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Why cause of vertigo is a question of balance

04 November 2014

Are you one of the many people who associate the term ‘Vertigo’ with a person’s fear of heights? The medical term for a fear of heights and the dizziness associated with looking down from a height, is actually called acrophobia.

Vertigo is a symptom rather than a condition and is commonly caused by a problem with the balance mechanisms in the inner ear.

People suffering from vertigo experience the sensation that they, or the environment around them, is moving or spinning. The duration of this sensation can vary from a few seconds of dizziness to, in severe cases, several days of disorientation causing day to day life to become very difficult. Other symptoms may include hot sweats and heart palpations, or, feeling or being sick due to the sensation of lightheadedness.

Mr John Phillips, consultant ENT surgeon at Spire Norwich Hospital, explains: “In severe cases, vertigo can prevent people doing day to day activities such as driving, lifting up their children, or going to places alone for fear they’ll lose their balance completely.

"If you are concerned that you may be suffering from vertigo, it can be useful to keep a record of the frequency and duration of your dizzy spells, whether you experience other symptoms and to what degree the disorientation interferes with your general quality of life (i.e. do the symptoms prevent you doing ‘normal’ activities). This information is helpful for your GP as your answers will guide your GP towards the likely cause of your symptoms.”

One of the most common causes for vertigo is benign paroxysmal positional vertigo (BPPV) which is brought on by sudden positional changes (such as turning over in bed) and head movements (such as looking up towards the sky).

Mr Phillips explains, “BPPV involves short, intense, recurrent attacks of vertigo (usually lasting a few seconds to a minute) and is thought to be caused by small fragments of debris (calcium carbonate crystals), breaking off from the lining of the channels in your inner ear.

"The fragments don't usually cause a problem unless they interfere with the function of one of the inner ear's fluid-filled canals. When the head is still, the fragments sit at the bottom of the canal. However, certain head movements cause them to be swept along the fluid-filled canal, setting off abnormal fluid movements. This sends messages to your brain, tricking it into ‘thinking’ that you are moving, when actually you may be sitting completely still.”

"Head injuries, certain medications and Meniere’s disease (a rare condition affecting the inner ear) can also cause vertigo. Other causes may include:

"Labyrinthitis - an inner ear condition that in poorly understood. The condition is often triggered from a common cold or flu virus. As the labyrinth controls hearing and balance, any malfunction can cause the information it sends to your brain to be different from the information sent from your unaffected ear. These conflicting signals can cause vertigo and dizziness.  Patients with labyrinthitis have problems hearing out of the affected ear.

"Vestibular neuronitis - a similar inner ear condition to labyrinthitis which is also poorly understood.  The condition usually comes on suddenly but fortunately people do not experience any hearing loss, people do experience vertigo, dizziness, unsteadiness and nausea."

Mr Phillips continues: “Treatment for vertigo will depend on the cause. Labyrinthitits and vestibular neuronitis often improve over several weeks, however recovery can be hastened by the implementation of a course of balance exercises. This can be formally applied by a kind of physiotherapy known as vestibular rehabilitation and this is a service that our physiotherapy department offers at Spire Norwich Hospital.”

“Patients suffering from BPPV usually get better after the loose debris in their inner ears is ‘relocated’ using a specific sequence of head movements, this is something that can be administered by your GP."

Mr Phillips concludes, “If you are suffering from any of these symptoms I would recommend a visit to your family GP as identifying the exact cause of your symptoms is key to managing the symptoms. It is also important to consider the safety implications if you work in a job which involves driving, operating machinery or working at heights to prevent putting yourself in any unnecessary risk.”

For further information or to arrange an appointment with Mr John Phillips, please call 01603 255614 or visit his profile.

The content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.

Mr John Phillips, Consultant ENT Surgeon

Mr John Phillips, Consultant ENT Surgeon at Spire Norwich Hospital