:
Vertigo can be caused by a variety of factors, including head injury, migraines, Labyrinthitis, or BPPV, all of which can be effectively treated with physiotherapy at home. Physiotherapy at home in Hyderabad can help treat vertigo and provide you with a personalized treatment plan to reduce your symptoms.
