Dizziness (Vertigo)

Causes of Vertigo

The causes of vertigo are categorized into two main types: central (originating in the brain) and peripheral (originating outside the brain).

Peripheral Vertigo

This type of vertigo primarily results from diseases affecting the inner or middle ear, including:

• Inner ear involvement following upper respiratory tract infections
• Meniere’s Disease
• Vestibular neuritis (inflammation of the nerve in the inner ear responsible for transmitting balance-related signals to the brain)
• Spread of chronic otitis media to the inner ear (labyrinthitis)
• Meningitis or other febrile illnesses affecting the inner ear
• Tumoral conditions involving the inner ear or its associated nerves

Central Vertigo

Central vertigo can result from conditions such as brain hemorrhage or brain infarction, which may necessitate emergency intervention or even intensive care.

Types of Vertigo

There are several types of vertigo. Cases where patients experience intense fear and panic, along with symptoms such as nausea, vomiting, sweating, and palpitations, are referred to by physicians as “true vertigo.”

Other symptoms of dizziness include sensations like: Feeling as though one is about to fall; the ground slipping away underfoot; swaying as if on a boat at sea. These symptoms are more commonly associated with balance disorders. In patients with balance disorders, dizziness may be less severe, but the sensation of their surroundings spinning like a wheel often causes significant discomfort. This symptom may occur repeatedly, lasting from seconds to hours. To ensure an accurate diagnosis and initiate the appropriate treatment for vertigo, it is crucial for the patient to describe their symptoms to the physician accurately.

For instance, dizziness lasting 10–20 seconds, triggered by tilting the head sideways or bending and standing up, may indicate positional vertigo. However, if dizziness persists for hours and is accompanied by other symptoms, conditions such as inner ear disease or blockages, narrowing, or circulation disorders in the brain’s blood vessels may be considered. Therefore, the duration of dizziness is a critical factor in diagnosis.

Benign Paroxysmal Positional Vertigo (BPPV) or positional vertigo is characterized by brief but intense episodes of vertigo triggered by specific changes in head position.

A person may experience positional vertigo even when turning over in bed. In some cases, BPPV can result from head trauma or aging.

Vertigo Treatment

Treatment methods for vertigo vary depending on its cause. These methods may include simple head movements, medication, or surgical intervention.

For instance, if the vertigo is related to the balance canals or is caused by “Benign Positional Paroxysmal Vertigo” (commonly referred to as crystal displacement), severe dizziness can occur when tilting the head forward, lying down, or standing up. This type of vertigo is treated using specific maneuvers, such as the Epley maneuver. After accurately diagnosing vertigo in such patients, dizziness can be effectively managed with the appropriate maneuvers.

If dizziness stems from vascular occlusion or blood circulation issues, it can be treated with appropriate medications.

When vertigo is caused by an inner ear disorder, the patient may need to adjust their lifestyle. Treatment may involve medications that suppress dizziness, improve circulation, and reduce the sensitivity of the balance nerves.

If vertigo results from a hemorrhage in the brainstem or cerebellum, the hemorrhage must be treated in a well-equipped medical facility. If a tumor is present, dizziness (vertigo) can be managed after surgical or other treatment methods are applied following diagnosis.

What Should People with Vertigo Pay Attention To?

Patients with vertigo should prioritize their lifestyle choices. Key factors include dietary habits, avoiding sudden and rapid movements when sitting or standing, and ensuring proper lighting in their living spaces.

For example, maintaining a regular sleep schedule is crucial in certain dizziness-related conditions, such as inner ear disorders. Lack of sleep can exacerbate dizziness. Irregular sleep patterns may trigger vertigo and lead to more frequent episodes of dizziness.

Certain foods and beverages, such as coffee, tea, and cigarettes, can also intensify dizziness. Patients diagnosed with “Meniere’s Disease” should be particularly cautious about consuming these substances.

Elderly patients, in particular, may lose their balance and fall due to dizziness and balance issues when waking up at night. To mitigate this risk, they should consider using a night light or keeping their rooms dimly lit. Additionally, simple precautions can be taken, such as securing slippery floors, placing non-slip materials under rugs or carpets, avoiding woolen and slippery carpets, walking on harder surfaces, and ensuring that slippers have non-slip soles.

Reducing the consumption of beverages like tea, coffee, and cigarettes, as well as monitoring salt intake, is also crucial for managing vertigo. Salt is a known trigger for “Meniere’s Disease.” Therefore, avoiding excessive salt consumption and following a diet rich in water and vegetables can help prevent dizziness or reduce its recurrence.

Vertigo Exercises

There are alternative methods to medication for treating dizziness.

One such method is maneuvers. Maneuvers are a highly preferred treatment for dizziness because they are quick, practical, and highly effective, with a success rate of 100%. However, they are not suitable for all types of dizziness. If the dizziness originates from balance channels, it can be resolved immediately with the correct maneuver performed by a specialist physician.

In addition, patients with dizziness and balance disorders often require long-term rehabilitation. For this reason, specific exercises are recommended.

One of these exercises involves head and eye movements.

Head and eye exercises include moving the head side to side and forward and backward while keeping the eyes fixed on a single point.  Conversely, when the head remains stationary, the eyes are moved left and right, up and down, focusing on specific points for a set number of repetitions. Some rehabilitation centers also provide more advanced instrumental rehabilitation methods for dizziness and balance disorders.

Another type of vertigo exercise includes walking and wall exercises.

Walking and wall exercises are performed by standing in front of a wall, leaning the back against it, and moving side to side with closed eyes and bare feet. With appropriate safety precautions, exercises such as standing on soft surfaces with closed eyes or balancing on one foot are important components of dizziness rehabilitation.

Some rehabilitation centers also provide more advanced instrumental rehabilitation methods for dizziness and balance disorders. Activities like jumping on a trampoline, sitting on a stability ball, or walking on sand are among the methods that enhance balance and improve functional stability.  

Rehabilitation for balance disorders tends to yield better results in elderly individuals, patients with vascular-related balance disorders, and over the long term. n certain clinical cases, initiating rehabilitation before starting medication can be beneficial.

When Should Vertigo Be Taken Seriously?

Vertigo refers to the sensation of spinning, either of oneself or the surrounding environment, despite being stationary. It should be taken seriously, as it may indicate an underlying significant condition.