Vertigo is a balance disorder characterized by an inaccurate perception of movement and is frequently described as swaying, tilting, or whirling. It is a symptom, not an illness, and is typically caused by abnormalities in the inner ear (vestibular system) or, less frequently, the brain.
Vertigo can significantly affect mobility, safety, and daily activities. An accurate diagnosis is essential to find out the underlying cause and recommend appropriate medical interventions.
Typical symptoms include nausea, vomiting, unsteadiness, perspiration, and difficulty concentrating. In some cases, certain head motions may abruptly induce symptoms.
The following are all warning signs that indicate the necessity of immediate medical assistance:
Sudden severe headache
Facial or limb weakness
Difficulty speaking
Double vision
A lack of coordination or altered awareness.
Peripheral Causes (Inner Ear-related): These are the most common causes of vertigo, which are the result of a malfunctioning inner ear balancing system. Ear-related vertigo causes intense symptoms; however, they are generally not life-threatening.
Brain-related Causes: Brain-related vertigos are rare but severe and are rooted in the medulla or cerebellum. As central vertigo causes serious neurological symptoms, patients will need to undergo a prompt evaluation and receive necessary treatment.
Benign Paroxysmal Positional Vertigo (BPPV)
Peripheral vertigo is caused by displaced calcium crystals in the inner ear. These crystals sit in the utricle, which is a part of the vestibular system that aids in sensing gravity and balance.
It manifests as brief episodes of vertigo that are induced by head movements, such as turning in bed.
Vestibular Neuritis
Vestibular neuritis is an inflammatory condition of the vestibular nerve, often triggered by a viral infection.
It induces acute, persistent vertigo without significant hearing loss.
Migraine-Associated Vertigo (Vestibular Migraines)
Vertigo can occur in people who have had a migraine.
Episodes are frequently linked to light or sound sensitivity and may or may not be accompanied by a headache.
Ménière’s Disease
It is a chronic ear problem that often occurs with symptoms like fluctuating hearing loss, tinnitus, and ear congestion. The symptoms are the result of an abnormal regulation of the fluid in the inner ear.
Central Vertigo
Disorders of the cerebellum or medulla (parts of the brain) can lead to central vertigo. It is often linked to neurological abnormalities and requires immediate medical attention.
The objective of vertigo diagnosis is to determine whether the vertigo is central or peripheral. This is achieved through focused testing and clinical examination.
Evaluation of Physical Condition: The physician will assess various factors, such as the onset, duration, etiology, changes in hearing, and associated neurological symptoms. Eye movements, coordination, and balance are also examined.
The Dix-Hallpike Test: This positional test is done to diagnose benign paroxysmal positional vertigo (BPPV). This test reproduces vertigo and characteristic eye movements through the placement of the head in specific positions.
Head Impulse Test: During this bedside examination, the vestibular-ocular reflex is assessed to check how well the eyes can stabilize vision when the head moves. A peripheral vestibular illness, such as vestibular neuritis, may be suggested by an atypical reaction.
Balance and Gait Assessment: Tests like Romberg and gait assessment are done to examine postural stability. Vestibular or neurological involvement may be indicated by abnormal results.
Audiological (Hearing) Assessment: Particularly when vertigo is associated with tinnitus or hearing loss, hearing evaluations are an effective method for distinguishing inner ear disorders.
Neuroimaging (CT, MRI): Imaging is advised in the event that central vertigo is suspected or when red flag symptoms are present. MRI is the best way to determine brainstem and cerebellar causes.
Canalith Repositioning (Epley Maneuver)
Often recommended for BPPV, this approach involves guided head and body movements. It relieves symptoms and helps in the repositioning of misplaced inner ear crystals.
Medicines
Nausea, vomiting, and extreme motion sensitivity associated with vertigo may be alleviated with short-term medications. Unless otherwise specified, it is not advised to use it for an extended period of time.
Vestibular Rehabilitation Therapy (VRT)
Vestibular rehabilitation therapy is an exercise regimen that is designed to improve equilibrium and alleviate dizziness. A type of dizziness treatment, it facilitates the brain’s adaptation to vestibular dysfunction, particularly in chronic conditions.
Managing Underlying Medical Conditions
Addressing underlying conditions like inner ear inflammation or migraines is extremely important in effective vertigo management. Treatment plans are made after an accurate diagnosis is made and underlying conditions are identified.
Safety and Supportive Measures
Fall prevention strategies and short-term activity modifications may be suggested during vertigo management. Healing and self-assurance necessitate patient education.
Avoiding quick head movements, drinking plenty of water, minimizing migraine triggers, and controlling long-term illnesses like diabetes and hypertension are some preventive strategies against vertigo, and they can differ depending on the cause. Patients must adhere to specific medical recommendations.
The neurology department at HCG Hospitals supervises comprehensive vertigo examinations and treatment in collaboration with ENT specialists, radiologists, and rehabilitation experts. Neurologists are instrumental in the differentiation between central (brain-related) vertigo and peripheral vestibular disorders by conducting comprehensive neurological testing.
Our neurologists have specialized expertise in accurately identifying diseases that affect the medulla and cerebellum using advanced neuroimaging facilities, including MRI and CT. Structured diagnostic pathways guarantee that patients experiencing red flag symptoms receive expedient evaluations and suitable referrals.
The seamless integration of neurological assessment, vestibular testing, and rehabilitation planning is facilitated by a coordinated, multidisciplinary care strategy. This method prioritizes the provision of ongoing care, evidence-based decision-making, and an accurate diagnosis throughout the vertigo treatment process.
For comprehensive vertigo treatment in India, please visit HCG Hospitals.
Vertigo is a spinning sensation, whereas dizziness is a more general term that encompasses lightheadedness or unsteadiness without spinning.
BPPV, vestibular migraine, persistent inner ear difficulties, or neurological issues can all contribute to recurrent vertigo. In order to ascertain the cause, it is imperative to undergo a medical examination.
BPPV occurs due to the displacement of calcium crystals in the inner ear. The Epley maneuver and other canalith repositioning techniques are frequently recommended as BPPV treatment options.
In most cases, vertigo is not associated with strokes. Nonetheless, vertigo accompanied by neurological symptoms necessitates immediate treatment.
There is no single treatment that is identified as the best approach for vertigo. For effective management, doctors recommend a tailored approach that is devised upon studying the underlying cause and other individual factors.
Disclaimer: This information is intended to educate patients and caregivers. It does not replace professional medical advice. All treatment decisions should be made in consultation with a qualified doctor.
(Prof.) Dr. Narendra Hiregoudar
Consultant Interventional Cardiology
Interventional Cardiology,
HCG Suchirayu Hospital, Hubli,
General Surgery, Laparoscopic Surgery
General Surgery,Laparoscopic Surgery,
HCG Suchirayu Hospital, Hubli,
Cardiothoracic and Vascular Surgery
Cardiothoracic and Vascular Surgery,
HCG Hospitals, Ahmedabad,HCG Hospitals, Bhavnagar,
Consultant Orthopaedic, Joint Replacement, and Arthroscopy Surgeon
Arthroscopy Surgery,
HCG Hospitals, Rajkot,
Dr. Keyur Pravinchandra Rathod
Consultant General Surgery
General Surgery,
HCG Hospitals, Bhavnagar,
Consultant Anaesthesiology & Intensive Care,
Anaesthesiology,Critical Care Medicine,
HCG Suchirayu Hospital, Hubli,
Consultant Oral & Maxillofacial Surgeon
Oral & Maxillofacial Surgery,
HCG Suchirayu Hospital, Hubli,
Dr. Priyank Chandraprakash Gupta
Senior Consultant Surgeon in Joint Replacement, Sports Injury, and Arthroscopy
Arthroscopy and Sports Medicine,
HCG Hospitals, Ahmedabad,
General Surgery and laproscopic surgery
General Surgery,Laparoscopic Surgery,
HCG Suchirayu Hospital, Hubli,
Medical Gastroenterology and Endoscopy
Medical Gastroentrology,Endoscopy,
HCG Suchirayu Hospital, Hubli,
Senior Consultant Cardiothoracic and Vascular Surgeon
Cardiothoracic and Vascular Surgery,
HCG Suchirayu Hospital, Hubli,
Vascular & Interventional Radiology
Endovascular & Interventional Radiology,
HCG Hospitals, Ahmedabad,
Consultant Endovasular & Interventional Radiologist
Endovascular & Interventional Radiology,
HCG Suchirayu Hospital, Hubli,
Consultant - General Surgery & Advance Laparoscopic Surgery
GI and Laparoscopic Surgery,
HCG Hospitals, Rajkot,
Neurosurgery 
Cardiology
Neurology
Orthopaedic And Joint Replacement Surgery
Spine Surgery
Urology 
Oncology
Pulmonology 
Dietician 
psychiatry
Nephrology
ENT
Gastroenterology 
Dentistry 
Radiology
Critical Care
