Vertigo (patient information)

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 * Associate Editor-In-Chief: Jinhui Wu, M.D.

Overview
Vertigo is not a disease but a symptom. Patients with vertigo may experience the sensation of disorientation or motion or the perception that surrounding objects are moving or spinning, lightheadedness, imbalance, nausea and vomiting, sweat, abnormal eye movements, tinnitus or hearing loss. Many diseases can cause vertigo, including upper respiratory tract or ear infection, labyrinthitis, head or ear injury, migraine, Ménière's disease, acoustic neuroma, brain stem tumors, nasopharyngeal carcinoma and stroke. It is important to indentify the cause of vertigo. Usual tests include vestibular function testing, hearing testing, neurological examination, and images such x-ray, CT and MRI. Treatment and prognosis of vertigo depend on the underlying cause.

What are the symptoms of Vertigo?
Patients with vertigo may experience one or more following symptons.
 * A sensation of disorientation or motion or the perception that surrounding objects are moving or spinning
 * Lightheadedness
 * Imbalance
 * Nausea and vomiting
 * Sweat
 * Abnormal eye movements
 * Tinnitus or hearing loss

What causes Vertigo?

 * Upper respiratory tract infection
 * Ear infection
 * Labyrinthitis
 * Head or ear injury
 * Multiple sclerosis
 * Epilepsy
 * Neck injuries
 * Migraine
 * Ménière's disease
 * Acoustic neuroma
 * Brain stem tumors
 * Nasopharyngeal carcinoma
 * Stroke or transient ischemic attack (TIA)

When to seek urgent medical care?
See your doctor immediately if you experience vertigo with any of the following:
 * A new, different or severe headache
 * Fever
 * Diplopia or loss of vision
 * Hearing loss
 * Trouble in speaking
 * Leg or arm weakness or paralysis, especially in one side
 * Loss of consciousness
 * Difficulty walking
 * Numbness

Diagnosis
The goal of the tests is to identify the cause of vertigo. It is important to rule out serious conditions such as stroke or tumor.
 * Medical history and physical examination
 * Vestibular function testing: Vestibular function testing includes a series of tests, such as earth-vertical axis rotational testing, caloric testing and head-only rotational testing. The purpose of vestibular function testing is to objectively and quantitatively assess the status of the vestibular system. Some techniques may provide information regarding peripheral vestibular function while others focus on central processing.
 * Hearing testing: Hearing testing is a means of evaluating an individual's overall hearing function and help diagnose the cause of vertigo. The tests are used to determine if there is something wrong with the hearing portion of the inner ear. They are often used as an initial screening. They are sometimes used in conjunction with vestibular testing to diagnose specific disorders, such as Meniere's disease.
 * Neurological examination: The neurological examination is the physical examination of the nervous system. It attempts to identify or exclude nervous system disease and to produce a likely anatomical or physiological explanation that can be tested through medical imaging, blood tests or a combination.
 * Blood tests, including complete blood count, blood gas analysis: These tests may help doctors know whether there is any inflammation in your body and may supply clues for the diagnosis.
 * X-ray tests in chest and neck: These x-ray tests may used to detect whether there is any pathological change in your chest and neck, and whether it is related to your vertigo.
 * CT scan and MRI scan in head or cervical spine: These images help to exclude serious conditions in your brain, such as stroke  or tumor and help find the cause of your vertigo.

Treatment options
Treatment of vertigo depends on the underlying causes.
 * Treat tne underlying causes, such as surgery for brain tumor, radiation therapy for nasopharyngeal carcinoma, antibiotics for ear infection.
 * Control or relieve the symptom of vertigo, medications such as meclizine hydrochloride, promethazine hydrochloride, scopolamine transdermal patch and diphenhydramine.

Where to find medical care for Vertigo?
Directions to Hospitals Treating vertigo

What to expect (Outlook/Prognosis)?
The prognosis of vertigo depends on the causes. Outcomes of vertigo caused by tumors are poorer than any other causes.

Prevention
Vertigo is a symptom of many diseases, the preventive measurements depends on the underlying causes.
 * Keep a healthy life-style, such as eat a low-lipid diet, do regular exercises.
 * Avoidance infection in the ears or head
 * Avoidance injuries in the ears, neck or head