Vertigo is a condition characterized by a sensation of spinning or dizziness. It can be disorienting, affecting one’s balance and sometimes leading to nausea or vomiting. While vertigo is a common complaint, its evaluation requires careful consideration and assessment to pinpoint the underlying cause. In this article, we’ll delve into the evaluation of vertigo, its potential causes, and diagnostic methods used by ENT specialists.

Symptoms of Vertigo:

Before delving into the evaluation process, recognizing the symptoms associated with vertigo is crucial:

1. Spinning Sensation: A false sensation of movement, where either the individual or the surroundings seem to be spinning.
2. Nausea and Vomiting: Vertigo often triggers feelings of nausea or vomiting due to the intense dizziness.
3. Loss of Balance: Difficulty maintaining balance, leading to unsteadiness or falls.
4. Tinnitus: Ringing or buzzing in the ears might accompany vertigo.
5. Nystagmus: Involuntary eye movements, usually rapid and jerking, may be observed during a vertigo episode.

Evaluation of Vertigo:

1. Patient History:

ENT surgeons typically begin by taking a detailed medical history. This involves understanding the duration, frequency, and triggers of vertigo episodes. Factors like past ear infections, head injuries, medication history, and family history of similar conditions are essential in evaluating vertigo.

2. Physical Examination:

A thorough physical examination, focusing on the neurological and ear, nose, and throat (ENT) systems, is conducted. This examination often includes checking for abnormal eye movements, assessing balance and coordination, and examining the inner ear.

3. Diagnostic Tests:

• Dix-Hallpike Maneuver: This test helps diagnose benign paroxysmal positional vertigo (BPPV), a common cause of vertigo. It involves specific head movements to induce vertigo and observe the characteristic eye movements.
• Videonystagmography (VNG): This test records eye movements to assess inner ear and central motor functions.
• MRI or CT Scan: Imaging tests can help rule out structural problems in the brain or inner ear that may be causing vertigo.
• Blood Tests: Blood tests might be conducted to check for infections, metabolic issues, or autoimmune conditions that could contribute to vertigo.

4. Specialized Evaluations:

For complex cases or when standard tests don’t provide a definitive diagnosis, specialists like neurologists or otolaryngologists may conduct additional evaluations such as vestibular evoked myogenic potentials (VEMP), electrocochleography (ECochG), or posturography.

Causes of Vertigo:

Various conditions can lead to vertigo, including:

• Benign Paroxysmal Positional Vertigo (BPPV): Caused by displaced calcium carbonate crystals in the inner ear.
• Meniere’s Disease: Inner ear disorder affecting balance and hearing.
• Vestibular Neuritis or Labyrinthitis: Inflammation of the vestibular nerve or inner ear structures.
• Migraines: Some individuals experience vertigo as a part of migraine attacks.
• Head Injuries: Trauma to the head can damage inner ear structures leading to vertigo.

Conclusion:

The evaluation of vertigo is a comprehensive process that involves understanding a patient’s medical history, conducting physical examinations, and utilizing various diagnostic tests. Pinpointing the exact cause of vertigo is crucial for devising an appropriate treatment plan. If you experience recurring vertigo episodes or associated symptoms, seeking medical attention is advisable to receive proper evaluation and care tailored to your specific condition.

Always consult with an ENT specialist for accurate diagnosis and treatment recommendations tailored to individual needs. Early evaluation and management of vertigo can significantly improve one’s quality of life by effectively addressing its underlying causes.