What is Vertigo?
Vertigo is a sensation of spinning movement. That is, the person with vertigo feels as if the world is rotating.
Quickcare or ER?
Red Flags that will send you to the ER:
- If you passed out
- If you have complains of a severe headache
- If you have any focal neurological deficits (weakness)
What has been your experience with vertigo?
What will your doctor ask?
Your doctor will want to know your symptoms. Remember, a symptom is your description of your condition to your doctor. It is your story.
Dizziness may mean that the “world is spinning around” or “feeling faint.”
This is a key distinction. Feeling faint is much different than the world spinning around
As mentioned, vertigo is the sensation of the world spinning.
Answering the following questions will help your doctor get a better picture of your illness:
- When did the “dizziness” start?
- What makes it better?
- What makes it worse?
- What is associated with it? Loss of consciousness? Headache?
What will doctor look for?
Your doctor will look for signs. A sign is an objective finding that a doctor sees during the examination.
A doctor is looking for a few key things. A thorough neurological exam is important. Your doctor will want to make sure that a person with vertigo is alert and coherent answering questions appropriately.
A doctor needs to make sure there is no paralysis (weakness) to indicate signs of a stroke. He should have good strength.
The neck should not be stiff. It should flex and extend without difficulty
One key piece of information is the ear exam. Many times an infection in the ear will effect the semicircular canals. These canals assist with the balance sensation which, if inflamed, may lead to vertigo.
Also, may persons with vertigo have nystagmus. This is rapid eye movements that are uncontrollable. Typically, vertigo is associated with horizontal nystagmus. That is, the eye is moving side-to-side.
What is your doctor thinking?
Your doctor will create a mental list of possible reasons for the sings and symptoms. This list is called the differential diagnosis.
Starting at the ear, your doctor will need to consider an infection causing the semicircular canals to be inflamed.
A stiff neck may indicate meningeal signs. This may occur with bleeds in the head. THIS IS SERIOUS.
Other more uncommon diagnoses include Meniere’s disease which is due to too much endolymph fluid.
Labyrinthitis may be the cause of vertigo if there is an associated hearing loss.
Always in the differential diagnosis is something more serious such as tumors (schwannomas or Meningiomas).
Your doctor will want to do a good drug history since certain medications such as aminoglycosides may cause vertigo.
Bleeds inside the brain may cause vertigo. A vertical nystagmus suggests the cause is inside the head.
What is the treatment of vertigo?
One treatment for simple vertigo is Meclizine (Antivert). It must be known that Meclizine will cause drowsiness similar to Benadryl.
Many times, after all the studies (CTs and MRIs) are done , there is no clear reason for the vertigo. It is frustrating for both the patient and the doctor.
How long will you be sick?
Even a simple case of vertigo may be lingering
A simple vertigo can last off and on for days. Sometimes weeks. I have seen it linger for years.
Flare ups are pretty common and there is no telling when they will occur.
Let me tell you a story
Pastor James was in his element. He was up on the podium preaching The Word to a packed house. There was no special occasion. The message simply ran through him. It touched his soul and naturally his voice got louder and his movements gyrated every which way.
The congregation picked up on his spirit. An old lady spoke in tongues. Most had their hands up high screaming, “Alleluia”
But Pastor James’ frenzy was halted when he could not stand up. The world was spinning. Faster and faster. He had to stop and put his head down. In front of everyone, he vomited up the roasted chicken that he just ate.
When he got to the Emergency Department, his entourage was beside him. There were bishops, the church elders, old black ladies with big-rimmed hat, and Mexican ladies with black, lacey head coverings.
Most persons with vertigo lay down quietly with their eyes closed. Pastor James was no exception.
In the case of Pastor James, his dizziness feels like the world is spinning. Every time he moved his head from side-to-side it got worse. Associated with the dizziness was vomiting but he always remained alert. He never passed out.
I hope this helps
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