Vertigo

Unless you are enjoying a ride on a merry-go-round, a sudden sensation of spinning or dizziness may be quite the unwelcomed alarm. Children love to engage in games that bring on the brief spinning sensation for the sake of the rush of adrenaline; it is bearable because it is mostly quite short-lived.  This sensation of spinning and dizziness, however is a continuous concern for people who suffer from Vertigo.

Vertigo is a disorder that causes a sudden sensation of being off balance, rotating, rocking, or spinning despite being absolutely stationary. This sensation may be spontaneous or begin to occur after an injury that may have affected the inner ear. Unlike self-induced vertigo which usually only last a moment, these dizzy spells can last from a few hours to a few days.

Causes of vertigo

Vertigo may occur from either a central or peripheral cause. Central causes are related to the brain and the spinal cord while peripheral causes are related to structures of the inner ear. It is the peripheral type with is the most common.

Peripheral Vertigo

• Paroxysmal positional vertigo (BPPV). Often due to aging, this condition is caused by tiny calcium particles (canaliths) which clump within the canals of the inner ear, affecting balance. The inner ear helps to maintain balance by sending signals to the brain about head and body movements relative to gravity.
   
• Meniere’s disease is a disease caused by a build-up of fluid within the inner ear, changing the pressure within the ear. Besides vertigo, Meniere’s disease may cause tinnitus (ringing in the ears) and ultimately, hearing loss.
   
• Vestibular neuritis or Labyrinthitis. This inner ear disease is caused by a viral infection of the inner ear. The infection can cause inflammation in the inner ear, close or relative to the nerves that effect the body’s balance sensation.

Central Vertigo

Diseases which affect the structures of the brain and spinal cord can cause vertigo. This can include:

• Head or neck injury
• Tumors of the brain
• Stroke
• Multiple sclerosis
• Basilar artery migraine

Symptoms of vertigo

Symptoms of vertigo are usually triggered by moving the head from one position to another. Symptoms can accompany other seemingly unrelated symptoms - such as nausea. Vertigo symptoms can be consistent and constant or be brief and irregular.

• Spinning
• Tilting
• Swaying
• Feeling of being pulled to one direction
• Nausea
• Headaches
• Vomiting
• Nystagmus (abnormal eye movements)
• Sweating

Risk factors for vertigo

Head and neck injuries, certain medication such as antidepressants, antiseizure medications and even aspirin may increase the risk for developing vertigo. Medical conditions and lifestyle habits that could lead to a stroke such as heart disease, high blood pressure, diabetes, smoking, and alcohol consumption may increase the risk. Out of the 2% to 3% of the population the condition seems to be most prevalent amongst older women.

Complementary therapies for Vertigo

In most cases vertigo will resolve on its own within a few days. However, for people with chronic vertigo or for a speedier resolution, natural therapies, diet and life style changes may help.

Gingko Biloba is known to increase blood flow to the head and brain and may help reverse symptoms of tinnitus. The active ingredients in Gingko Biloba, heterosides and gingkolisides, may help with head related disorders which contribute to vertigo. 

Vitamin D. Vertigo is associated with deficiency of vitamin D.  Supplementing with Vitamin D has been shown to greatly improve the occurrence and symptoms of vertigo.

Vitamin C. According to a study conducted by the Hiroshima University of Medicine in Japan, patients suffering from Meniere’s disease showed a significant improvement in symptoms associated with vertigo when Vitamin C was inceased. Fruits and vegetables that contain vitamin C include strawberries, oranges, tomatoes, green peppers, apples and leafy greens. A higher amount can be achieved through supplementing.

Coenzyme Q10 has shown improve the severity and frequency of migraine headaches and vertigo. Coenzyme Q10 helps to normalize LDL cholesterol levels and improve general heart health. Patients who suffered from vertigo secondary to heart failure reported significant improvement for vertigo after being treated with Coenzyme Q10. 

Low-sodium diet

Excess salt intake may result in fluid retention a common trigger for vertigo. Avoid processed, fast foods, deli foods and tin foods which often have a high salt content. Instead look for low-salt varieties and increase fluid intake. 

Physio therapy

Physio therapy is suggested benign paroxysmal positional vertigo - where loose calcium crystals are irritating the inner ear structures, or from muscular or skeletal issues.  Physio therapy uses certain manoeuvres, such as Epley Manoeuvre, and exercise to achieve results. 

Acupressure - may relieve vertigo through the stimulation of specific ressure points.

Ginger tea can reduce nausea symptoms associated with vertigo. A research published in the U.S Library of Medicine reported that ginger tea was actually more effective for treating vertigo compared to a placebo. 

Vertigo is relatively harmless condition which will often resolve on its own. Avoid activities that require focus and concentration, such as driving or working with industrial machinery during attacks.  

The information provided is not intended to be used for diagnosis or treatment. If you are experiencing any health concerns, please consult your doctor for advice.

References

1. Bhattacharyya, N., et al. "Clinical practice guideline: benign paroxysmal positional vertigo." Otolaryngology -- Head and Neck Surgery 139.5 Suppl 4 (2008): S47-S81.
2. von Brevern, M., et al. "Epidemiology of benign paroxysmal positional vertigo: a population based study." Journal of Neurology, Neurosurgery, and Psychiatry 78.7 (2007): 710–715.
3. Burmeister, D. B., et al. "Management of benign paroxysmal positional vertigo with the canalith repositioning maneuver in the emergency department setting." The Journal of the American Osteopathic Association 110.10 (2010): 602-604. 
4. Takumida M, Anniko M, Ohtani M. Radical scavengers for Ménière's disease after failure of conventional therapy: a pilot study. Acta Otolaryngol. 2003 Aug;123(6):697-703. doi: 10.1080/00016480310000728a. PMID: 12953767.https://www.ncbi.nlm.nih.gov/pubmed/12953767
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6.  Fife TD, et al. (2008). Practice parameter: Therapies for benign paroxysmal positional vertigo (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 70(22): 2067-2074.
7.  Ear, Nose, and Throat Consultants of Nevada Staff. (n.d.). Cawthorne’s head exercises. Retrieved from http://entc.com/handouts/handout_cawthorne.pdf
8. Büki B, Ecker M, Jünger H, Lundberg YW. Vitamin D deficiency and benign paroxysmal positioning vertigo. Med Hypotheses. 2013 Feb;80(2):201-4. doi: 10.1016/j.mehy.2012.11.029. Epub 2012 Dec 14. PMID: 23245911; PMCID: PMC4196321. https://www.ncbi.nlm.nih.gov/pubmed/23245911
9. Grøntved A, Hentzer E. Vertigo-reducing effect of ginger root. A controlled clinical study. ORL J Otorhinolaryngol Relat Spec. 1986;48(5):282-6. doi: 10.1159/000275883. PMID: 3537898. https://www.ncbi.nlm.nih.gov/pubmed/3537898
10.  Santos, P. M., et al. (1993). "Diuretic and diet effect on Meniere's disease evaluated by the 1985 Committee on Hearing and Equilibrium guidelines." Otolaryngology - Head & Neck Surgery 109(4): 680-689.
11.  “American Journal of Chinese Medicine"; Effect of Acupressure and Trigger Points in Treating Headache: A Randomized Controlled Trial; Lisa Li-Chen Hsieh, et al.; February 2010