VERTIGO

H.SINDHU
LECTURER
BGS GLOBAL INSTITUTE OF MEDICAL
SCIENCES
 DEFINITION
• Vertigo is a sensation of feeling off balance. If you have these dizzy spells,
you might feel like you are spinning or that the world around you is
spinning.
• Causes of Vertigo
• Vertigo is often caused by an inner ear problem. Some of the most common
causes include:
• BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV
occurs when tiny calcium particles (canaliths) are dislodged from their normal
location and collect in the inner ear. The inner ear sends signals to the brain about
head and body movements relative to gravity. It helps you keep your balance.
• BPPV can occur for no known reason and may be associated with age.
• Meniere's disease. This is an inner ear disorder thought to be caused by a buildup
of fluid and changing pressure in the ear. It can cause episodes of vertigo along
with ringing in the ears (tinnitus) and hearing loss.
• Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related
to infection (usually viral). The infection causes inflammation in the inner ear
around nerves that are important for helping the body sense balance
• Less often vertigo may be associated with:
• Head or neck injury
• Brain problems such as stroke or tumor
• Certain medications that cause ear damage
• Migraine headaches
• Symptoms of Vertigo
• Vertigo is often triggered by a change in the position of your head.
• People with vertigo typically describe it as feeling like they are:
• Spinning
• Tilting
• Swaying
• Unbalanced
• Pulled to one direction
• Other symptoms that may accompany vertigo include:
• Feeling nauseated
• Vomiting
• Abnormal or jerking eye movements (nystagmus)
• Headache
• Sweating
• Ringing in the ears or hearing loss
• Treatment for Vertigo
• Treatment for vertigo depends on what's causing it. In many cases, vertigo goes
away without any treatment. This is because your brain is able to adapt, at least in
part, to the inner ear changes, relying on other mechanisms to maintain balance.
• For some, treatment is needed and may include:
• Vestibular rehabilitation. This is a type of physical therapy aimed at helping
strengthen the vestibular system. The function of the vestibular system is to send
signals to the brain about head and body movements relative to gravity.
 MIGRAINE
• A migraine is a headache that can cause severe throbbing pain or a pulsing
sensation, usually on one side of the head. It's often accompanied by nausea,
vomiting, and extreme sensitivity to light and sound. Migraine attacks can last
for hours to days, and the pain can be so severe that it interferes with your daily
activities.
• For some people, a warning symptom known as an aura occurs before or with
the headache. An aura can include visual disturbances, such as flashes of light
or blind spots, or other disturbances, such as tingling on one side of the face or
in an arm or leg and difficulty speaking.
 CAUSES
• Causes
• Though migraine causes aren't fully understood, genetics and environmental factors
appear to play a role.
• Migraine triggers
• There are a number of migraine triggers, including:
• Hormonal changes in women.
• Drinks
• Stress
• Sleep changes
• Medications
• Foods
• Symptoms
• Migraines, which affect children and teenagers as well as adults, can progress
through four stages: prodrome, aura, attack and post-drome. Not everyone who
has migraines goes through all stages.
• PRODROME
• AURA
• ATTACK
• POST - DROME
• Prodrome
• One or two days before a migraine, you might notice subtle changes that
warn of an upcoming migraine, including:
• Constipation
• Mood changes, from depression to euphoria
• Food cravings
• Neck stiffness
• Increased urination
• Fluid retention
• Frequent yawning
• Aura
• For some people, an aura might occur before or during migraines. Auras
are reversible symptoms of the nervous system. They're usually visual but
can also include other disturbances. Each symptom usually begins
gradually, builds up over several minutes and can last up to 60 minutes.
• Examples of migraine auras include:
• Visual phenomena, such as seeing various shapes, bright spots or flashes
of light
• Vision loss
• Pins and needles sensations in an arm or leg
• Attack
• A migraine usually lasts from 4 to 72 hours if untreated. How often migraines
occur varies from person to person. Migraines might occur rarely or strike several
times a month.
• Post-drome
• After a migraine attack, you might feel drained, confused and washed out for up
to a day. Some people report feeling elated. Sudden head movement might bring
on the pain again briefly.
TREATMENT
 SYNCOPE
• Syncope is the medical term for fainting or passing out. It is caused by a
temporary drop in the amount of blood that flows to the brain.
• Syncope can happen if you have a sudden drop in blood pressure, a drop in heart
rate, or changes in the amount of blood in areas of your body
• Types of Syncope
• There are several different types of syncope. The type you have depends on what
causes the problem.
• Vasovagal syncope (also called cardio-neurogenic syncope)
• Vasovagal syncope is the most common type of syncope. It is caused by a sudden
drop in blood pressure, which causes a drop in blood flow to the brain.
• Some patients with vasovagal syncope have a condition called orthostatic
hypotension. This condition keeps the blood vessels from getting smaller (as they
should) when the patient stands.
• Situational syncope
• Situational syncope is a type of vasovagal syncope. It happens only during certain
situations that affect the nervous system and lead to syncope.It cause due to
dehydration, anxiety or during Hyperventilation.
• Postural syncope (also called postural hypotension)
• Postural syncope is caused by a sudden drop in blood pressure due to a quick
change in position, such as from lying down to standing
• Cardiac syncope is caused by a heart or blood vessel condition that affects blood
flow to the brain. These conditions can include an abnormal heart rhythm
(arrhythmia), obstructed blood flow in the heart due to structural heart disease.
• Neurologic syncope
• Neurologic syncope is caused by a neurological condition such as seizure, stroke
or transient ischemic attack (TIA). Other less common conditions that lead to
neurologic syncope include migraines and normal pressure hydrocephalus
The most common symptoms of syncope include:
• Blacking out
• Feeling lightheaded
• Falling for no reason
• Feeling dizzy
• Feeling drowsy or groggy
• Fainting
 DIAGNOSIS
• Tilt Test
• Your heart rate and blood pressure will be measured and recorded while you are
in different positions including lying down, sitting and standing.
• Tests to determine causes of syncope include:
• Laboratory testing: Blood work to check for anemia or metabolic changes.
• Electrocardiogram (EKG or ECG)
• Echocardiogram
 TREATMENT
Treatment options include:

• Taking medications or making changes to medications you already take.

• Avoiding or changing the situations or “triggers” that cause a syncope episode.
 LOSS OF CONSCIOUSNESS
• The major characteristics of consciousness are alertness and being oriented to
place and time. Alertness means that you’re able to respond appropriately to the
people and things around you.
• The brain is ultimately responsible for maintaining consciousness. Your brain
requires certain amounts of oxygen and glucose in order to function properly.
• Many substances you consume can affect your brain chemistry. These substances
can help to maintain or decrease consciousness
• Diseases that damage your brain cells can also cause impaired consciousness. A coma is the most severe level of consciousness
impairment.
• Symptoms that may be associated with decreased consciousness include:

• seizures
• loss of bowel or bladder function
• poor balance
• falling
• difficulty walking
• fainting
• lightheadedness
• irregular heartbeat
• Confusion
• Confusion is marked by the absence of clear thinking and may result in poor
decision-making.
• Disorientation
• Disorientation is the inability to understand how you relate to people, places,
objects, and time. The first stage of disorientation is usually around awareness of
your current surroundings
• DELIRIUM
• Their emotional responses range from fear to anger. People who are delirious are
often highly agitated as well.
• Lethargy
• Lethargy is a state of decreased consciousness that resembles drowsiness.
• Common causes of decreased consciousness include:
• drugs
• alcohol
• substance abuse
• certain medications
• epilepsy
• low blood sugar
 DIAGNOSIS AND TREATMENT

• Toxicology screen
• Complete blood count (CBC). This blood test reveals whether you have a low
hemoglobin level, which indicates anemia. An elevated white blood cell (WBC) count
indicates infections, such as meningitis or pneumonia.
• Liver function test
• Electroencephalography
• Electrocardiogram (EKG).
• Chest X - ray
THANK U….