VERTIGO GIDDINESS

Giddiness or lightheadedness, a very common symptom seen in practise, is a term used to describe a sensation of altered orientation in space usually described by the patient as “chakar”. Giddiness, lightheadedness, disequilibrium and syncope are often mistaken for one another; most often caused by relative decrease in sensorium and are caused by different conditions.

Vertigo/ Dizziness is hallucination of movements which results in sensation of external environment spinning and rotating and is mostly caused by an otological disorder and sometimes by CNS disorders. Syncope which is loss of consciousness occurs secondary to inadequate cerebral profusion, a common cause of which is postural hypertension and cardiogenic factors.

CAUSES OF VERTIGO

BPPV (Benign paroxysmal positional vertigo):It is caused by displacement of otoconia into the posterior semi circular canal and it manifests as a rotational dizziness. The patient complains that the surroundings seem to rotate.

The key distinguishing feature is that it is positional. There is severe vertigo only in same positions of the head (i.e. right or left). In addition to vertigo, symptoms of BPPV may include dizziness (lightheadedness), imbalance, difficulty concentrating, and nausea.

Meniere’s disease:It is caused by collection of fluid in the inner ear. Presents with a combination of severe vertigo, tinnitus and nausea.

Labrinthitis:Inflammation of the vestibular labyrinth(a system of intercommunicating cavities & canals in the inner ears). Clinically, patient experiences disturbances of balance and hearing to varying degrees and may affect 1 or both ears.

Vestibular neuritisVestibular neuritis is acute, sustained dysfunction of the peripheral vestibular system which presents as nausea, vomiting, and vertigo, and normal hearing. Vestibular neuritis is generally distinguished from labyrinthitis by preserved auditory function.

Migrainous vertigo:Vertigo associated with migraine headache.

Vertebrobasilar insufficiency:This results from decreased blood supply to brain from its posterior vascular supply .There is a sudden onset of dizziness with imbalance while walking along with nausea and vomiting. In advanced stages loss of consciousness may occur

OTHER CAUSES OF VERTIGO

Orthostatic hypotension
Cardiac arrhythmias/ other cardiac problems
Hypoglycemia / other manifestations of Diabetes
Alcohol intoxication
Hyperventilation syndrome
Panic related
Drug toxicity (anticonvulsants,salicylates)
Medical conditions like Uremia.