Vertigo is a sensation of spinning, imbalance, or dizziness that may occur due to disorders of the inner ear and vestibular system. Proper evaluation is important to identify the underlying cause, as treatment varies for different types of vertigo. Management may include repositioning maneuvers, medications, vestibular rehabilitation, lifestyle modifications, and balance exercises, depending on the diagnosis.
1. BPPV (Benign Paroxysmal Positional Vertigo)
BPPV is one of the most common causes of vertigo. It occurs when tiny calcium crystals inside the inner ear become displaced and interfere with the balance system. Patients typically experience brief episodes of spinning when turning in bed, looking up, bending down, or changing head position. It can often be effectively managed with specific canalith repositioning maneuvers such as the Epley maneuver.
2. Ménière’s Disease
Ménière’s disease is an inner-ear disorder that can cause recurrent episodes of vertigo along with fluctuating hearing loss, ringing in the ear (tinnitus), and a feeling of pressure or fullness in the affected ear. Management may include dietary and lifestyle modifications, medications, and other treatment options depending on the frequency and severity of symptoms.
3. Vestibular Neuritis
Vestibular neuritis occurs due to inflammation affecting the vestibular nerve, which carries balance information from the inner ear to the brain. It commonly causes a sudden and prolonged episode of severe vertigo, imbalance, nausea, and vomiting, generally without significant hearing loss. Treatment may include short-term symptom-control medications followed by vestibular rehabilitation exercises to help restore balance.
4. Labyrinthitis
Labyrinthitis is inflammation of the inner-ear labyrinth and can affect both balance and hearing. Patients may experience sudden vertigo, nausea, imbalance, tinnitus, and hearing loss. Treatment depends on the underlying cause and severity, and may include medications for symptom relief, appropriate treatment of the underlying condition, and vestibular rehabilitation when required.