Management And Treatment Of Vertigo And Meniere’s Disease
When an object or human being’s weight Is evenly distributed, enabling someone or something to remain steady in a particular position, ¡lis termed as balance. But how do we maintain balance? Signals from our eyes, ears, joints of the body and muscles are combined in the brain to tell us the position and angle of our body. Signals from the brain then cause muscles around our body to tighten or loosen, so as to keep the balance.
Vertigo is the slightly dizzy feeling we get at great heights, while looking down, or which occurs at any time for no reason. This may be central from the brain, or peripheral from other parts of the body and may be accompanied by vomiting, sudden falls to the ground, or a ringing sensation in the ears.
Disturbance of the balance mechanism in the ears or balancing signals from joints, muscles or eyes, blood pressure and cardiac medicines, alcohol, ear infections and diseases that affect the functioning of the nerves and brain, like diabetes, strokes or spinal cord injury can lead to vertigo. Other causes are medical conditions like benign paroxysmal positional vertigo, Meniere’s syndrome (increased ear pressures with ringing in ears, deafness and vertigo), spondylitis or cardiac problems.
Patients suffering with vertigo may have some or all of the following symptoms:
- A feeling of spinning, tilting, swaying, unbalanced, pulled to one direction, kind of sensation.
- Feeling nauseated, abnormal or jerking eye movements (nystagmus)
- Headache, sweating, ringing in the ears or hearing loss Symptoms can last a few minutes to a few hours, or more and may appear and subside.
Questions A Patient Has To Answer Maintain a vertigo diary with the following:
- Is the feeling there all the time, or caused by movement, position changes, worse when tired or haven’t eaten, worse in the dark, worse outside, or worse when walking on uneven surfaces?
- Does it have anything to do with lying down, sitting or standing up?
- What is your current functional status with regard to fears of moving around in the dark, taking walks alone, working and carrying out parenting activities, driving, being in enclosed spaces like malls, reading, watching TV or using computers, travelling, getting in and out of bed, doing household chores, concentrating on something?
- Does physical activity of any kind increase your problem? Would you rate your symptoms as negligible, bothersome, interfering with outdoor activities, disrupting both work and home duties, causing you to take medical leave often, or total inability to work?
In many cases, vertigo disappears on its own, as the brain adapts, but if it continues to persist, then it is advisable to seek medical attention.
- There are currently no surgical remedies for menieres disease as such
- Tinnitus or ringing in the ears may be treated medically, or by Injection of a steroid through the ear drum, or by a device that applies pressure pulses to the ear like a pump to help lower ear fluid pressures, or by masking hearing aids that deliver a soft noise that hides the ringing.
- Vertigo may be treated with medications or surgery.
- Medications to control infections, vomiting, giddiness, and allergy are given in combinations, with multivitamins that help nerves recover and regenerate.
- Transtympanic steroid or gentamycin injections (Injections through the eardrum) for very severe giddiness not responding to medicines, which as a side etlect, causes hearing loss.
- Vestibular rehabilitation for vertigo
- Canalith repositioning manoeuvres
- Special hearing aids to stop ringing in the ears and pulsed pressure devices to reduce ear pressures
Surgery for vertigo either tries to correct the cause of the vertigo, or in extreme cases tries to destroy the areas generating false signals, but in destroying or damaging the nerve endings some amount of hearing capacity is lost.
- Physical therapy like Cawthorne Cooksey head exercises, half somersault exercises for vertigo, along with general fitness and balance exercise programs like tai chi or yoga can be practiced.
- Control diabetes, blood pressure, cholesterol levels, weight, salt intake and limit total fluid intake per day to three litres.
- Identity movements, positions, and situations that cause giddiness and avoid them.
How to Avoid Vertigo
As most cases appear spontaneously, prevention is not possible, but maintaining a healthy lifestyle will decrease risks of experiencing this condition.