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Vertigo, a specific type of dizziness, is a major symptom of a balance disorder. It is the sensation of spinning or swaying while the body is stationary with respect to the earth or surroundings. With the eyes shut, there will be a sensation that the body is in movement, called subjective vertigo; if the eyes are open, the surroundings will appear to move past the field of vision, called objective vertigo.
The effects of vertigo may be slight. It can cause nausea and vomiting or, if severe, may give rise to difficulty with standing and walking.
The word “vertigo” comes from the Latin “vertere”, to turn + the suffix “-igo”, a condition = a condition of turning about.
When your whole world is spinning, itâ€™s hard to convince yourself everythingâ€™s going to be okay. You feel weak, helpless, and scared â€“ and itâ€™s downright dangerous to suffer a vertigo spell in public, particularly in the midst of a crowd. Itâ€™s also extremely embarrassing, knowing other people are staring at you like you’re some sort of carnival attraction.
It might surprise you to learn that vertigo is one of the most frequent health disorders reported by adults. The National Institute of Health reports that as many as 40 percent of adults in the United States alone experience vertigo at least once during their lifetimes.
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Causes of vertigo:
Vertigo is usually caused by problems in the nerves and structures of the inner ear, called the vestibular system. This system senses the position of your head and body in space as they move.
Vertigo can occur with the following conditions:
Benign Paroxysmal Positional Vertigo (BPPV) â€“tiny particles naturally present in the canals of the inner ear, dislodge, and move abnormally when the head is tilted, pushing ear fluid against hair-like sensors in the ear. BPPV may result from:
Disorders of the inner ear
Age-related breakdown of the vestibular system
Labyrinthitisin (Vestibular Neuritis)â€“inflammation of the inner ear. This often follows an upper respiratory infection.
Vertigo is usually associated with a problem in the inner ear balance mechanisms (vestibular system), in the brain, or with the nerve connections between these two organs.
The most common cause of vertigo is benign paroxysmal positional vertigo, or BPPV. Vertigo can be a symptom of an underlying harmless cause, such as in BPPV or it can suggest more serious problems. These include drug toxicities (specifically gentamicin), strokes or tumors (though these are much less common than BPPV).
Vertigo can also be brought on suddenly through various actions or incidents, such as skull fractures or brain trauma, sudden changes of blood pressure, or as a symptom of motion sickness while sailing, riding amusement rides, airplanes or in a vehicle.
Vertigo is typically classified into one of two categories depending on the location of the damaged vestibular pathway. These are peripheral or central vertigo. Each category has a distinct set of characteristics and associated findings.
There are two major types of Vertigo:
Subjective Vertigo (when the person feels that they are spinning) or Peripheral vertigo
Objective Vertigo (when the person feels that objects around them are spinning) or Central vertigo
Head movement causes electronic impulses to be transmitted to the labyrinth, a part of the inner ear consisting of three semicircular canals surrounded by fluid. The labyrinth, in turn, transmits the movement information to the vestibular nerve.
The vestibular nerve then carries the signal to the brainstem and the cerebellum which are responsible for coordinating balance, movement, blood pressure, and consciousness.
When the nerves responsible for transmitting the signals donâ€™t transmit them correctly (or when the nerves in the brain stem or the inner ear wrongly interpret these signals), the dizziness, disequilibrium, and lightheadedness related to vertigo occur.
The lesions, or the damaged areas, affect the inner ear or the vestibular division of the auditory nerve or (Cranial VIII nerve). Vertigo that is peripheral in origin tends to be felt as more severe than central vertigo, intermittent in timing, always associated with nystagmus in the horizontal plane and occasionally hearing loss or tinnitus (ringing of the ears).
Peripheral vertigo can be caused by BPPV , labyrinthitis, MÃ©niÃ¨re’s disease, perilymphatic fistula or acute vestibular neuronitis. Peripheral vertigo, compared to the central type, though subjectively felt as more severe, is usually from a less serious cause.
The lesions in central vertigo involve the brainstem vestibulocochlear nerve nuclei. Central vertigo is typically described as constant in timing, less severe in nature and occasionally with nystagmus that can be multi-directional. Associated symptoms include motor or sensory deficits, dysarthria (slurred speech) or ataxia.
Causes include things such as migraines, multiple sclerosis, posterior fossa tumors, and Arnold-Chiari malf formation. Less commonly, strokes (specifically posterior circulation stroke), seizures, trauma (such as concussion) or infections can cause also central vertigo.
Vertigo in context with the cervical spine:
According to chiropractors, ligamental injuries of the upper cervical spine can result in head-neck-joint instabilities which can cause vertigo. In this view, instabilities of the head neck joint are affected by rupture or overstretching of the alar ligaments and/or capsule structures mostly caused by whiplash or similar biomechanical movements.
Symptoms during damaged alar ligaments besides vertigo often are
reduced vigilance, such as somnolence
seeing problems, such as seeing “stars”, tunnel views or double contures.
Some patients tell about unreal feelings that stands in correlation with:
depersonalization and attentual alterations
Medical doctors (MDs) do not endorse this explanation to vertigo due to a lack of any data to support it, from an anatomical or physiological standpoint. Often the patients are having an odyssey of medical consultations without any clear diagnosis and are then sent to psychiatrist because doctors think about depression or hypochondria. Standard imaging technologies such as CT Scan or MRI are not capable of finding instabilities without taking functional poses
Neurochemistry of vertigo
The neurochemistry of vertigo includes 6 primary neurotransmitters that have been identified between the 3-neuron arc that drives the vestibulo-ocular reflex (VOR). Many others play more minor roles.
Three neurotransmitters that work peripherally and centrally include glutamate, acetylcholine, and GABA.
Glutamate maintains the resting discharge of the central vestibular neurons, and may modulate synaptic transmission in all 3 neurons of the VOR arc. Acetylcholine appears to function as an excitatory neurotransmitter in both the peripheral and central synapses. GABA is thought to be inhibitory for the commissures of the medial vestibular nucleus, the connections between the cerebellar Purkinje cells and the lateral vestibular nucleus, and the vertical VOR.
Three other neurotransmitters work centrally. Dopamine may accelerate vestibular compensation. Norepinephrine modulates the intensity of central reactions to vestibular stimulation and facilitates compensation. Histamine is present only centrally, but its role is unclear. It is known that centrally acting antihistamines modulate the symptoms of motion sickness.
The neurochemistry of emesis overlaps with the neurochemistry of motion sickness and vertigo. Acetylcholinc, histamine, and dopamine are excitatory neurotransmitters, working centrally on the control of emesis. GABA inhibits central emesis reflexes. Serotonin is involved in central and peripheral control of emesis but has little influence on vertigo and motion sickness.
Modern Diagnostic testing
Tests of vestibular system (balance) function include electronystagmography (ENG), rotation tests, Computerized Dynamic Posturography (CDP), and Caloric reflex test.
Tests of auditory system (hearing) function include pure-tone audiometry, speech audiometry, acoustic-reflex, electrocochleography (ECoG), otoacoustic emissions (OAE), and auditory brainstem response test (ABR; also known as BER, BSER, or BAER).
Other diagnostic tests include magnetic resonance imaging (MRI) and computerized axial tomography (CAT, or CT).
Treatment is specific for underlying disorder of vertigo.
calcium channel antagonists, specifically Verapamil and Nimodipine
GABA modulators, specifically gabapentin and baclofen
Neurotransmitter reuptake inhibitors such as SSRI’s, SNRI’s and Tricyclics
Herbal Treatment:THE HERBS listed below can help ease impaired sense of balance often described as “light-headedness” or “dizziness,” either of which can be symptoms of serious conditions, such as heart attack or stroke.
Butcher’s broom, cayenne 40,000 Scoville heat units, ginkgo biloba, coral calcium with trace minerals, kelp.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.
Sources:http://en.wikipedia.org/wiki/Vertigo_(medical) and http://www.herbnews.org/vertigodone.htm