Last week, we discussed what vertigo is, its types, causes, and related aspects. Vertigo can cause falls, which may result in bone (broken bones or other injuries. Vertigo can also affect quality of life and hinder the ability to drive or go to work. A healthcare provider will perform a physical exam and ask questions about the vertigo symptoms. Then one or more tests are recommended to confirm the diagnosis.
Vertigo diagnosis
When a person comes with dizziness, usually treating doctor performs some tests to diagnose vertigo, which include, Fukuda-Unterberger test, also known as the Unterberger Stepping Test, or Fukuda Stepping Test.
Fukuda-Unterberger
In this test, the important information about the patient’s stability, balance, and vestibular function will be assessed. The testing doctor asks the patient to walk in place for 30 seconds while closing their eyes. If the patient rotates or leans to one side, it could mean that there is an issue with the inner ear labyrinth. This could cause vertigo.
Romberg’s test
The other test is Romberg’s test. In this, the clinician asks the patient to remove his shoes and stand with his two feet together while his arms are held next to the body or crossed in front of the body, and tells the patient to first stand quietly with eyes open, and subsequently with eyes closed. If the patient feels unbalanced or unsteady, it could mean that there is an issue with the central nervous system, brain or spinal cord. It measures a person’s sense of balance. Specifically, the test assesses the function of the dorsal column of the spinal cord (the dorsal column is responsible for proprioception).
Head impulse test.
In this test, the physician will gently move the head to each side while the patient focuses his eyes on a stationary target, for example, a spot on the wall. The physician pays close attention to the eye movements while the patient’s head is moving. This can give an inference whether there’s an issue with the balance system in the inner ear or not
Vestibular test battery:
This includes several different tests to check the vestibular portion of the inner ear system. A vestibular test battery can help determine whether vertigo symptoms are a result of an inner ear issue or a brain issue.
Imaging tests
These may include CT (computed tomography) scans or MRI (magnetic resonance imaging. These imaging tests are crucial for diagnosing specific structural or central causes of vertigo (e.g., tumours, stroke, bone abnormalities) and for ruling out serious underlying conditions, especially when red flags are present. However, they are generally not needed for common causes like positional vertigo.
The red flags are, when a patient experiences vertigo along with symptoms like chest pain, weakness, trouble walking, or slurred speech, a spinning or tilting sensation, loss of balance, or dizziness, even when standing still. Other common symptoms include nausea, vomiting, blurred vision, and involuntary eye movements. With a severe headache, fever, or difficulty speaking, you should seek emergency medical care.
Care and Treatment
Vertigo treatment depends on the underlying cause. The clinician uses a variety of treatments, which may include repositioning maneuvers, vertigo medication. Vestibular rehabilitation therapy and Vertigo medication may help in some cases of acute (sudden onset, short duration) vertigo. Usually the motion sickness medications (like meclizine or dimenhydrinate or antihistamines (like cyclizine to ease vertigo symptoms are recommended.
Vestibular rehabilitation therapy usually involves a range of exercises to improve common vertigo symptoms like dizziness, unstable vision and balance issues. Exercises may include stretching, strengthening, eye movement control, and marching in place. A physician teaches how to do these exercises at home so one can manage these symptoms whenever a vertigo episode.
Surgery
It’s rare, but it might need surgery when a serious underlying health issue, like a brain tumor or neck injury, causes vertigo. It is recommended only when other treatments don’t work.
Will vertigo go away on its own?
It’s not always possible to get rid of vertigo. But here are some methods one can try at home to ease the symptoms, such as moving slowly when standing up, turning the head or performing other triggering movements. While sleeping head is to be kept elevated on two pillows. Advised to sleep in a dark, quiet room to reduce the spinning sensation and to sit down as soon as feeling dizzy. Further to squat down instead of bending over at the waist when picking something up. Turning on the lights when getting up during the night. If necessary cane or a walking stick may be used to prevent a fall.
Vertigo permanent cure
Unfortunately, there’s no guaranteed way to get rid of vertigo permanently and keep it from coming back. Some people have vertigo once and never have it again. Others experience recurring (returning) episodes. By following the techniques mentioned above, people can manage the symptoms of vertigo and improve their quality of life.
