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| What is Vertigo: Everyone has felt dizzy at one time or another. Dizziness is defined as a feeling of unsteadiness, faintness or light headedness. The term vertigo is used interchangeably with the term dizziness. True vertigo is a certain type of dizziness consisting of a sensation that you or your surroundings are spinning. Causes of Vertigo: Causes of vertigo include but are not limited to some type of inner ear disorder in most people. In patients with neurological disorders such as MS vertigo can be caused by lesions located in particular parts of the brain. The sensation of vertigo can come on suddenly, lasting only seconds to minutes or it can come and go over days, weeks or even months. Other than the symptom of nausea, some other symptoms of vertigo are sweatiness,nystagmus ( a rapid involuntary movement of the eyes) and a lack of balance. To differentiate between vertigo and dizziness you must ask yourself if you feel lightheaded and woozy or does it appear as if your world is spinning around you. Demyelinating lesions may occur in the part of the brainstem that receives signals from the inner earare interrelated with the inner ear. The result is often vertigo that behaves much like a viral inner ear infection and often accompanied by nystagmus. Shelley experienced this in 1991. She was unable to keep food down for almost a month and basically was only comfortable laying on the couch. |
| Demyelination may also occur in other areas of the brainstem resulting in vertigo. This is called "central vertigo", meaning it originates in the central system part of the brainstem. If the symptoms of vertigo last for weeks or months central vertigo is most likely the culprit. Balance and problems walking are more common in central vertigo. Inner ear causes of vertigo are usually brief and are more likely to be triggered bycertain head positions or movement. All vertigo is aggravated to some degree so that is not helpful in determining the form of vertigo. Testing is imperative to the treatment of vertigo because different types are treated differently. The type of eye movements as well as the head movement or position which bring on the spinning room feeling are usually specific to the type of vertigo. Areas of plaque (lesions) in the central nervous system will most likely show up on an MRI. Inner ear balance testing (electronystagmography or video nystagmography can also confimr whether there is brain disturbance or not. It has been determined that vertigo occurs in about 20% of MS cases. In 5 % of those the vertigo was the first symptom which lead to the diagnosis of MS. When vertigo is the first symptom that leads to a diagnosis of MS physicians will look for other signs of MS and use an MRI to confirm the diagnosis. reatments Treament/symptom management of vertigo There is no definite proof that diet or lifestyle change will benefit MS patients suffering from vertigo there are some studies which were done on animals which point to possible changes one can make to help with the symptoms. Meal skipping and caloric intake reduction seem to produce a cellular stress which leaves nerves more tolerant to stimuli. Anyone attempting this "home remedy should consult their physician first and should not take it to the point of becoming under nourished or underweight. Another change one can make is one of regular exercise and just socializing. Outside stimuli increases nerve activity, making nerves less susceptible to demylenation. In severe cases of vertigo symptom management thru medication as those used for motion sickness. These include meclizine,dimenhydrinate,diazepam, and promethazine. For those with chronic vertigo daily or intermittent use ofdiazepam,clonaepam,lorazepam may be the only effective alternative. Central Vertigo may vary in intensity. In more severe cases treatment with corticosteroids such as Solumedrol may be necessary. Side effects of corticosteroids given over a 3-5 day may include insomnia,euphoria as well as possible loss of bone mass. Transient hyperglycemia can also affect those with diabetes. Long term side effects of steroids are considerable so steroid treatment should be reserved for use during acute MS attacks. It is important that physicians carefully diagnose the cause of vertigo since the different types are treated differently. |
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