Dizziness and vertigo are the most common symptoms that lead the patient to visit a physician.
The most common causes of peripheal vertigo include Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuritis (or neuronitis) and Menière disease.
The incidence of vertigo, dizziness and imbalance is about 5% in the total population, to get even 20% among those who are over 50 years. In those over 65 years old and suffer from vertigo is about 2% risk of falling. Mild hearing loss is a most common disability. The incidence of hearing loss associated with vertigo is about 15% in people older than 50 years. About 8% in the total population report tinnitus. This proportion is much higher among those who suffer from vertigo and hearing loss.
| Tipology of Vertigo | |||
| 01 | PHYSILOGIC VERTIGO |
• Motion induced vertigo |
|
| 02 | PATHOLOGIC VERTIGO | • Persistent vertigo | - Rotational vertigo - Translational vertigo - Imbalance - Phobic vertigo - Acute unilateral vestibular dysfunction (vestibular neuritis) |
| 03 | PATHOLOGIC VERTIGO | • Vertigo relating to movements and body position |
- Positional vertigo |
| 04 | PATHOLOGIC VERTIGO | • Episodic vertigo: Benign paroxismal positional vertigo (BPPV) |
- whith auditory symptoms - whithout auditory symptoms |
| 05 | PATHOLOGIC VERTIGO | • Episodic vertigo whith auditory symptoms in peripheral Vestibulas diseases |
- Menière disease - Vertiginous attack whith unilateral sensorineural hearing loss and tinnitus |
Benign paroxysmal positional vertigo (BPPV) is the most common causes of imbalance and vertigo. Vertigo is a sensation of rotation of the head that lasts a few minutes and then recedes slowly. The BPPV often is without a specific associated illness; in some cases it is a result of whiplash, head trauma or mild aging. The damage is related to the labyrinth system, inside the inner ear. The labyrinth system is located in the inner ear and is responsible for maintaining balance in the human body.
Severe vertigo can be associated nausea and vomiting.
The definitive treatment for benign paroxysmal positional vertigo are the Epley maneuvers. To these it is good to associate a treatment with drugs. Very useful is betahistine hydrochloride.
The ototoxic drugs can cause dizziness or unsteadiness.
Reference
Sacco RR et al.: Management of benign Paroxysmal Positional Vertigo: a randomized controlled trial. J. Emerg Med. Apr 2014; 46(4): 575-81
Trune DR: Ion homeostasis in the ear: mechanisms, maladies, and management. Curr Opin Otolaryngol Head Neck Surg Oct 2010; 18(5): 413-9
Carlo Govoni MD received his second-level master's degree in Vestibology at the "La Sapienza" University in Rome.
See also:
Otolaryngology and Head and Neck Surgery
Carlo Govoni performs surgery ENT at the nursing home in Columbus Clinic Center, via Buonarroti, 48 Milan; Clinic Institute Sant'Anna, Brescia and Hesperia Hospital, Arquà street, 80 - Modena. Another ambulatory is located in MILAN, Magenta street, civic number 64. Phone: (+39) 0258103023
Only private visits by appointment. Phone (+39) 3358040811
