What is Dizziness or giddiness?
Dizziness or giddiness is a symptom which encompasses a variety of sensations experienced by the patients. It includes vertigo, blackout, imbalance of gait, confusion, lightheadedness, whirling, spinning etc.
What are the types of dizziness and what is the difference between dizziness and vertigo?
There are 5 different types of dizziness.
First is vertigo, which means the patient feels the illusory movement of head or surroundings.
The second type is syncopal dizziness in which patient feels blackout or lightheaded which may or may not be followed by loss of consciousness.
The third type is dysequilibrium dizziness in which patient feels imbalance on standing and or while walking.
The fourth type of dizziness is particularly seen in elderly due to deficient vision, deficient sensations, and balance control issues. It is called Multisensory deficit dizziness.
The last and fifth type of dizziness is ill-defined dizziness in which patients will not be able to correctly tell the type of dizziness. It is usually seen in patients with anxiety and panic disorder.
What is vertigo?
Vertigo is one of the most common types of dizziness in which patient feels spinning, reeling, whirling, rotating, tilting or pushing sensation. The patient feels either the head is rotating or the environment is rotating.
What are the causes of vertigo?
Vertigo can be caused by two main categories of problems.
First one is called peripheral vertigo which is the due problem in balance control system of the body which is located in the inner ear.
The most common causes of peripheral vertigo are benign paroxysmal positional vertigo, vestibular neuronitis, and Meniere’s disease.
The second one is called central vertigo which is due to a problem in the balance controlling structures in the brain (Brainstem and small brain).
The most common cause of central vertigo is Vestibular migraine, stroke, multiple sclerosis, tumors etc.
How is it diagnosed?
It is diagnosed by detailed symptom analysis and focussed examination of the patient which involves specialized positioning maneuvers done by experts.
What are the treatment options available for patients with vertigo?
The most important thing which needs to be understood is ‘Vertigo is not a disease, its a symptom of some underlying disease. Hence, the most important step is’ diagnosis of the cause of vertigo’. Then, comes the treatment of the Vertigo which depends on the underlying cause of the Vertigo. The treatment differs with each and every cause.
If the cause of the Vertigo is benign paroxysmal positional vertigo, then the treatment is various repositioning maneuvers which are done by experts in this field.
If the cause of the Vertigo is due to migraine, then the treatment is preventive medications for migraine.
If the cause of the Vertigo is due to stroke or tumors, we have to treat accordingly.
What is VNG? How does it help in the diagnosis of Vertigo?
Eyes serve the important function of vision. The movements of eyeballs help in focusing the attention on one target and also in shifting the attention from one target to another target. The eye movements are adjusted according to the position and velocity of the head with the help of widespread brain circuits.
Various diseases can affect these brain circuits and can lead to eye movement abnormalities. Hence, the eyes provide a window for the diagnosis of numerous neurological disorders.
Video-nystagmography (VNG) is equipment which does video-recording of the eye movements. During the VNG test, the patient wears the VNG goggles and sits in front of a TV screen which displays various stimuli. The eye movements occurring in response to these stimuli are recorded in graphical as well as video format. This record aids in the accurate diagnosis, monitoring and treatment of the neurological disorders.
Dr. Vishal Pawar
Specialist Neurologist
Aster Speciality Clinic, International City
