What is Vertigo?

It’s important to understand that Vertigo is a SYMPTOM and not a diagnosis or a disease. It is often described as a sensation of dizziness, spinning or whirling of the surrounding environment (“room spinning”). It is a distinct feeling of movement when no movement is happening.

The most common disorders that result in vertigo are:

• Benign paroxysmal positional vertigo (BPPV)

• Meniere’s disease

• Vestibular neuritis

Vertigo can be associated with loss of balance, nausea and vomiting.

Anatomy of the inner ear

Semi-circular Canals are filled with endolymph fluid and are responsible for detecting rotational movement of the head. The motion of the fluid assists the brain to know when one is moving and gives an individual their orientation in space.

Utricle and Saccule are called Otolith organs, and they are covered by OTOCONIA CRYSTALS (carbonate crystals). These otoconia crystals are responsible for sensing linear acceleration and gravity. 

B-benign  (not dangerous)

P-paroxysmal (sudden onset, violent)

P-positional (dependant on head position)

V-vertigo (true sense of spinning)

Let’s try to understand what happens during BPPV

Due to various factors such as mild- severe head trauma, inner ear disorders, age related changes etc, the otoconia crystals that cover the otolith organs, can become loose and eventually dislodge. The dislodged crystals then travel into one of the semi- circular canals. This causes the affected canal to become sensitive to changes of the head position in relation to gravity and this is called BPPV. 

The otoconia will not cause any problems by being in the semi-circular canals, until the person changes their head position ie, looking up or down, rolling in the bed, getting from lying to sitting, sitting to standing. The otoconia move to the lowest part of the semi-circular canal causing the endolymph fluid to flow and this causes the symptom vertigo.

Characteristics of vertigo

• Lasts <15 sec-1.5 mins

• Short duration of true vertigo (spinning)

• Memorable onset

• Nystagmus always present (beating toward the affected ear)

Signs and Symptoms of Vertigo

• Poor balance

• Nausea 

• Vomiting

• Blurred vision

• Difficulty walking