20 May 2019 Author : Sandra Sousa e Castro What is vertigo? Vertigo is not a diagnosis, it is a symptom / description of a sensation. Disturbances in balance cause sensations that are difficult to describe in words. In the face of complaints of balance disorders, the initial concern is classify it, distinguishing whether they are: Vertigo , which is a false sense of self or environment movement. Perceived movement is usually rotational - a sensation of spinning or turning - but in some cases the person just feels that it is pulled to one side. Usually this sensation is associated with nausea and vomiting. Imbalance , which corresponds to a feeling of instability, a tendency to fall when walking. Dizziness , which is a more inaccurate term and can refer to sensations such as fluctuation, "head empty", "head out of body", blurred vision, weakness in the lower limbs and almost fainting. Who can suffer from vertigo? Globally, balance changes are very common and are estimated to affect about 15% to 30% of adults. They may also occur in children, although less frequently. The prevalence of vertigo increases with age and affects approximately 40% of people over 40 years, at some moment in their lives. Vertigo crisis can be disabling, not allowing to work or even leaving the home. Falls can be frequent and with severe sequelae. What causes vertigo? Vertigo can be: Central , when due to brain diseases such as tumors, degenerative diseases, strokes, toxicity, and infections such as meningitis, encephalitis or abscesses. Peripheral , when due to changes in the inner ear, specifically the vestibular system. In a quarter of cases, the cause of the sensation of vertigo is vestibular, ie, it is related to diseases of the inner ear. Inner ear diseases associated with symptoms of vertigo include: Benign paroxysmal positional vertigo , which is the most common, is due to the displacement of otoliths (commonly known as crystals) causing brief episodes of vertigo related to head movements, especially when rotating, lying down and getting up from bed. Vestibular neuronitis , which is an inflammation of the nerve that transmits balance information, causing sudden and severe vertigo, usually lasting a few days. Labyrinthitis , which is a vestibular neuronitis associated with hearing loss. Ménière's disease , in which recurrent seizures of vertigo, deafness, tinnitus and feeling of fullness occur in the affected ear. Vestibular migraine , which manifests in migraine sufferers, but dizziness attacks do not always occur associated with headache and the patient also complains of light and noise intolerance. How is the diagnosis made? Key to establishing the diagnosis of the cause of vertigo are: Detailed clinical history; Otoneurological examination. It may also be necessary to perform medical exams that assess auditory and vestibular function, such as: Audiogram; Auditory evoked potentials; Videonystagmography; Electrocochleography; Dynamic posturography. How is vertigo treated? Benign paroxysmal positional vertigo is treated through maneuvers in which the otoliths (“crystals”) are repositioned. These maneuvers are performed in consultation and are highly effective in solving the problem. Treatment of other illnesses that may be associated with symptoms of vertigo may involve: Implementation of dietary measures; Lifestyle changes; Medication; Vestibular rehabilitation. Vestibular rehabilitation consists of performing specific exercises in speical equipment, individually planned based on the specificities of each case. It aims to improve vertigo and balance, allowing the patients return to professional and daily activities, thus contributing to the recovery of self-confidence and improving the quality of life. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
