Dizziness and vertigo

The above terms are used by the patients to describe a wide variety of abnormal sensations in the head like sense of spinning, black outs, falling forward, swaying, e.t.c. They are 2 different conditions as per the causes but clinical features often overlap. Faintness or dizziness is usually described as a light headedness by the patient. It may or may not be accompanied by disturbance of posture. It occurs commonly due to deficiency of blood, glucose or oxygen to the brain. Such conditions can be hypoglycaemia (deficiency of glucose in blood), or severe dehydration, severe anaemia e.t.c. Those suffering from defects in the heart valves often suffer from syncope or fainting on exertion because of diminished blood supply to brain which is again due to defective functioning of the heart. Faintness can also occur before an epileptic seizure. School students who have to stand for long time in the sun can also experience faintness due to pooling of blood in lower limbs reducing supply to the brain. Elderly people sometimes complaint of dizziness because of weakening of the peripheral receptors of the limbs which help in maintaining the correct position. The term vertigo (described by people as feeling “vertish”) technically refers to a sense of rotation of the head. But like faintness, people use it loosely to describe any abnormal sensation in the head. Vertigo is caused due to disturbances in the balancing system of the body whether in brain or inside the ear. It may be physiological as in driving around hills or sea travel (motion sickness) or looking down from heights. Pathological vertigo, i.e. which is caused by some disease can be due to infection or trauma in the balancing organs in the brain or ear. Common conditions include ear infections or discharge, frequent cold leading to inflammation inside ear, brain tumours, e.t.c. Drugs like gentamycin, quinine e.t.c. which cause ototoxicity can also cause vertigo. Elderly persons may suffer from vertigo due to cervical spondylosis. The affected person suffering from vertigo experiences spinning sensation and falling either on left or right or both sides, depending on the side of damage. There is often associated nausea, vomiting, tinnitus (sounds heard inside ear). In severe cases, there is difficulty in walking or standing straight. Faintness or vertigo is also one of the commonest psychosomatic complaints. Many people particularly young ones pretend to be suffering from faintness or vertigo for some personal gain. Treatment is by drugs or surgery in case of tumours, but chances of relapse are there if the basic cause persists. Drugs have to be taken for the medical conditions like anaemia which cause fainting or vertigo. Surgery is used for tumours in the brain or auditory nerve or severe cervical spondylosis. It is better to prevent these conditions. Conditions causing dehydration or hypoglycaemia should be prevented or treated at the earliest. Those whose work involves standing for long hours should keep on moving their toes to improve circulation and prevent pooling of blood. Recurrent cold should be controlled by regular steam inhalation and avoidance of allergy producing substances if possible. Ears should be always kept dry. Pricking or needling of ears should be avoided. Similarly draughts of hot or cold air affecting the ears should be avoided as during travelling by keeping the ears covered by cotton or head scarves. In case of cervical spondylosis high pillows should not be used below the head for sleeping. Similarly bending of neck should be avoided. It is important to use corrective eye glasses in case of any reduced vision. Because long duration reduced vision, also affects the equilibrium of the body and causes faintness. Positional adaptation is very useful for those who suffer from recurrent or chronic vertigo. If vertigo is experienced in a particular position or side, one should keep the head for few seconds in the same position. This will adapt the labyrinthine system (balancing part inside the ear) to that position, thus gradually vertigo is reduced. The author is an expert in Internal Medicine E-mail – rachna212002@yahoo.co.uk