Vertigo treatments
Dizziness
It’s common to sometimes feel dizzy, lightheaded or off-balance, and it’s not usually serious.
Check if you have dizziness
Dizziness includes feeling:
- Off-balance
- Giddy
- Lightheaded or faint
- Like you're spinning or things around you are spinning (vertigo)
How you can treat dizziness yourself
Dizziness usually goes away on its own. But there are things you can do to take care of yourself while you’re feeling dizzy.
What to do if you are dizzy?
- Lie down until the dizziness passes, then get up slowly
- Move slowly and carefully
- Get plenty of rest
- Drink plenty of fluids, especially water
- Drink plenty of fluids, especially water
- Avoid coffee, cigarettes, alcohol and drugs
Don’t
- Do not bend down suddenly
- Do not get up suddenly after sitting or lying down
- Do not do anything that could be dangerous while you're dizzy, like driving, climbing a ladder or using heavy machinery
Non-urgent advice: Consult ENT
You’re worried about your dizziness or vertigo?
- It will not go away or it keeps coming back
- You're finding it harder to hear or speak
- There's ringing or other sounds in your ears (tinnitus)
- You have double vision, blurred vision or other changes in your eyesight
- Your face, arms or legs feel numb or weak
- You have other symptoms like changes to your pulse, fainting or collapsing, headaches, feeling or being sick
Causes of dizziness
If you have other symptoms, this might give you an idea of the cause. Do not self-diagnose. See a GP if you’re worried.
Dizziness while you’re ill with something else
Dizziness often goes away after you’re treated for something else. For example:
- An ear infection
- Migraine
- Dehydration or heat exhaustion
- Stress or anxiety
- Low blood sugar (hypoglycaemia) because of diabetes
- Iron deficiency anaemia
- Motion sickness
Dizziness for no obvious reason
Dizziness symptoms Possible causes
- When standing or sitting up suddenly
- Sudden drop in blood pressure (postural hypotension)
- Feeling off-balance, losing some hearing, ringing or other sounds in your ears (tinnitus)
- Inner-ear problems
- Feeling off-balance or like things are spinning, feeling or being sick, sometimes after a cold or flu
- Feeling off-balance or like things are spinning, feeling or being sick, sometimes after a cold or flu
- Labyrinthitis
- After starting new prescription medicine
Treatment
The cause of any brain disorder causing vertigo should be identified and treated when possible.
To help resolve symptoms of benign positional vertigo, the provider may perform the Epley maneuver on you. This involves placing your head in different positions to help reset the balance organ.
You may be prescribed medicines to treat symptoms of peripheral vertigo, such as nausea and vomiting.
Physical therapy may help improve balance problems. You’ll be taught exercises to restore your sense of balance. Exercises can also strengthen your muscles to help prevent falls.
To prevent worsening of symptoms during an episode of vertigo, try the following:
- Keep still. Sit or lie down when symptoms occur.
- Gradually resume activity.
- Avoid sudden position changes.
- Do not try to read when symptoms occur.
- Avoid bright lights.
You may need help walking when symptoms occur. Avoid hazardous activities such as driving, operating heavy machinery, and climbing until 1 week after symptoms have disappeared.
Other treatment depends on the cause of the vertigo. Surgery, including microvascular decompression, may be suggested in some cases.
Balance rehabilitation
Balance rehabilitation combines exercises and physical therapies to help restore balance. In every human ear, the cochlea is filled with a fluid called Endolymph, also known as Scarpa’s fluid. The cochlea has two main structures, which are:
- Hearing system
- Vestibular system
The vestibular system is the part responsible for maintaining balance within the body. However, when vertigo sets in, there’s a disconnect in this system, causing dizziness, an internal spinning sensation or an intense off-balance feeling.
In some circles, balance rehabilitation is known as vestibular rehabilitation therapy. It usually involves exercises such as a guided head movement to either retrain or reactivate the vestibular system. These exercises aim to equip individuals with measures to minimize the risk of falling and injuring themselves.
Diet and lifestyle
Suppose your vertigo was brought on by a medical condition known as Meniere’s disease. Your ENT doctor will recommend a diet and lifestyle change. For example,
- Reducing your high sugar intake
- Limiting or cutting out your caffeine consumption
- Avoiding processed foods as much as you can
What is Hearing Loss?
Hearing loss is a symptom of various conditions affecting the hearing organ or its nerve connection to the brain. It may be caused by problems affecting the transmission of sound through the eardrum and bones of hearing (called ossicles) to the cochlea (the organ of hearing), or it may be due to problems in the cochlea and the auditory nerve that connects the cochlea to the brain.
Conductive hearing loss is caused when something interferes with sound transmission from the ear canal to the cochlea. A problem with the cochlea, or the nerve connection from the cochlea to the brain, causes sensorineural hearing loss.
Investigations and Treatment
Your doctor or specialist will arrange for you to have hearing tests performed. A variety of tests are available, and special test techniques can be used to assess children, even when they are newborns.
This will help establish the nature and severity of the hearing loss. The severity of the hearing loss is graded as mild, moderate, severe and profound. Treatment depends on the severity of the hearing loss and whether it is conductive or sensorineural.
In conductive hearing loss, there may be an infection of other disease processes that needs to be treated. Treatment may include surgery to treat the infection and restore hearing.
In cases where the hearing loss is due to a problem with the ossicles (e.g. otosclerosis), surgical hearing restoration is usually possible. This may involve using metal or plastic implants or reusing your existing ossicles to restore the hearing mechanism.
Headaches
Most people will suffer headaches occasionally, and there is usually no reason to consult your doctor or an ear, nose, and throat (ENT) professional. However, in cases where individuals experience chronic pain, medical professionals can provide many different treatment solutions based on the cause of the problem. If you’re unsure how an ENT might treat headaches and migraines, you’ve come to the right place today. Below are some methods and practices that could make a difference and provide you with some relief from the pain. If you visit an ENT specialist during the next few weeks, these are some treatments you can expect to receive.
Tension-type headaches
Many people who suffer tension-type headaches complain about a band of pain around the middle of their heads. In many instances, headaches happen when you expose yourself to high-stress levels. They can also occur when you’ve had a lack of sleep or haven’t been eating correctly. Most ENTs will recommend dietary changes and painkillers like Aspirin for the best results. Other medications like ibuprofen and acetaminophen can also provide mild relief. So, in most instances, you won’t have to worry about painful treatments or anything requiring you to take time off work.
Tinnitus
Tinnitus is the perception of sound that does not have an external source, so other people cannot hear it. Tinnitus is commonly described as a ringing sound, but some people hear other sounds, such as roaring or buzzing.
Tinnitus is not a disease per se but a common symptom, and because it involves the perception of hearing sound or sounds in one or both ears, it is commonly associated with the hearing system. Various parts of the hearing system, including the inner ear, are often responsible for this symptom. At times, it is relatively easy to associate the symptom of tinnitus with specific problems affecting the hearing system; at other times, the connection is less clear.
Common symptoms of tinnitus include:
- Constant high- or low-pitched ringing in ears
- Intermittent or constant roaring in ears
- Pulsation or beating noises in ears
- Associated with or without hearing loss
Tinnitus is a noise in the ears. It is experienced by 10 to 15% of the population.
Subjective tinnitus is the perception of sound without an acoustic stimulus and is heard only by the patient. Most tinnitus is subjective.
Objective tinnitus is uncommon and results from noise generated by structures near the ear. Sometimes the tinnitus is loud enough to be heard by the examiner.
Characteristics
Tinnitus may be described as buzzing, ringing, roaring, whistling, or hissing and is sometimes variable and complex. Objective tinnitus is typically pulsatile (synchronous with the heartbeat) or intermittent. Tinnitus is most noticeable in quiet environments and in the absence of distracting stimuli and, thus, frequently seems worse at bedtime.
Tinnitus may be intermittent or continuous. Continuous tinnitus is, at best annoying and is often quite distressing. Some patients adapt to its presence better than others; depression occasionally results. Stress generally exacerbates tinnitus.
Pathophysiology of Tinnitus
Subjective tinnitus is thought to be caused by abnormal neuronal activity in the auditory cortex. This activity results when input from the auditory pathway (cochlea, auditory nerve, brain stem nuclei, auditory cortex) is disrupted or altered in some manner. This disruption may cause a loss of suppression of intrinsic cortical activity and the creation of new neural connections. Some believe the phenomenon is similar to the development of phantom limb pain after amputation. Conductive hearing loss (e.g., caused by cerumen impaction, otitis media, or eustachian tube dysfunction) may also be associated with subjective tinnitus by altering sound input to the central auditory system.
Objective tinnitus represents noise generated by physiologic phenomena near the middle ear. Usually, the noise comes from blood vessels, either normal vessels in conditions of increased or turbulent flow (e.g., caused by atherosclerosis) or abnormal vessels (e.g., in tumors or vascular malformations). Sometimes muscle spasms or myoclonus of palatal muscles or muscles in the middle ear (stapedius, tensor tympani) cause clicking sounds.
Etiology of Tinnitus
Causes may be considered by whether they cause subjective or objective tinnitus (see Table Some Causes of Tinnitus).
Subjective tinnitus
Subjective tinnitus may occur with almost any disorder affecting the auditory pathways.
The most common disorders are those that involve sensorineural hearing loss, particularly
- Acoustic trauma (noise-induced sensorineural hearing loss)
- Presbycusis (with aging)
- Ototoxic drugs
- Meniere disease
- Migraines
Infections and central nervous system lesions (e.g., caused by a tumour, stroke, or multiple sclerosis) that affect auditory pathways also may be responsible.
Disorders causing conductive hearing loss also may cause tinnitus. These include obstruction of the ear canal by cerumen, a foreign body, or external otitis. Tinnitus may also be associated with otitis media, barotrauma, eustachian tube dysfunction, and otosclerosis.
Temporomandibular joint dysfunction may be associated with tinnitus in some patients.
Objective tinnitus
Objective tinnitus usually involves noise from vascular flow, which causes an audible pulsating sound synchronous with the pulse. Causes include
- Turbulent flow through the carotid artery or jugular vein
- Highly vascular middle ear tumours
- Dural arteriovenous malformations (AVMs)
Muscle spasms or myoclonus of palatal muscles or those of the middle ear (stapedius, tensor tympani) may cause perceptible noise, typically a rhythmic clicking. Such spasms may be idiopathic or caused by tumours, head trauma, and infectious or demyelinating diseases (e.g., multiple sclerosis). Palatal myoclonus causes visible movement of the palate, tympanic membrane, or both that coincides with tinnitus.
Treatment of Tinnitus
Treatment of the underlying disorder may lessen tinnitus. Correcting hearing loss (e.g., with a hearing aid) relieves tinnitus in about 50% of patients.
Because stress and other mental factors (e.g., depression) can exacerbate symptoms, efforts to recognize and treat these factors may help. Many patients are reassured by learning that their tinnitus is not a serious medical problem. Tinnitus also can be worsened by caffeine and other stimulants, so patients should try eliminating the use of these substances.
Although no specific medical or surgical therapy is available, many patients find that background sound masks tinnitus and may help them fall asleep. Some patients benefit from a tinnitus masker, a device worn like a hearing aid that provides a low-level sound that can cover up the tinnitus. Tinnitus retraining therapy, offered by programs specializing in tinnitus treatment, is helpful for some patients. Electrical stimulation of the inner ear, as with a cochlear implant, occasionally reduces tinnitus but is appropriate only for patients who are profoundly deaf.
Talk to Bengaluru’s Best Ent Specialist Now.
Dr. SHALINA RAY
Consultant – Ear Nose and Throat
MBBS | DLO | MS (ENT) | MRCS (UK) | DOHNS (UK)
