Symptoms of vertigo
Vertigo attacks are often very distressing: the sensation that everything is spinning, the general malaise it causes, the nausea and vomiting, the excessive sweating and the auditory symptoms that may accompany the episode such as hearing loss or noises in the ear, are very disabling for patients.
Symptoms that should alarm and cause the patient to go to the Emergency Department are loss of consciousness, severe headache, loss of strength or sensation in a limb or sudden loss of vision in one eye. It should also be taken into account if the patient has risk factors for stroke such as diabetes, hypertension, hypercholesterolemia or taking drugs that alter blood clotting, as it is more likely that the cause of vertigo is central.
Diagnosis of vertigo
The patient’s interview with the ENT specialist is very orientative to identify whether the problem lies in the inner ear or not. The otoneurological examination, which is the set of tests to assess the patient’s behavior with changes in position and passive movements of the head, provides very detailed information on the cause of the problem. In the case of vertigo with hearing loss, a tonal audiometry is performed as a diagnostic test, and if the otoneurological examination points to a possible brain problem, a Brain Magnetic Resonance Imaging will be requested.
Treatment for vertigo
- Acute vertigo crises are treated with drugs called vestibular sedatives whose main objective is the remission of symptoms as soon as possible. The patient often reports a sensation of instability that should be treated with drugs that help the brain to gradually readjust the balance centers.
- In benign paroxysmal positional vertigo, the treatment does not include the administration of drugs, but the performance of the Epley maneuver of physiotherapy, which is performed in the office.
- In some vertigo of chronic behavior that tends to manifest itself recurrently, such as Ménière’s or Vestibular Migraine, prophylactic treatments are carried out to distance the vertigo crises in time.
- When the vertigo is of cerebral origin (stroke or tumor), the next step is to stabilize the patient and refer him/her to a neurologist or neurosurgeon.
- If the trigger is due to an ear infection such as otitis, apart from vestibular sedatives, antibiotics will be prescribed in order to eradicate the infection and prevent irreversible damage to the inner ear.
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