Vertigo (Dizziness)

Vertigo is a medical term used to describe the symptom of dizziness. This is a vast area where neurology and otolaryngology meet. Vertigo can be a non specific sign and be a harmless fleeting sign never to reoccur again. It can also be associated with Menieres disease, a stroke, a cerebello-pontine angle tumor, a head concussion, epilepsy, a skull fracture, a migraine headache and many other conditions.

The physician needs to distinguish the origin of vertigo. Does it come from the balance organ or does it originate from the nervous system such as the cerebellum, the brain stem or the nerve connections to the eyes? A common cause of epidemic vertigo is a viral labyrinthitis that seems to directly affect the vestibular nerve or the labyrinth (the balance organ).

Mostly this occurs 1 or 2 weeks after a flu and symptoms are those of vertigo, nausea and vomiting. This lasts for several days and then subsides in most patients. However, in some it reoccurs periodically from then onwards.

About 10 % of vertigo patients have Menieres disease. Otosclerosis, bacterial otomastoiditis, vertebrobasilar blood vessel insufficiency and others can all produce vertigo.

As there can be many reasons, it is important to have the patient referred to a specialist who will order appropriate testing (otolaryngologist, neurologist). Such tests as MRI scans, electronystagmography (ENG study), audiometry studies etc. should be done to pinpoint the cause. It is only when the underlying condition has been diagnosed that effective treatment of that condition can be offered for the vertigo.

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 84.

2. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001, Mosby Inc.

3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 85.

4. Rakel: Conn's Current Therapy 2001, 53rd ed.,2001, W. B. Saunders Company

5. Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company

6. Mandell: Principles and Practice of Infectious Diseases, 5th ed.,2000, Churchill Livingstone, Inc.

7. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 265.

8. MF Williams: Otolaryngol Clin North Am; Oct1999; 32(5): 819-834.

9. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 106.

Last Modified: Feb. 2, 2008