What is Vertigo?
Vertigo is feeling unbalanced, often described as the sensation that one’s surroundings are spinning around them.
Vertigo is a form of dizziness involving the sensation of motion (usually rotation), though it should be distinguished from light-headedness or presyncope.
Vertigo is a subtype of dizziness that is characterised by an aberration of the sensory system of the vestibular apparatus (part of the inner ear and brain whose responsibility is to help process the sensory information underlying control of both head- and whole-body movements, and also to control eye movement) [1, 2, 3].
What Are The Causes of Vertigo?
Vertigo can have several causes, most of which centre around inner ear or brain pathology. The most common forms include benign paroxysmal positional vertigo (BPPV), acute vestibular neuronitis or labyrinthitis, Ménière’s disease, migraine and anxiety disorders. At the same time, vertebrobasilar ischaemia and retrocochlear tumours are less frequent causes [1].
BPPV is the most common cause of Vertigo, which describes a brief, fierce sensation. These attacks are triggered by a (quick) change in head movement, such as when your head bumps against the stall or headrest when getting out of a car. An infection of the vestibular nerve can cause intense, constant Vertigo, called vestibular neuritis or labyrinthitis [2].
Ménière’s disease, where excess fluid fills up the inner ear, triggers episodes of Vertigo that last hours. Migraine-induced Vertigo can last minutes to hours. Vertigo is often part of a wide array of symptoms (those might include dizziness, as well as hearing loss, tinnitus or ringing of the ears) after head or neck trauma, particularly if the trauma has damaged the vestibular system. Medications can cause vertigo and symptoms such as dizziness, hearing loss, tinnitus or ringing of the ears [2].
Other conditions that can cause Vertigo include:
- Stroke
- Multiple sclerosis
- Head injuries
- Brain tumours
- Certain types of medication, such as seizure and epilepsy medications and salicylates [4].
Types of Vertigo
Vertigo, a sensation of feeling off balance, is typically categorized into two main types: Peripheral and Central Vertigo [2].
Peripheral Vertigo
Peripheral Vertigo is the most common sort and results from the balance mechanism in the inner ear, or the cranial nerve VIII (called the vestibular nerve) that connects with it, not functioning correctly. Peripheral Vertigo has a few subtypes. Benign paroxysmal positional vertigo (BPPV) represents one of these. With BPPV, patients typically experience brief episodes of mild to moderate dizziness [5, 6]. Meniere’s disease, which involves a similar pathophysiology to BPPV, is characterised by an accumulation of fluid and fluctuating pressure in the ear. Vestibular neuritis, inflammation of the inner ear, is another kind of Peripheral Vertigo [7].
Central Vertigo
Central Vertigo, on the other hand, results from a problem in the brain, for example, from a stroke, a brain tumour, migraine aura, a traumatic brain injury, an infection, or multiple sclerosis [2].
Another way to categorize Vertigo is based on the duration and frequency of the episodes. This includes acute prolonged spontaneous vertigo, recurrent spontaneous vertigo, recurrent positional vertigo, and chronic persistent dizziness and imbalance [6].
It should be remembered, however, that a thorough anamnesis (a comprehensive asking of the patient about symptoms and complaints or their medical history) and clinical examination are key to diagnosing Vertigo. In two out of three cases, diagnosis is based on these methods alone [8].
Risk Factors of Vertigo
Vertigo, a sensation of feeling off balance, can be triggered by various factors.
The most prominent risk factor for Vertigo is ageing, where people over 60 years old are particularly at risk [9], with predominantly females being at greater risk than males [10, 11].
Migraine, diabetes and atrial fibrillation are associated with increased risk of Vertigo [10, 9, 11]. Neck and shoulder pain correlated with stress increased the risk of Vestibular Vertigo [11].
Many types of psychiatric disorders – most commonly anxiety or depression – are associated with a heightened risk of vertigo, especially in adolescents [10]. Others might have a history of head injury, osteoporosis, or a vestibular or inner-ear condition that serves as a risk factor for BPV [12].
Lifestyle factors also pose a risk for vertigo. Low levels of physical activity, short sleep duration, and high-stress levels have all been linked to an increased risk of Vertigo [11].
Can You Die From Vertigo?
Vertigo is not a severe or life-threatening disease; it’s a symptom that induces a sense of spinning or unsteadiness, usually caused by inner ear or brain problems. [13] Nevertheless, vertigo can be a symptom of serious conditions that can be life-threatening.
One of these is stroke, connected to Vertigo. Brain stem stroke refers to an interruption of blood flow through the brain stem caused by blockage of blood vessels (ischaemic stroke) or bleeding in or around the brain (haemorrhagic stroke). It is a serious health emergency [13].
Using 1,931 patients with dizziness or vertigo, the patients with a cerebrovascular cause of dizziness had higher mortality in adjusted Cox regression analyses (HR 1.56, 95% CI: 1.11-2.19) [14]. Another study showed an increased mortality rate in adults with dizziness compared with nondizzy adults; after adjusting for covariates, dizziness was significantly associated with mortality [15].
Divers experiencing Vertigo can drown [16]. Vertigo can precipitate sudden hearing loss with a greater risk of stroke than sudden hearing loss or Vertigo alone [17].
Conclusion
Finally, Vertigo itself is not life-threatening, but it can be a symptom of serious, potentially life-threatening conditions, so anybody with persistent or severe Vertigo should see a clinician to exclude serious underlying causes.