Dizziness can arise in many different conditions but rotational vertigo usually indicates an inner ear problem. The symptoms can be confusing but once a diagnosis is made treatment will usually cure the condition. To reach a diagnosis a detailed account of the symptoms will be discussed and a full examination of the balance system carried out. It is often necessary to test the hearing and sometimes audiovestibular testing may give further information about the way the balance system is working in the two ears.
Benign Paroxysmal Positional Vertigo (BPPV) is a relatively common cause of vertigo due to the build up of some debris (otoconia) within the semi-circular canals and can be successfully treated with the
Epley or Particle Repositioning manoeuvre
. The attacks are usually of short duration but sometimes recur.
Labyrinthitis sometimes occurs with a viral infection and can be of sudden onset and disabling; however, the symptoms usually resolve in time but treatment may be needed to make a full recovery.
Menieres disease
can cause recurring attacks of vertigo in association with hearing loss and tinnitus in the affected ear. It is usually controlled with medication but occasionally an injection of Gentamicin, or steroids into the middle ear (Intratympanic gentamicin) may be necessary to control the symptoms. Medications generally control the vertigo in patients with Meniere’s disease but in a small proportion of patients, they require more invasive treatment such as surgery to the endolymphatic duct or sac. Migraine associated vertigo can cause very similar symptoms. There is an active patient support group which several times a year, as
The Meniere’s Society.
There are many other causes of vertigo which can only be confirmed with a specialist opinion. Investigations can be promptly organised and rehabilitation can be offered with vestibular rehabilitation exercises by our Physiotherapy colleagues.
