Questions on Vertigo

Living beings live in a world made up of four dimensions. The first three relate us to space, while the fourth relates us to time. In order to stay oriented and stable in space and time, we have developed the ability to balance, which allows us to cope with forces such as gravity or other translational movements.

Balance is achieved thanks to a complex neuromuscular process, which allows us to develop a kind of mental coordinates of the environment and our body.

The origin of vertigo is found in the Latin word “verteré”, which means “to turn around or turn”. As such, vertigo represents a false sensation of movement of our body or our environment. Vertigo is a sign that is directly related to numerous diseases, so it becomes an alarm signal sent by the brain when there is any alteration that prevents or hinders the maintenance of this balance. On many occasions, when vertigo is very intense, it is directly associated with other manifestations, such as sweating, dizziness, nausea, vomiting, low blood pressure and even anxiety crises or panic attacks.

What causes vertigo?

As such, vertigo occurs when there is no correspondence between our internal system of coordinates and the information perceived by the sensors that are in charge of our balance. One of them is the vestibular system, which is composed of the balance nerve, the labyrinth of the ear and the brain neurons that process balance information.

Main causes of vertigo

Over the course of time, more than one hundred diseases have been listed that have the capacity to cause vertigo. These include ear lesions, infectious lesions, cerebral, metabolic… However, less than ten are the most frequent, accounting for almost nine out of ten cases.

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It is therefore very important that the physician – through the information transmitted by the patient and the tests performed – is able to distinguish whether the vertigo affects the brain or not. About 15% of patients with severe acute vertigo (nausea, vomiting, spinning of objects lasting for hours…) may be suffering from thrombosis or cerebral hemorrhage. However, the medical technology developed in the last two decades allows a correct and rapid diagnosis, so it is relatively easy to make an appropriate treatment.

Important epidemiological studies have indicated that vertigo may occur in five to ten percent of the population throughout life.

Benign paroxysmal positional vertigo is the most common and is caused by displacement of the otoliths in the semicircular canals of the labyrinth of the ear. This causes vertigo, which occurs abruptly, for example when getting up or changing position in bed. The treatment of this type of vertigo is simple, by “repositioning” the otoliths in their original place.

The second main cause of vertigo today is migraine, which has the capacity to create a very intense headache, being more common in women. A good number of these patients develop vertigo during their migraine attacks, which, together with the severe headache, makes it very difficult for the sufferer. Dietary measures and anti-migraine treatment should be sufficient to cure this vertigo.

Ménière’s disease is another common disorder associated with vertigo. Characteristic of this disease is vertigo associated with tinnitus in one ear, as well as sudden hearing loss. Currently there are numerous treatment options, either medical or surgical, which allow the patient to lead a practically normal life.

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How should a person with vertigo act?

A patient with acute vertigo should visit his or her family physician for an evaluation. If this assessment leads to a cerebral origin, the patient will be referred to the emergency department, where radiological and exploratory tests will be performed.

If the origin of the vertigo is different, each disease will have its appropriate treatment. This is why it is advisable to refer the patient to an ENT specialist in vertigo. These are the so-called Otoneurology units, which have specific exploration techniques for the study of patients with vertigo.