Vertigo requires diligence to diagnose, treat

Mar 26, 2018

 Brian Hess, an independent emergency medicine physician and medical director of Abrazo Central Campus Emergency Department, explains about vertigo.

Vertigo is often considered a form or type of dizziness. Many symptoms such as lightheadedness, unsteadiness, and weakness are categorized as forms of dizziness. But true vertigo involves the disorientation in space with an inappropriate perception of motion.

There are three different pathways involved in the maintenance of our equilibrium so many different disease entities can result in the final common pathway of a patient experiencing vertigo as a symptom. This basically means that many disease processes can result in the patient experiencing vertigo involving different organ systems whether neurological, vascular, metabolic, eye or ear. It also can include different mechanisms such as trauma, cancer, infection with different severity of benign or life threatening. Associated symptoms could include nausea, vomiting, eye movements called nystagmus, hearing loss and tinnitus.

Vertigo is a challenge to characterize without seeking help from a healthcare professional. Sometimes the causes can be emergent as in the case of stroke, trauma, hypoglycemia, enlarging tumor, or serious infection. Other times, it can be a benign or self-limiting problem. The testing indicated varies significantly by what each patient's history and physical exam reveal.

If your healthcare provider has determined that a benign cause is at the root of these symptoms, they may prescribe symptomatic relief. With infectious causes such as labyrinthitis or otitis media, antibiotics may be indicated. With regard to stroke and other vascular causes, there are many surgical or interventional therapies available to intervene if the patient presents within the treatable time frame.

 A discussion of vertigo and its many causes can be complex and require diligence on the part of the patient to report all of their symptoms to their healthcare professional in a timely manner whether that be a primary care provider or the emergency staff in the emergency department.


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