WHAT IS VERTIGO?
About 20-40% of people experience some type of dizziness in their lifetime. These instance become more prevalent with age. Often, this disoriented experience is accompanied with nausea, difficulty walking, the sense of spinning, difficulty driving or sitting in a car, and other symptoms ranging from subtle to debilitating.
Vertigo is not a disease; it is a collection of symptoms. Vertigo is the most common form of dizziness and often worsens with head and eye movement. It can be caused by several different sources and may require different kinds of treatment.
CAUSES AND TRIGGERS OF VERTIGO
Vertigo can be triggered by conditional circumstances. One familiar trigger comes in the form of physiologic vertigo, which we most frequently associate with general motion sickness. Physiologic vertigo is the product of long periods of motion, such as travel. Even the playful spinning of a child and the subsequent disorientation provide an example of physiologic vertigo. Toxin exposure is another common conditional trigger. Drunkenness, drug overdose, and carbon monoxide exposure can all cause symptoms of vertigo.
Most commonly, however, vertigo typically results from an underlying issues such as benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and labyrinthitis, head trauma, migraines, stroke, or tumors.
BENIGN PAROXYSMAL POSITIONAL VERTIGO
Benign paroxysmal positional vertigo (BPPV) is a vestibular disorder in which the symptoms are brief, recurrent, and typically occur when changing head position. These bouts of vertigo typically last less than one full minute.
BPPV is most likely to occur in people over the age of 50, with women twice as likely to be affected than men.
BPPV can be diagnosed using the Dix-Hallpike test, in which the patient experiences nystagmus (rapid, uncontrolled eye movements). While the specific cause of BPPV is still unclear, cases of BPPV have a number of noteworthy consistencies, which involve the movement of tiny, calcified crystals within the inner ear.
Collections of calcium otolithic crystals grow in the labyrinth of the inner ear. These crystals lie on beds of hair cells and detect gravity and movement. Movement causes the crystals to shift, causing the hair cells to bend, which then sends a signal to our brain to inform us we are moving. In cases of BPPV, these crystals dislocate from their usual position into another part of the inner ear. This causes a sensation of moving when we are still or the continuation of that sense after we have stopped moving. Essentially, it tricks our brain into thinking we are moving when we are not.
Symptoms of BPPV are most often treated with therapeutic exercises that relocate the crystals back into their optimal position. Professionally-assisted exercises like the Epley maneuver, or home treatments such as Brandt–Daroff exercises have proven to be successful in many cases.
Meniere’s disease is another vestibular disorder. Symptoms of Meniere’s disease include tinnitus (ringing in the ears), hearing impairment, and fluid buildup in the ear. Usually the disease begins in one ear, but may build up in both ears. In cases of Meniere’s disease, the bouts of vertigo can last from twenty minutes to a few hours at a time.
Meniere’s disease is most likely to occur in people over the age of 40. As with BPPV, women are more commonly affected than men. The cause of Meniere’s disease is thought to be a combination of hereditary and environmental factors, with symptoms occurring as a result of increased fluid buildup in the inner ear.
Meniere’s symptoms are treated several different ways. Surgical procedures, while popularly applied, are not without risk and have proven to be no more successful than other preventatives. Functional neurologic treatment is a safer form of treatment for the symptoms of Meniere’s disease. Preventative measures including a low-salt diet and prescribed diuretics in conjunction with functional neurology therapy may also improve symptoms.
VERTIGO AND LABYRITHITIS
Our vestibular system is made up of labyrinths or networks of canals and other structures. Labyrinthitis results from the inflammation of these areas in the inner ear. This inflammation can trigger vertigo in patients, as well as other symptoms such as nausea, nystagmus, tinnitus and hearing impairment.
The symptoms of labyrinthitis may occur only once, as a series of episodes, or even as a persistent and ongoing condition. In any such case, the symptoms typically diminish in about six weeks.
As with many diseases associated with vertigo, the cause of the disease is not always clear and may result from many different sources. Viruses, bacteria, head trauma, stress, allergies, and environmental stressors can all cause inflammation of the vestibular system. According to the Journal of Immunology research, approximately one-third of labyrinthitis patient experienced a common cold prior to the disease.
TREATMENT FOR VERTIGO
Consultation and treatment with a competent professional should always take priority if one experiences vertigo symptoms. While physical therapy and pharmaceuticals may help in some cases, one may consider treatment and consultation with a functional neurologist. Functional neurology takes an all-encompassing approach to treating vertigo symptoms from the many countless causes.
Dr. Ralph DeStephano of Spring Grove Physical Medicine & Rehabilitation & Chicago Neuro explains that functional neurology is a safe and effective treatment program, one that stimulates neuroplasticity. If the neurons have “plasticity” (the ability to learn and change), they can be “rewired” or conditioned to better overcome the symptoms. To promote neuroplasticity, our brain needs three things: glucose, oxygen and activation. Glucose can be obtained through the good sugars found in fruits and vegetables. Oxygen and activation are two of the main routes used in functional neurology treatments. Dr. DeStephano explains that, “Oxygen and activation through eye exercises, vestibular rehabilitation, etc. are all tools that we can use to help people with vertigo issues. Once you create that neuroplasticity again then the brain starts to feel better.”
“After several treatments, balance and coordination start to improve and the patient’s life starts to get back to normal. Once you’ve rewired somebody’s brain, that rewiring now becomes the new norm and the patient no longer needs consistent treatment. In other words, the changes made in the brain are permanent barring, of course, another physical, emotional or chemical injury occurs.”
AT HOME REMEDIES FOR VERTIGO
There are many safe home remedies for vertigo that are easy to incorporate into your lifestyle. While they are not as effective as therapy, they may help ease your symptoms.
Hydration is important – substitute some of your daily beverages for a glass of water and reduce your salt and sugar intake.
Get some sleep! – 35% of people do not get the recommended amount of sleep each night. Try getting a minimum of seven hours of sleep every night.
Reduce your alcohol intake – according to the Vestibular Disorders Association, alcohol can change the fluid composition of the inner ear, as well as dehydrate you.
Ginkgo Biloba – according to the US National Library of Medicine, a multi-center clinical trial was performed to compare the efficacy and safety of ginkgo biloba and was found to be reasonably effective. Be sure to consult your doctor before taking any supplements.
Less stress – stress reduction can effectively manage vertigo. Meditation and deep breathing exercises are great ways to begin. While we cannot eliminate all sources of stress, mindfully identifying stressful triggers in your life can provide a clear perspective on how to manage and deal with stress.
Try yoga or tai chi – in addition to lowering stress, these techniques can also condition the human brain. Avoid exercises that might augment your symptoms, such as any exercise that include sudden movements. Start with simple poses that open the back, neck, shoulders, and abs.
Increase your vitamin D – a publication by the US National Library of Medicine finds a direct correlation between BBPV and a lack of vitamin D. Tuna, egg yolks, fortified milk, orange juice, and supplements can be of great benefit.
As clarified above, these home remedies are no substitute for functional neurological treatment, but may be a helpful way of managing your vertigo symptoms.
Vertigo is not a disease, it is a symptom. It may be an indicator of a deeper, underlying problem. It is important to determine its source, and treat accordingly.