Contrary to popular belief, vertigo in itself is not a disease. It is a symptom that can be indicative of various underlying conditions. Vertigo describes the sensation of spinning, wherein you feel like your surroundings are in a state of motion or you yourself are moving, when in fact everything is stationary. Although used to describe dizziness and light headedness, vertigo specifically refers to that sensation of movement.
In most cases, the cause can be traced to disorders that affect the vestibular system. This can include structures of the inner ear and the vestibular nerve, as well as brain structures such as the cerebellum. 93% of cases fall into this category and are described as peripheral vertigo. In other cases, vertigo may originate from disorders that affect the central nervous system, which includes the brain and spinal cord. However, identifying the underlying cause and measuring the risk can be tricky because of the wide range of health conditions that can cause vertigo.
Vertigo Warning Signs that You Should Never Ignore
Although the occasional bout of vertigo is usually non-threatening, it can sometimes be indicative of a serious underlying health condition. If it occurs when you stand suddenly or if you haven’t eaten all day, it’s most likely nothing to worry about. However, vertigo can sometimes be a warning sign of undiagnosed health conditions like hypertension, hearing loss, vestibular migraines, heart disease, or tumors. It can be hard to tell when vertigo is serious. If you’re unsure, look for accompanying symptoms that can be indicative of a more serious health condition. Here are some of those vertigo warning signs that you should be watchful for.
Extreme Nausea and Vomiting
Although vertigo in itself is rarely worrying, it’s quite a different matter when you also experience nausea and vomiting. Profuse vomiting can lead to severe dehydration, but the symptom is in itself worrying. When vertigo is accompanied by nausea and vomiting, it could be connected to vestibular migraines, Meniere’s disease, or meningitis. In most cases, the nausea and vomiting may be brought on by the experience of vertigo itself. In such situations, vestibular suppressants and anti-emetics usually suffice as treatment. Urgent attention is warranted however, as in rare cases it can be indicative of a life-threatening condition like cerebellar hemorrhage. When diagnosed quickly and dealt with appropriately, such conditions are highly treatable.
Suffered a Head Injury
Many of us tend to ignore head injuries if there is no visible damage or blood loss. However, the absence of a surface wound does not rule out the risk of internal injury. If your experience of vertigo follows a head injury, it could be a sign of serious trauma. This likelihood is even higher if you experienced a loss of consciousness at the time of impact. Medical attention should be sought immediately, as symptoms like vertigo can often surface much later. Either way, vertigo following a head injury is a definite warning sign that you need emergency medical care. There is a high risk of concussion, injury to the vestibular system, or of internal bleeding. Benign paroxysmal positional vertigo (BPPV) is perhaps the most common type of vestibular pathologic condition that surfaces following head injuries, affecting around 28% of patients.
Fever and Neck Stiffness or Pain
As is the case with many of these accompanying symptoms, they can be indicative of conditions that are non-threatening. However, they should be treated as serious because of more threatening conditions that display similar symptoms. While labyrinthitis or vestibular neuritis, which is an inflammatory condition of the inner ear, is the most common cause of vertigo with fever and neck stiffness, it can also be indicative of a more serious condition – meningitis. Meningitis can be caused by both bacterial and viral infections and describes the condition of inflammation that affects membranes surrounding the brain and spinal cord. If not treated promptly, meningitis can cause permanent damage and can even be fatal. This is why you should seek immediate medical care when fever and neck stiffness accompanies vertigo, especially if the fever exceeds 102 degrees. Meningitis may also be accompanied by other symptoms such as nausea and vomiting, skin rashes, and seizures.
Chest Pain or Discomfort
As you probably know, chest pain is worrying even when it occurs in isolation because of its association with heart disease. When you experience chest pain or discomfort alongside vertigo it is even more disturbing, as this is a strong sign of heart disease or an impending heart attack. Although this may sound terrifying, heart attacks can be treated effectively if medical attention is provided promptly. Because of the huge disparity in success or survival rates when dealt with swiftly, it is imperative that you seek emergency medical care as soon as you experience such symptoms. In addition to vertigo and chest pain, it is also likely that you could experience other symptoms such as shortness of breath.
Impaired Speech and Double Vision
While vertigo in itself is unlikely to be indicative of an ischemic stroke, this is a serious concern when accompanied by symptoms like slurring of speech or difficulty swallowing and double vision. As is the case with heart attacks, time is of the essence in such situations. This makes it best to seek immediate medical attention, although there may be more benign causes. The likelihood of a stroke is also high if you notice other warning signs such as sudden onset of fatigue, numbness or tingling in the arms and legs, or drooping of facial muscles. Once again, patients may also suffer from other symptoms like nausea, vomiting, and neck pain, which makes it hard to identify the underlying cause without medical attention and diagnostic testing.
Fainting or Loss of Consciousness
Vertigo and severe bouts of dizziness can often lead to a loss of consciousness or fainting. Depending on associated circumstances, this may not always be serious. If you have skipped meals, are dehydrated, or are experiencing high levels of stress, this may explain the problem. Postural hypotension, which describes a drop in blood pressure when you stand suddenly, or vasovagal reaction, which describes the reaction to triggers such as the sight of blood or extreme emotional distress, are also common but harmless causes. However, if there are no such obvious causes, it could be a sign of more serious problems that demand emergency care. These symptoms can surface as a result of heart disease, including arterial blockage or irregularities in cardiac rhythm. Because of higher morbidity rates associated with cardiac disease, it is best to seek early treatment.
Severe and Recurring Headaches
Headaches affect all of us from time and they are usually nothing more than an inconvenience. Persistent and severe headaches that accompany vertigo can be a lot more threatening however. For most patients, the symptoms could be indicative of migraine-associated vertigos or benign paroxysmal vertigo. As seen in studies, migraines have a strong association with various symptoms of vestibular system dysfunction, including vertigo. In rare cases, patients may also be diagnosed with basilar migraines, which originate in the brain stem. Blood vessel constriction and other conditions that restrict blood flow to the brain can also cause basilar migraines. In such cases, you may also experience other visual symptoms such as flashes of light, or spots. Similarly, acoustic neuromas, which are tumors that develop on the vestibular or cochlear, can also cause vertigo and headaches, along with loss of balance, hearing loss, and tinnitus.
Continuous or Persistent Vertigo
Persistent of continuous vertigo that lasts for days or weeks can be caused by a variety of peripheral vestibular disorders, including benign paroxysmal positional vertigo, Meniere’s disease, and vestibular neuronitis, among others. Vestibular neuritis, which is viral infection that affects the vestibular nerve, is one possible cause of severe and continuous vertigo. Similarly, labyrinthitis is also an infection that causes inflammation of the inner ear or vestibular nerve. These infections cause a disruption in the relaying of sensory information to the brain from the ear, resulting not just in vertigo, but also affecting vision, hearing, and balance. In case of labyrinthitis, patients will also most likely experience tinnitus or a ringing sensation in the ear. In rare cases, persistent vertigo could also be caused by acute cerebellar ataxia, which is a condition of inflammation or damage to the cerebellum. Continuous vertigo that is accompanied by loss of balance and vomiting could also relate to a stroke, as 25% of acute vestibular syndrome cases are caused by stroke.
Although there are warning signs and possible conditions associated with vertigo, this list is not comprehensive. As a symptom in itself, vertigo can be indicative of a wide range of health conditions, with many overlapping symptoms. This makes diagnosis rather tricky even in a medical facility. Although most cases may have benign causes, seeking timely intervention is important when vertigo presents with other symptoms. This can help with a more accurate and swift diagnosis, improving the prognosis in cases where the underlying condition poses a serious threat. If you suffer from chronic vertigo, take steps to reduce your stress as some studies show that elevated stress levels can prompt relapses of vertigo symptoms. Mindful meditation and regular exercise will lower your stress and increase your resilience which will reduce your risk of experiencing a vertigo episode.
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