- Spinning or whirling sensation
- Disruption of balance
- Nausea and vomiting may occur
- Hearing may be affected
- Rest, plus monitoring by physician and/or
- Diet modification
- Balance retraining exercises
- Surgery (rarely)
A person who is experiencing dizziness accompanied by a spinning, out-of-control sensation and nausea/vomiting, is probably being affected by a malady called vertigo. While vertigo can be quite frightening, it is important to remember that in most cases the discomfort is temporary and clears up in time. You should, however, seek advice from a doctor to rule out serious implications.
The brain is the control center of good balance. It depends on accurate signals from the eyes, ears, muscles, joints and feet to perform a complicated job we take for granted until something malfunctions. If signals to the brain are disrupted, vertigo may occur. The most common culprit is the inner ear where sense of balance is maintained in a space about three-quarters of an inch long. The inner ear houses a couple of balance organs and an organ for hearing. It is a delicate arrangement of fluids, fine hairs and tiny protective stones that orchestrate signals to the brain.
If the brain receives conflicting messages or no message at all from the inner ear, balance is disrupted. This is usually caused by one of four possibilities:
- Viral infection
- Meniere’s Disease
- Head injury
- Benign Paroxysmal Positional Vertigo
In the case of viral infection, symptoms may last for several days or weeks. A viral infection may damage the balance mechanism of the inner ear, but eventually the brain adjusts to the injury through what is known as “compensation.” In most cases the vertigo doesn’t reappear and balance is restored.
Meniere’s Disease is not fully understood. It is believed to be caused by fluid buildup in the inner ear and in addition to loss of balance, may also affect hearing. Typical symptoms may be accompanied by noise and some sense of fullness in the ear. Symptoms may last from 15 minutes to hours, subside for a time, only to reappear over months or years.
Head injuries can damage the semicircular canals or vestibules, which house the tiny balance organs. Damage can range from inner ear concussion to fracture. Severe injury can cause symptoms similar to viral infections. The brain eventually adjusts to the trauma and balance is restored.
Benign Paroxysmal Positional Vertigo sounds a lot worse than it is. It occurs when the head moves into a particular position. The cause is unknown, although it can occur from infection, injury or old age. Discomfort lasts only a few moments and over time usually subsides.
The doctor has several tests to guide him in his diagnosis of your symptoms. The tests are not complicated, but can take an hour or so each, scheduled over several days. The physician will conduct standard hearing and eye movement tests, an electrical monitoring of the balance organs of the inner ear, and an auditory brain stem response test, (which measures the length of time it takes for a message to move along the nerves from the inner ear to the brain.) He may also want to utilize an MRI, an apparatus that can look inside the brain and inner ear without X-ray. This will allow the doctor to eliminate the rare possibility of stroke or tumor.
Whatever the diagnosis, the vertigo will likely go away in time. However, the doctor may want to make you more comfortable until the symptoms subside. He may prescribe medication that lowers the brain’s response to conflicting messages from the inner ear or one that curtails nausea. He may also suggest balance retraining exercises that can be done at home. These exercises can be effective in helping the brain to get along with input from one inner ear. In the case of Meniere’s Disease, the doctor may recommend a low sodium diet to reduce fluid buildup, plus a diurectic to increase urine flow. The doctor will recommend the elimination of nicotine, alcohol and caffeine, all of which aggravate the condition.