Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
While individuals may use the word dizziness, vertigo symptoms are described by
the feeling that either the world is spinning around the person or that the
person themselves is spinning. This is the same type of sensation that happens
when a person quickly steps off a merry-go-round or when they twirl
themselves and then quickly stop. The feeling of spinning may be associated with
loss of balance to the point that the person walks unsteadily or falls down.
The individual or family member may describe the person walking as if they were
drunk. Vertigo itself is a symptom or indicator of an underlying balance
problem, either involving the labyrinth of the inner ear or the cerebellum of
the brain.
If other structures of the ear are involved, associated symptoms may include
decreased hearing and ringing in the ear (tinnitus).
If there are issues with the cerebellum, the person may also complain of
difficulty with coordination.
Nausea and vomiting are often associated symptoms with vertigo. Frequently,
the more intense the vertigo, the more intense the nausea and vomiting become.
These symptoms may be so severe that the individual becomes dehydrated and weak.
How is vertigo diagnosed?
Vertigo is diagnosed by history and physical examination. It is important to
confirm the symptom before proceeding to the cause. The key begins with the
health care practitioner understanding the patient's complaint and proceeding from there.
Questions may be asked in regard to what makes the vertigo worse, what makes the
spinning better, and whether there are other associated signs including loss of
hearing, tinnitus (ringing in the ear), and nausea and vomiting. Past medical
history and medication use may offer clues as to the cause.
Physical examination is helpful in confirming the presence of nystagmus, the
abnormal eye motion that the body uses to try to compensate for the abnormal
balance signals coming to the brain. A full neurologic exam may be done to make
certain that the cause of vertigo is peripheral and due to inner ear issues
rather than central problems with the brain. Testing for balance and
coordination may help decide if the cerebellum is working properly.
Hearing tests may be appropriate to make certain that the middle ear, the
cochlea, and the auditory nerve are functioning properly and it is only the labyrinth
that is the cause of vertigo.
The Dix-Hallpike test can be performed by the health care practitioner and help with the
diagnosis. By moving the head in different directions, eye movements can be
assessed and see whether they correlate with the vertigo symptoms.
If there is concern that there is a central brain problem may be the cause of
vertigo, CT or
MRI imaging of the brain may be considered. Screening blood tests
may also be done.
Specialist consultation with a neurologist or otolaryngologist (ear, nose and
throat specialist) may be considered to help with the diagnosis and treatment.
Physical therapists specially trained in vestibular rehabilitation may be
helpful, not only in making the diagnosis, but also in treating peripheral causes
like benign paroxysmal positional vertigo or labyrinthitis.
Vertigo (Dizziness and Vestibular Balance Disorders) - CauseQuestion: How was the diagnosis as to the cause of your vertigo (dizziness and vestibular balance disorders)?
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
A brain tumor can be either benign (non cancerous) or malignant (cancerous), primary, or secondary. Causes and risk factors include age, gender, family history, and exposure to chemicals. Symptoms range from headaches, leg and feet numbness to seizures. Treatment is dependant upon the type and location of the brain tumor.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Migraine is usually periodic attacks of headaches on one or both sides of the head. These may be accompanied by nausea, vomiting, increased sensitivity of the eyes to light (photophobia), increased sensitivity to sound (phonophobia), dizziness, blurred vision, cognitive disturbances, and other symptoms. Treatments for migraine headache include therapies that may or may not involve medications.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Multiple sclerosis (MS) is a disease which progressively injures the nerves of the brain and spinal cord, reflected by alterations of virtually every sensory or motor function in the body. The cause of MS is primarily unknown. There are different types of MS including relapsing-remitting MS, primary-progressive MS, and secondary-progressive MS. Symptoms of MS rang from mild to severe and examples include visual disturbances, muscle weakness, spasm, and fatigue. Decreased concentration, memory loss, and impaired judgment. Treatment for MS is generally with medications.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Middle ear infection or inflammation (otitis media) is inflammation fo the middle ear. There are two types of otitis media, acute and chronic. Acute otitis media is generally short in duration, and chronic otitis media generally lasts several weeks. Seventy-five percent of children in the U.S. suffer from otitis media at some point. Treatment depends upon the type (chronic or acute).
Motion sickness, often referred to as car sickness, sea sickness, or air sickness, is a very common disturbance of the inner ear that is caused by repeated motion. The cause of motion sickness is complex. Symptoms of motion sickness include vomiting, nausea, dizziness, vertigo, sweating, and a feeling of malaise. Treatment of motion sickness include antihistamine medications such as meclizine (Bonine, Antivert, Dramamine), and scopolamine (Transderm Scop) a skin patch.
Orthostatic hypotension symptoms include lightheadedness, weakness, blurred vision, and syncope or passing out. Causes of orthostatic hypotension include dehydration, anemia, medication, blood loss, low blood pressure, heat related illnesses and more. Treatment of orthostatic hypotension depends on the underlying cause.
Trichinosis is a food-borne disease caused by ingesting parasites (roundworms) in undercooked pork or wild-game meat. Symptoms of trichinosis include diarrhea, nausea, muscle aches, itching, fever, chills, and joint pains. Trichinosis usually resolves without treatment, but more severe cases are treated with thiabendazole, albendazole, or mebendazole.
Meniere disease (idiopathic endolymphatic hydrops) is an inner ear disorder with symptoms that include vertigo, tinnitus, hearing loss, and the sensation of ear fullness. Diuretics, anti-vertigo, anti-nausea and low salt diets are the primary treatment for Meniere disease. Surgery may be recommended if the vertigo cannot be controlled with medication.
Balance is a state of body equilibrium or stability. We often take for granted how dependent we are on a healthy balance system. When the system breaks down, however, patients will describe symptoms such as dizziness, vertigo, lightheadedness, or motion sickness.
Arsenic comes in two forms, inorganic and organic. Organic arsenic poisoning is usually not poisonous to humans; however, inorganic arsenic in large enough amounts can lead to shock and death. Symptoms of arsenic poisoning include nausea, abdominal pain, diarrhea, dehydration, dark urine, vertigo, delirium, shock, and death. Treatment for arsenic poisoning includes Hemodialysis and a variety of drugs.
Noise-induced hearing loss may be an acoustic trauma (temporary hearing loss), or permanent due to an acute acoustic trauma. Experts agree that continual exposure to more then 85 dBs (decibels) is dangerous to the ears. Ear plugs and ear muffs can help prevent noise-induced hearing loss as well as decreasing exposure to loud noises.
Hearing loss (deafness) may be present at birth or it may manifest later in life. Deafness may be genetic or due to damage from noise. Treatment of deafness depends upon its cause.
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