Giddiness & Vertigo

Vertigo is a sensation that you or the environment around you is moving.

It is a symptom of an underlying problem in the inner ear balance organ (peripheral vertigo) or a problem with the posterior part of the brain (central vertigo), which is important for balance and movement control.

Vertigo can be both mild and severe. In severe cases, you may feel a loss of balance when trying to perform everyday tasks. Just a slight movement of the head could result in nausea and vomiting.

There are different causes of vertigo. Some may last for several seconds, while others will last for hours or even days.

1. Benign Paroxysmal Positional Vertigo (BPPV)
   1. One of the most common causes of vertigo
   2. It occurs typically when tilting the head backwards and turning to one side
   3. Lasts several seconds to minutes, and accompanied by nausea
   4. May feel lightheaded for hours later
   5. More common in people aged 50 and above
2. Vestibular Neuronitis
   1. Common cause of vertigo
   2. Caused by an inflammation of the vestibular nerve (nerve for balance) and is usually caused by a viral infection
   3. The vertigo is continuous, persistent and is worse with any head movement
   4. Comes on suddenly and is associated with nausea and vomiting
   5. Usually improves on its own within days even without treatment
3. Acute Labyrinthitis
   1. Usually caused by a viral inflammation of the inner ear
   2. Affects both the balance and hearing organs of the inner ear
   3. Causes vertigo, nausea, vomiting and hearing loss
   4. Hearing loss is treated with oral steroids and bed rest is advised
   5. If it’s caused by a bacterial infection, antibiotics can be used
4. Meniere's Disease
   1. Symptoms: tinnitus, hearing loss, vertigo and pressure in the ear
   2. Can last for a short time (20 minutes) but it will often last for several hours
   3. Attacks are often unpredictable and occur in clusters
   4. Treatment include diet control, medication and in rare cases, surgery
5. Central Causes of Vertigo
   1. Caused by problems within the brain, such as the cerebellum and brainstem that are important in maintaining one’s balance
   2. E.g. migraines, strokes, brain tumours
   3. Your ENT doctor may refer you a neurologist if this is suspected