Evaluation of

VERTIGO
Dr. Saddam Hossain

Maintenance of
balance:
EYES

PROPRIOCEPTI
VE SYSTEMS

EARS

What is Vertigo:

Vertigo is when a person feels as if they

or the objects around them are moving
when they are not. Often it feels like a
spinning or swaying movement.

Epidemiology:
At least 40% of the world population are
said to suffer from balance problems.

Classification of
vertigo:
1. Otological
2. Central
3. Systemic
4. Unknown

Otological Causes:
a) Benign paroxysmal positional vertigo
(BPPV)- 32%
b) Meniere's disease (12%),
c) superior canal dehiscence syndrome,
d) labyrinthitis, and
e) visual vertigo
f) Common cold
g) Drugs: aminoglycosides

Central Causes:
a) Migraine
b) Brain Tumor
c) Stroke
d) Meningitis
e) Intracranial haemorrhage

Systemic:
a) DM
b) hypoglycaemia
c) HTN
d) Pregnancy
e) Neuro-degenerative disease
f) Hepato-lenticular disease

History:
a) Duration of illness
b) Duration of attacks
c) Triggers
d) Associated symptoms

Duration of episodes:
duration

Probable cause

seconds

Late ototoxicity

minutes

BPPV, TIA

hours

Menieres disease, migraine

day

Vestibular neuritis

Months to year

hysterical

According to Triggers:
Factors

Probable causes

Change in posture

BPPV

uri

Vestibular neuritis

Raised intrathoracic pressure

Perilymph fistula

Symptoms of Vertigo:
People with vertigo typically describe it
as feeling like they are:
1)
2)
3)
4)
5)

Spinning
Tilting
Swaying
Unbalanced
Pulled to one direction

Other symptoms:
Other symptoms that may accompany
vertigo include:
1) Feeling nauseated
2) Abnormal or jerking eye movements
(nystagmus)
3) Headache
4) Sweating
5) Ringing in the ears or hearing loss

Investigations:
Routine
Specials:
1) Audiometry
2) EEG
3) craniocorpography

Treatment:
1) Vestibular rehabilitation
2) Canalith repositioning maneuvers:
Guidelines from the American Academy of Neurology
recommend a series of specific head and body
movements for BPPV. The movements are done to
move the calcium deposits out of the canal into an
inner ear chamber so they can be absorbed by the
body. You will likely have vertigo symptoms during the
procedure as the canaliths move.
A doctor or physical therapist can guide you through
the movements. The movements are safe and often
effective

3) Medicine:
a) antibiotics
b) Steroids
c) Meniere's disease, diuretics (water pills)

4) Surgery.