In one of the popular Telugu movies, Waltair Veerayya, the hero, Mega Star Chiranjeevi, is allotted a room on the 13th floor of a star hotel. Before checking in, he confides in the beautiful front office executive, Ms. Shruti Haasan, that he suffers from vertigo. For a moment, the young lady, who handles guest check-ins and check-outs, appears puzzled, unable to understand what vertigo means or the nature of his problem. Chiranjeevi then explains that he feels dizzy and loses balance while using lifts or walking at heights. The charming Ms. Shruti Haasan reassures him, encouraging him to overcome his fear, and even assists him to his room by gently holding his hand to help him avoid vertigo — a false sensation that the world around a person is spinning, tilting, or moving. In the film, this episode eventually leads Ms. Haasan to fall in love with the hero. But in real life, such a thing may not happen. Vertigo is no romantic condition; it is a medical problem that demands attention and care. One must be cautious.
Vertigo is defined as an abnormal perception of movement of the environment or self, which occurs due to conflicting sensory information reaching the brain. This confusion arises from differences between visual, proprioceptive (kinaesthetic), and vestibular signals — the three key systems that help a person maintain body balance and orientation. Kinaesthesia is the body’s ability to sense movement, action, and location, primarily influenced by muscle spindles, with secondary input from skin and joint receptors. The vestibular system, located in the inner ear, provides the sense of balance and spatial orientation. It comprises semicircular canals and otolith organs, which work together to maintain equilibrium. The semicircular canals detect rotational movements such as tilting or turning the head, while the otolith organs — the utricle and saccule — detect linear movements like forward, backward, upward, or downward motions and respond to gravity. These structures send information to the brain to control eye movements, maintain posture, and keep the body upright. When this system is disrupted, it can lead to dizziness, fainting, or loss of coordination.
What is Vertigo?
Vertigo is not a disease but a symptom — a sensation that the environment around a person is spinning or moving in circles, making one feel off balance. It can occur with other symptoms such as nausea, vomiting, dizziness, loss of balance, hearing loss in one or both ears, tinnitus (ringing in the ears), headache, a feeling of fullness in the ears, and motion sickness. In some cases, it may be accompanied by nystagmus, a condition in which the eyes move rapidly and uncontrollably from side to side. Motion sickness occurs when the brain receives conflicting sensory signals from the inner ear, eyes, and body sensors — for example, when the inner ear senses motion but the eyes do not, as often happens while travelling in a moving vehicle, riding an amusement park ride, or even playing video games.
Types of Vertigo
There are two main types of vertigo: peripheral and central. Peripheral vertigo is the most common type and occurs when there is a problem in the inner ear or the vestibular nerve. Conditions such as benign paroxysmal positional vertigo (BPPV), labyrinthitis, vestibular neuritis, and Ménière’s disease fall under this category. Central vertigo, though less common, is generally more serious. It occurs due to conditions affecting the brain, such as infections, stroke, or traumatic brain injury. Patients with central vertigo often experience severe imbalance and difficulty walking.
Possible Causes
The causes of vertigo vary from person to person. They include migraine headaches, certain medications such as some antibiotics, anti-inflammatory and cardiovascular drugs, stroke, arrhythmia, diabetes, head injuries, prolonged bed rest, and shingles in or near the ear. Shingles, also known as herpes zoster, is a viral infection that causes a painful rash with blisters, usually on one side of the body. It is caused by the varicella-zoster virus, the same virus that causes chickenpox. Even after recovery from chickenpox, the virus may remain dormant in the body and reactivate years later, especially when the immune system weakens, leading to shingles.
Other causes include perilymphatic fistula, where inner ear fluid leaks into the middle ear; otosclerosis, an abnormal bone growth in the middle ear; brain diseases; multiple sclerosis (MS); acoustic neuroma, a benign tumour on the vestibular nerve; and syphilis. Vertigo is one of the symptoms of otosyphilis, a complication of syphilis that can also cause hearing loss and tinnitus. It can also be seen in other forms of neurosyphilis, such as meningovascular neurosyphilis, which affects blood vessels in the brain. During vertigo episodes, some may experience rapid breathing, a fall in blood pressure when standing, and muscle weakness.
Vertigo is not something to be ignored or taken lightly. It requires prompt medical diagnosis, care, and appropriate treatment to prevent complications and ensure a better quality of life. Vertigo diagnosis, care, and treatment will be discussed next week. (To be concluded.)
