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Vertigo and Dizziness

Vertigo is an extremely difficult symptom to treat, let alone live with. Many patients have trouble describing vertigo and it can be hard to differentiate it from simple dizziness. On this page some of the causes and treatments for vertigo are described.

There are two words that many people get mixed up with. Vertigo and Dizziness are very difficult to describe properly, and doctors often find it difficult to tell them apart. Sometimes also one patient may have vertigo and dizziness at the same time making diagnosis even harder to unravel. Unfortunately many people are given an incorrect and often put on Betahistine or Stemetil which may actually be making them worse.

Vertigo is generally caused by ear problems, whereas dizziness can be caused by almost anything else. Below is a list of common causes of vertigo and dizziness.

ENT related Vertigo

  • BPPV - Benign Paroxysmal Positional Vertigo
  • Ménière's disease
  • Vestibular neuritis / Labyrinthitis
  • Acoustic Neuroma (and other brain masses)

Non-ENT related Vertigo

  • Migraine
  • Stroke
  • Cerebellar tumours
  • Multiple sclerosis
  • Head injuries
  • Multiple sclerosis

Causes of Dizziness

  • Anaemia (heavy periods, pregnancy, bleeding from your gut (gastric ulcer, piles, gut cancers), chronic kidney disease, iron deficiency, blood donation)
  • Medication (betahistine, stemetil, beta blockers, blood pressure tablets, painkillers like codeine, (ibruprofen and aspirin can cause bleeding from your stomach), medication for depression or anxiety, cancer medication)
  • Heart disease (arrhythmias, heart attacks, heart failure, angina)
  • Lung problems that make you breathless
  • Infections
  • Diabetes
  • Thyroid problems
  • Many other causes...

Below is a list of symptoms that are commonly associated with vertigo and then symptoms that characterise dizziness.

 The world spins around.  This is like being spun around on a swivel chair or a merry-go-round Rather than vertigo, dizziness is actually more vague and difficult to describe.  Many people describe it like feeling light-headed, or woozy.  Some people say it feels like they have drunk too much alcohol.  
 The eyes flicker uncontrollably (normally from side to side).  This is also known as ‘Nystagmus’ – a good example of this can be seen here.  Unlike vertigo, it is quite common to feel like you are going to pass out (black out / become unconscious).
 People with vertigo always fall over on the same side each time.  They feel like they are being pushed to that side.  Dizziness has no particular direction, and therefore people will feel like they could fall on either side.  

Working out if you have vertigo or dizziness is the main problem at the start. It can be extremely difficult to tell the two apart, but it makes a huge difference to the accuracy of the diagnosis. Many of the causes of vertigo and dizziness require an MRI of the brain and other tests to try and investigate the exact cause of the problems.

Once the diagnosis has been made, treatments for these problems can be started and the results are good. The hardest part is the diagnosis particularly when there are multiple problems at the same time. These patients are extremely difficult for doctors to diagnosis properly and require a lot of care and attention to get them treated correctly. Often they are passed from clinic to clinic with little help provided.

BPPV (Benign Paroxysmal Positional Vertigo)

BPPV is a condition where the sufferer get very short (between a few seconds to 10 minutes), of vertigo particularly when they move their head in a certain way. Most patients complain of the world going round and round when they roll over in bed or when they look up to pick something up from a high cupboard

Is very easily treated with an Epley Manoeuvre, which can be done in clinic.

Ménière's disease

Ménière's disease is extremely rare, but sadly it is over diagnosed and many people are incorrectly told they have this disease.

Here are the typical symptoms of Ménière's disease. If you have do not have all of these symptoms, but you have been told that you have Ménière's disease, then you should seek advice about a possible other diagnosis:

  • Episodes true Vertigo (see above for the difference between vertigo and dizziness)
  • Episodes of vertigo last for less than a day
  • During the episodes of vertigo the hearing in one ear

Read about Eustachian Tube Dysfunction

Read about Hearing Loss

Read about Tinnitus

Read about Vertigo

Read about Ear Wax

Read about Ear Infections

Read about Ear Perforations

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