What Is Vertigo?
Vertigo is a symptom with a sensation of self or spinning around which happens suddenly. There's a mild vertigo condition and not too noticeable and there is a severe that inhibits the routine. Vertigo attacks may vary, ranging from mild dizziness and appearing periodically to severe and prolonged. Severe attacks can persist for several days so that the sufferer can not move normally.
Other Symptoms Accompanying Vertigo
Another symptom associated with vertigo is loss of balance. These signs will trigger people with vertigo to have difficulty standing or walking, nausea , vomiting, sweating, sometimes accompanied by nystagmus (abnormal eye movements) and dizziness .
Please consult a doctor if your vertigo does not heal. Your doctor will usually ask for your symptoms, perform a simple examination, and advise further examination. Especially when the frequency of vertigo is included is often experienced, so the diagnosis of vertigo can be ascertained.
Various Causes of Vertigo
Vertigo is usually caused by interference with the inner ear. This disorder will trigger the problem of the body's balance mechanism. While other common causes include:
- Vertigo Paroxysmal Position Benign or commonly term Benign Paroxysmal Positional Vertigo (BBPV) Â â € "vertigo triggered by a certain head position change.
- Migraine - an unbearable headache.
- Meniere's disease â € "a disorder that attacks the inner ear.
- Vestibular neur oni ti s , namely inflammation of the vestibular nerve in the inner ear.
- Disorders of the brain, such as tumors.
- Certain medications that cause ear damage.
- Trauma or injury to the head and neck.
Treatment and Prevention Vertigo
Vertigo itself includes symptoms and not disease. Therefore, how to overcome vertigo depends on the disease that causes it.
Most cases of vertigo can heal without treatment. This may be because the brain is successfully adapting to changes in the inner ear.
There are also several causes of vertigo that require special treatment steps. Among others are:
- Epley's maneuver to deal with BBPV.
- Drugs, such as prochlorperazine and antihistamines. However, these drugs are usually only effective for the early stages and should not be used long term.
- Vestibular rehabilitation therapy to help the brain to adapt to the confusing signal from the ear that causes vertigo, so the frequency is reduced.
In addition to treatment from a doctor or therapist, we can also do a number of ways to reduce or prevent symptoms of vertigo. These steps include:
- Avoid movement suddenly so as not to fall.
- Immediately sit if vertigo attack.
- Use some pillows to position the head during sleep becomes higher.
- Move your head slowly.
- Avoid head movements looking up, crouching, or body bending.
- Get to know your vertigo triggers and do exercises that can trigger your vertigo. Your brain will become accustomed and even lower the frequency of recurrence of vertigo. Do this exercise by asking someone for help.
- For those of you who also suffer from Meniere's disease, limit the consumption of salt in the daily menu.
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Causes Of Vertigo
In general, vertigo is a symptom triggered by a distorted mechanism of balance in the inner ear. However, there are some other diseases that can also be the cause.
This type of vertigo can be divided into two categories according to the cause. The two categories are:
- Peripheral vertigo . This is the most common type of vertigo. Peripheral vertigo is triggered by a distortion of the balance mechanism located on the inner ear. These disorders include labyrinitis, vestibular neur on itis , vertigo of benign paroxysmal position (BPPV), and Meniere disease.
- Central Vertigo . Disorders or problems in the cerebellum (cerebellum) located beneath the cerebellum or brain stem (the lower part of the brain connected to the spinal cord) are potentially causing this vertigo. Other central vertigo causes include migraine , multiple sclerosis , stroke and transient ischaemic attack (TIA) , due to certain drugs, as well as brain tumors located in the cerebellum or benign tumors of the auditory nerve (acoustic neuroma).
The following are the disorders that cause peripheral vertigo, among others:
Vertigo Benign Paroxysmal Positional Vertigo (BPPV )
BPPV is a major trigger for vertigo and is generally caused by sudden change of position and head movement. For example:
- Look up.
- Standing up from a squat position
- Rotate or bow your head.
BPPV can also attack for no apparent reason. Or it could happen after the patient has ear infections, ear surgery, head injury, and long lay.
The cases are characterized by short, intense, and repetitive vertigo attacks (usually lasting for a few seconds or minutes). The symptoms that accompany it can also be nausea, vomiting, dizziness, dizziness, and nystagmus (uncontrolled eyeball movement) that lasts briefly so you can not focus.
Experts suspect that BPPV occurs due to debris debris (calcium carbonate crystals) that escape from the inner ear canal wall. These flakes only cause disruption when it enters the inner ear canal full of fluid. And finally trigger an abnormal fluid movement when we do certain head movements. That movement will send a confusing signal to the brain and cause vertigo.
BPPV generally attacks the elderly aged 50 years and over. However, it is possible to be experienced by older and younger people.
Vertigo and Labirinitis
The labyrinth is a tortuous and fluid channel to the inner ear that controls hearing and balance. Inflammation due to infection of the sensitive structure is known as labyrinthitis.
Labyrinthism will cause differences in information sent to the brain from sick ears, healthy ears, and eyes. This is what can trigger vertigo and dizziness.
Common causes of labyrinthitis are viruses, for example in people with colds or flu . However, bacteria can also be a trigger although rare. Vertigo due to labyrinthitis is usually accompanied by symptoms:
- Pain in the ear.
- Gag.
- Nausea .
- Tinnitus or ringing ears.
- Loss of hearing.
- High fever .
Vestibular Neur on itis Behind Vertigo
Inflammation of the nerves linking the labyrinth and brain is called vestibular neur on itis . This inflammation may also spread to the labyrinth in the ear. Vestibular Neur on itis may last for several hours to several days, but it can sometimes take 1.5 months to fully recover.
The disease that often comes suddenly is usually caused by a viral infection. Meanwhile, the symptoms include a sullen body, nausea, and vomiting. However, patients usually do not experience hearing loss.
Vertigo Due to Meniere's Disease
Meniere's disease is a rare disease that attacks the inner ear. Severe vertigo, hearing loss, ringing ears, and full sensation of the ear are some of the common symptoms.
Vertigo in Meniere's disease will occur suddenly and last for hours, or even days. These symptoms also often trigger nausea and vomiting.
The cause of this disease is not known for certain, but the symptoms can be controlled with diet and medication. This condition rarely requires surgery as a follow-up.
Impact of Head Injury
Vertigo can sometimes arise after a head injury. Immediately go to the doctor or go to the hospital if symptoms occur, such as dizziness or vertigo, after a head collision. Central vertigo is commonly caused by disruption of the cerebellum or cerebellum and brainstem.
Vertigo Due to Migraine
Migraine is an irresistible headache attack, especially on the front or on one side of the head that is sometimes accompanied by nausea and is sensitive to light (photophobia).
Migraine is usually experienced by young people and is considered as one of the common causes of vertigo. Avoiding triggers and treating migraines can usually cure vertigo.
Diagnosis Of Vertigo
The first stage of diagnosis in each disease usually begins with a doctor who asks your symptoms. In people with vertigo, a detailed description of the symptoms will be asked. For example, about the situation in your first attack, the duration, the frequency of occurrence, the trigger, the effects of symptoms on everyday life, changes in hearing, Â tinnitus , Â or vomiting.
In addition to symptoms, your doctor will also ask for your medical history as well as your family, and any medications you consume regularly. Likewise with ear infections or head injuries that have been experienced in the near future.
Further examination stage will be recommended if needed. Some of these inspection methods include:
Examination by Triggering Vertigo
Doctors generally advise health checks to distinguish the causes behind vertigo. This process involves examining the inside of the ear and eyes to check for the presence or absence of uncontrolled eyeball movement (nystagmus).
Your doctor may also check your balance or fish your vertigo with Dix-Hallpike maneuvers. The most commonly diagnosed cause of vertigo with this process is Vertigo Position Paroxysmal Benign (BPPV).
Hearing Examination to ENT Specialist
Examination through a tuning fork test and audiometric test will be performed by ear, nose and throat (ENT) specialists, especially if you have tinnitus (ear buzzing) or hearing loss.
Nystagmus Examination
Nystagmus may indicate a problem in the organs that control the body's balance. Detailed examination sometimes uses electronistagmographic (ENG) processes and eye recording process with videonistagmography (VNG) glasses.
Caloric Testing for Balancing Organs
This test uses warm or cold water to be poured into the ear. This is to check the performance of balance organs in the ear that are already stimulated by changes in temperature of water
Posturography to Check the Balance
Posturography will help with rehabilitation planning as well as monitor the treatment process, and use a balance testing machine.
Scanning Process in Head
Doctors also sometimes recommend an MRI scan  or a CT scan  at the head to check for the cause of vertigo, such as acoustic neuroma ( benign tumor ).
Treatment Of Vertigo
Sometimes vertigo does not require special treatment and can heal by itself. However, there are various treatment methods for vertigo.
Step treatment of this symptom is determined based on the cause and severity of vertigo experienced by the patient. For example, nausea and spinning sensations may be reduced by lying still in a dark room, avoiding stress-inducing situations that decrease anxiety and severity of vertigo, as well as the consumption of drugs.
Vertigo Benign Paroxysmal Positional Vertigo (BPPV)
Vertigo The position of Paroxysmally Benign (BPPV) has the potential to heal without special treatment. This process usually takes several weeks or several months. Estimated, this healing occurs because the debris causes vertigo in the ear canal has been melted and absorbed by the body, or attached to other parts. However, there is still a possibility of relapse.
As long as BPPV is not fully healed, you should wake up slowly and avoid activities that require you to look up. This step serves to reduce the percentage of vertigo recurrence.
If needed, your doctor will recommend some special steps to handle BPPV. Among them include:
Treatment of vertigo through Epley maneuver
This procedure, also called canalite repositioning, has been shown to be effective in treating vertigo. The Epley maneuver includes four different head movements, and each head position should be held for at least 30 seconds. You may experience vertigo during the procedure.
Your condition will generally improve after the Epley maneuver, but total recovery takes up to a maximum of two weeks. The effect of this procedure is usually short-term and needs to be repeated, but consult your doctor if you remain vertigo after four weeks.
Treatment of vertigo with Brandt-Daroff exercise
This procedure is a series of movements BBPV relief to relieve vertigo. Although it can not heal, Brandt-Daroff exercise can reduce symptoms of vertigo in the long run.
This exercise you can do yourself at home, but you are encouraged to learn it first from the doctor. Do it at least twice a day.
Migraine Triggering Vertigo
If a migraine is diagnosed as a cause of vertigo, the person may be treated at home. Drugs used are also generally the same as migraines, such as triptans.
Labyrinthine Infection
The disease is generally caused by viral infections and can be cured without treatment. Although rare, bacterial infections may also cause labyrinthitis and are usually treated with antibiotics.
Your doctor may refer you to an Ear, Nose and Throat (ENT) specialist or an audiovestibular specialist (a doctor who specializes in hearing and balance disorders) if you are losing your hearing. You may need emergency treatment to restore your hearing.
Labyrinthitis can also be treated with vestibular rehabilitation therapy. Although this type of therapy is still very rare in Indonesia, you can ask your doctor further.
Vestibular Neuronitis
The disease can recover within weeks without treatment, but you may have to lie down if you have severe vestibular neuritis . Get to the doctor immediately if your condition does not improve after seven days. The disease can also be treated with vestibular rehabilitation therapy and medication.
Meniere's Rare Disease
If your vertigo is caused by this disease, there are several effective steps to simultaneously deal with both. Among others are:
- Medication to prevent and deal with Meniere's disease.
- Improving diet, especially low-salt.
- Physiotherapy to overcome balance disorders.
- Handling for hearing loss, such as hearing aids.
- Treatment for tinnitus (ringing ears), such as sound therapy that can reduce the difference between tinnitus noise with other sounds to reduce tinnitus ence.
Treatment for secondary symptoms of Meniere's disease, such as stress, anxiety, and depression .
Steps of Vestibular Rehabilitation Therapy
This therapy is called Vestibular Rehabilitation Training ( VRT ) and is generally recommended for treating recurrent vertigo.
VRT includes a series of specific exercises to encourage the brain to adapt to the vertigo trigger signals from the ear. The brain is stimulated to rely on signals from other parts of the body, such as the eyes and feet, rather than the inner ear.
When used, the brain will minimize the symptoms of vertigo and maintain the balance of the body. This therapy is done with the guidance of a specialist audiology doctor or physiotherapist.
Used Medicines
Vertigo attacks that can be treated with drugs are:
- Vertigo caused by vestibular neuritis or Meniere's disease.
- Central Vertigo.
- Vertigo without obvious cause.
The duration of taking medicine given by the doctor depends on the severity of the vertigo, but generally for three days to two weeks. Drugs that may be given are:
- Prochlorperazine . This drug will block the effects of dopamine that helps to relieve severe nausea and vomiting due to vertigo. Side effects include tremor (shaking), uncontrolled body or facial movements, and drowsiness.
- Antihistamines that function to inhibit the influence of histamine compounds. This drug can be used to relieve nausea, vomiting, and symptoms of lighter vertigo. The types of antihistamines that doctors usually give are cinnarizine, cyclizine , and promethazine theoclate . In addition to drowsiness, this medication may also cause side effects such as headaches and stomach aches .
- Betahistine . This drug is used to treat Meniere's disease and other balance disorders. Its performance is similar to antihistamines and is usually given for long term.
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