Earth moving under your feet? It could be Vertigo!

Feeling the ground move under your feet can be scary especially when coupled with extreme nausea. These symptoms of Vertigo can be overwhelming but this common condition effects many people. Dr Mélissandre Noël explains all about Vertigo.

What is vertigo?

As family physicians, dizziness and vertigo are amongst the common symptoms we see in our clinics. Experiencing vertigo (the sensation that you or the room around you is spinning) can be quite scary and dramatic.

Most of the causes of vertigo are benign and only require monitoring or simple treatments, but it is not a symptom you should ever ignore because it could be a sign of something more serious.

It is also really important to differentiate between vertigo and dizziness. Dizziness is the sensation of feeling light-headed, weak, or unsteady. Causes of dizziness can include neck issues, vascular problems,  low blood pressure, anemia, low blood sugar, dehydration or heart problems. Anxiety or panic attacks and some medications can also cause dizziness.

So, what could be causing my vertigo attack?

There are multiple causes of vertigo and we can classify them into two broad categories: peripheral vertigo (issues with your inner ear) and central vertigo (injury or disease of the brain).

If you have ever experienced vertigo before, chances are it was of peripheral origin, this is the most common type of vertigo. Peripheral vertigo includes inner ear problems such as infection from a virus, little crystals loose in middle ear fluid, this can happen spontaneously or from a head injury. Most people who experience peripheral vertigo will have other symptoms like nausea, vomiting, hearing loss, or a ringing or whooshing sound in the ears.

Things that cause central vertigo are usually more serious. This is why it is important to see your doctor when having symptoms of vertigo so more serious causes can be excluded. They are extremely rare but can include brain tumors, stroke, infection of the nervous system or autoimmune disorders.

Who is affected by vertigo, dizziness, and imbalance? 

As we get older, those symptoms are more common. It is estimated that about 40% of people who are over 40 years old will experience vertigo or dizziness in the course of their lives. Women also tend to be more affected than men.

How long can it last?

Depending on the cause, vertigo and dizziness can be very short-lived and resolve on their own.

Peripheral vertigo caused by a viral infection will resolve in 1-2 weeks.

BPPV (Benign Peripheral Positional Vertigo, in which little crystals in the inner ear balance center are in the wrong position) will come and go in dramatic attacks, and can either resolve on its own or with simple treatments. BPPV is the most common cause of vertigo.

Meniere’s disease (in which people experience vertigo with hearing loss and tinnitus) is usually chronic and can be managed but not cured.

Central vertigo is usually felt as constant vertigo and will resolve only if the underlying cause is treated.

Dizziness, depending on the cause, can also be constant or occasional. It will resolve when we find the cause and treat it.

Are there any medicines I can take to help with my vertigo?

The acute symptoms of peripheral vertigo can be improved with medicine, and again it depends on the cause of vertigo. Corticosteroids (cortisone, prednisone) can be helpful in Meniere’s disease or viral infection of the inner ear. Anti-nausea medication and vestibular suppressants (medicine that will calm down your balance center) can also help in the short term.

What is the definitive treatment for my vertigo?

Apart from short courses of medication, the most effective treatment for peripheral vertigo caused by BPPV is repositioning the crystals in their correct place. This can be done with home exercises. However, the help of a middle ear physiotherapist improves the chances of success and speeds up recovery time.

Can I do anything differently to try and manage my vertigo or prevent it from coming back?

As with everything, lifestyle can play a big role in the management of vertigo. Depending on the cause, your doctor might recommend that you avoid foods that have a high salt content, caffeine, and alcohol. If you are a smoker, smoking cessation will also be helpful. During vertigo attacks, lying still in a dark or dimly lit room, sleeping with an extra pillow, performing head movements more slowly can all help reduce the symptoms.

But remember, although most people with vertigo will have a simple and benign underlying cause, it is always important to see your doctor and make sure nothing more serious could be going on.



Dr Mélissandre Noël - Doctor IMC SingaporeDr Mélissandre Noël is a Canadian French speaking doctor who graduated from the University of Montreal in 2009 and completed a residency in Family Medicine at the University of British Columbia (2011).  Dr Meli practices in IMC’s Jelita clinic call 6465 4440 for an appointment.


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