Definition

Vertigo is a sensation of spinning or movement, either of oneself or the environment, often described as dizziness. It is a symptom, not a disease, and usually indicates a problem in the inner ear (vestibular system) or the brain.

Types of Vertigo

1. Peripheral Vertigo
   Caused by problems in the inner ear or vestibular nerve.

   • Common and usually less serious.

2. Central Vertigo
   Originates from the brainstem or cerebellum.

   • Less common, potentially more serious.

Causes

Peripheral Causes

• Benign Paroxysmal Positional Vertigo (BPPV): Most common cause; triggered by head position changes.

• Vestibular Neuritis: Viral infection of the vestibular nerve.

• Labyrinthitis: Inner ear infection involving hearing loss.

• Ménière’s Disease: Fluid imbalance in the inner ear, with hearing loss and tinnitus.

Central Causes

• Stroke or transient ischemic attacks (TIA)

• Multiple Sclerosis (MS)

• Brain tumors (e.g., acoustic neuroma)

• Migraine-associated vertigo

Symptoms

• Spinning sensation

• Nausea or vomiting

• Loss of balance or unsteadiness

• Nystagmus (abnormal eye movements)

• Tinnitus (ringing in ears)

• Hearing loss (in some cases)

Diagnosis

• Physical Examination and Neurological Exam

• Dix-Hallpike Test (for BPPV)

• MRI or CT scan (to rule out central causes)

• Audiometry (hearing test)

• ENG/VNG (eye movement testing)

Treatment

General Treatment

• Bed rest during acute episodes

• Avoid sudden head movements

• Hydration and stress management

Medications

• Vestibular suppressants: Meclizine, dimenhydrinate, promethazine

• Antiemetics: For nausea (e.g., ondansetron)

• Benzodiazepines: Short-term use (e.g., diazepam)

• Diuretics: For Ménière’s disease

Physical Therapy

• Vestibular rehabilitation therapy (VRT)

• Epley maneuver (for BPPV)

• Brandt-Daroff exercises

Homeopathic Treatment (Supportive)

• Conium maculatum: Vertigo on turning head or looking around.

• Gelsemium: For vertigo with dizziness and trembling.

• Cocculus indicus: Vertigo from motion or travel.

• Bryonia alba: Worse with motion, improves when still.

(Note: Use under supervision of a qualified homeopathic practitioner.)

Ayurvedic Perspective & Remedies

• Vertigo = "Bhrama" (vata and pitta imbalance)

• Treatments:

  • Brahmi, Shankhpushpi, Ashwagandha

  • Nasya (nasal therapy)

  • Abhyanga (head and body oil massage)

  • Shirodhara (oil pouring therapy)

When to See a Doctor

• First-time or severe vertigo

• Vertigo lasting more than a few hours

• Associated with headache, vision trouble, speech or coordination issues

• Hearing loss or ringing in ears

• Recurrent or worsening episodes

Conclusion

Vertigo is a common but often manageable symptom. Identifying the cause—whether inner ear-related or neurological—is essential. Proper diagnosis and individualized treatment, including lifestyle adjustments and therapy, can significantly improve quality of life.