Vertigo is a type of dizziness that affects balance or spatial orientation, characterized by:

  • feelings of spinning
  • lightheadedness
  • swaying
  • inability to stand up and/or walk in a straight line.

Dizziness in vertigo creates an illusion of movement making the world seem to move in ways it is not.

What causes Vertigo?

Vertigo is caused by the result of conflicting information from the sensory organs that contribute to the sensation of balance. These include the eyes, ears, musculature and blood/fluids within the body.

Many common phenomena can trigger this condition. These include:

  • Being on a carousel or rollercoaster
  • Trips by car or boat
  • Disorders of the inner ear (including the semicircular canals)
  • Arteriosclerosis (diseases of the arteries)
  • Changes in blood pressure or blood flow
  • Changes in the spine especially the cervical vertebral discs.

There are many common causes. It is important when developing the treatment for a patient suffering from this condition to understand the cause. Common causes include an underlying physical disorder/condition or a dysfunction in one of the systems that control balance such as the inner ear. Other causes can be more systemic and internal including high blood pressure, multiple sclerosis, a viral infection of the body or ear (vestibular neuritis), irregular heartbeat, migraine-associated, stress, low blood sugar and hypotension (low blood pressure).

How do you treat Vertigo?

Treatment includes vestibular rehabilitation and vestibular rehabilitation exercises focused on the inner ear. Depending on the cause, possible treatments can include neck surgery, regulating blood sugar, certain maneuvers (the Dix-Hallpike maneuver and Epley manoeuvre), viral infection treatment, physical therapy, specific exercises, draining fluid-filled ears and more. Treatment and diagnosis are completed based on clinical practice guidelines. Certain medications may be available depending on the cause. Caution should be taken as they may have side effects. Treatments goals include targeting the symptoms each person is feeling, increasing one’s ability to function and exercise as well as decrease lightheadedness.

Symptoms commonly targeted include:

  • Drowsiness,
  • Tinnitus (ringing in the ears),
  • Nausea,
  • Vomiting,
  • Nystagmus (irregular eye movements),
  • Spinning sensation,
  • Lightheadedness,
  • Fainting,
  • Dizziness
  • Ear problems

Treatment is often very challenging and unique to each person who is suffering due to the many different factors contributing to the development of vertigo. It is also important to distinguish between peripheral (directional vertigo) and central (non-directional) vertigo when initiating treatment.

Vertigopas is a homeopathic remedy to relieve symptoms of vertigo and dizziness. It comes in 50 ml drops, creating easy general dosing and acute dosing. Perfect for helping relieve symptoms of dizziness and vertigo on those long summer bus rides or flying through the air to go snowboarding in the Canadian Rockies. Don't let Vertigo stop you from enjoying yourself.

What types of vertigo are there?

There are two main types of vertigo, peripheral vertigo, and central vertigo.

Peripheral Vertigo is related to the vestibular system in the inner ear, which oversees balance. The system ensures we stay steady, balanced & coordinated, by coordinating our eye & postural movements. When this is not functioning properly, it causes vertigo. Peripheral vertigo is related to when the vestibular apparatus is not working optimally our body cannot compensate for our movements causing us to lose our sense of balance.

Resulting in balance disorders, such as:

  • wooziness
  • lightheadedness
  • Drowsiness,
  • Nausea
  • Vomiting
  • And other symptoms

Central Vertigo is the passing or permanent sensation of spatial uncertainty or unsteadiness, this includes the feeling of passing out, lightheadedness, off-balance or the feeling of uncertainty when walking. Central vertigo is commonly described as a "strange feeling in the head".

Permanent central vertigo is associated with:

  • Medications
  • psychological problems
  • Fluctuations in blood pressure
  • Low salt
  • Head injuries
  • Disorders of the central nervous system such as multiple sclerosis.

These conditions will often have nystagmus unrelated to the head position as seen in BPPV. It can also be associated with dehydration or adrenal fatigue (burn out). In these conditions, our bodies can no longer control our internal regulatory systems and classic symptoms, as well as orthostatic hypotension or nystagmus, may result.

What are some other causes of Vertigo?

  1. Orthostatic Vertigo - Results from changes in blood pressure when we move quickly from sitting to standing. In these cases, the body cannot compensate for these changes quickly enough to stay balanced, changes in heart rate, lightheadedness, & dizziness arise, which can be exacerbated by dehydration.
  2. Ménière's disease – is caused by a fluid imbalance in the inner ear which causes transient recurrent vertigo attacks of vertigo, dizzy spells, ringing in the ears (tinnitus), and hearing loss or feeling of fullness in the ears.
  3. Benign Paroxysmal Positional Vertigo (BPPV) - causes symptoms when the head is placed in a certain position, often triggered when a patient is lying down with their head turned to the affected side. Nystagmus will also arise in this position. Specific head movements such as the Dix-Hallpike position will also trigger these symptoms. BPPV results from a dysfunction in either the horizontal or posterior canal of the semicircular canals in the internal ear. One common treatment option for Benign Paroxysmal Positional Vertigo (BPPV) is the Epley maneuver performed by a trained physician. Another common symptom of Benign Paroxysmal Positional Vertigo (BPPV) is positional nystagmus (irregular eye movements when they are placed in a certain position). The Epley maneuver may need to be performed regularly to treat this condition. The home Epley maneuver can be taught and performed in certain situations. When trained properly this maneuver can be very helpful and very safe in the treatment of Benign Paroxysmal Positional Vertigo (BPPV).
  4. Psychogenic Vertigo - arises due to stress or psychological pressure. This will have the lightheadedness & other related symptoms but not usually the nystagmus.
  5. Motion sickness (Rotary Vertigo) - This occurs when motions activate the vestibular apparatus causing dizziness, lightheadedness and nausea. Movements that trigger motion sickness or rotary vertigo can include being on a carousel or spinning object. On the other hand, being on an upwards-downwards path (such as jumping or rollercoasters) can cause a floating sensation with the lightheadedness.

When should you go to the doctor?

When symptoms are impacting daily functioning or getting worse it is important to have a medical professional such as your family medicine practitioner evaluate.

Causes of this phenomenon can be extremely varied and some can be life-threatening. It is important to evaluate any cause of nystagmus to understand the underlying cause.

What are some evaluations for Vertigo?

There are many types of evaluations for vertigo. One can be evaluated from a neurology standpoint looking for head injuries and overall nervous system function. On the other hand, one can be looked at in the field of otolaryngology. The ear and throat doctor investigate for vestibular disorders and examines the inner ear. This field will examine the vestibular-ocular relationship (the relationship between the ears and eyes) as well as look at all aspects of the inner ear including:

  • The semicircular canals (both horizontal canal and posterior canal which can both contribute to the formation of BPPV),
  • Vestibular nerve,
  • Saccule,
  • Utricle
  • The canalith.

Other possible causes may need other medical attention such as internal medicine or family medicine specialist. It is important to rule out any heart-related causes. Internal medicine looks at what is going on systemically to ensure it is not a contributing factor to the symptoms as well as rule out other medical conditions.

 What can you do if you are prone to vertigo?

It is important to identify triggers and risk factors that make the lightheadedness or dizziness worse. This will help to reduce the number of recurrent vertigo attacks that a patient will experience. Also, creating a balanced lifestyle that nourishes and supports the body will help support the central nervous system, decrease inflammation in the body, support vestibular disorders and maintain a sense of equilibrium.

Some aspects of a generally healthy lifestyle include:

  • Getting enough sleep
  • Eating regular and healthy meals rich in vegetables, fruits, whole grains, lean protein, and good fats such as nuts/seeds, avocado, olive oil etc.
  • Go outside
  • Exercise regularly (exercise can be a trigger for certain causes such as BPPV and Ménière Disease based on one's head position).

It is important to find ways to move the body that will not activate symptoms of this condition. Exercise has many positive benefits for the body and if it is not aggravating it may help decrease symptoms. However, caution should be taken with certain conditions as it can make symptoms such as lightheadedness, vomiting and nystagmus worse.

Take time to rest and relax, and lastly, to treat any infections that are present that could be causing inflammation in the ear/nerves (including labyrinthitis, neuritis).

What is travel sickness?

Travel sickness (seasickness or carsickness) is postural vertigo which causes nausea, dizziness, and vomiting, brought on by transportation (bus, car or ship). Travel sickness is caused by conflicting input from the eyes and the sense of balance in the inner ear (canalith etc.).

During a cruise, for example, the ear perceives the motion of the sea waves, while the eyes register no motion, as the ship is not moving relative to the observer. For the patient symptoms such as dizziness, feeling lightheaded and nausea result as the brain cannot process this information properly.

Advice to counter travel sickness

  1. Get fresh air during your trip
  2. Take breaks during the journey if possible
  3. Try to sit straight behind the front axle in a bus (you will feel the least motion).
  4. Look at the horizon to try and decrease the difference in perception between the eyes and the ears.
  5. Find ways to distract yourself on the journey, such as playing games but avoid certain aggravating exercises.
  6. Drink plenty of water to avoid low blood pressure.
  7. Do not travel with an empty or a full stomach.
  8. Eat light and easily digestible foods in the hours before the journey.
  9. And lastly, do not read while you are on the journey.

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