Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Severe Persistent Vertigo
Question: Have been suffering from vertigo for 2 weeks. The worse being in the mornings. Less symptoms if I sleep propped up on 2 pillows. Still all day I feel as if a cloud is following me and at times feel a bit nauseated to remind me that the problem is not going. What should I do?
Brief Answer:
Most likely to be BPPV.
Detailed Answer:
Hi,
Thank you for your query,
1. This is most likely to be BPPV. BPPV (Benign Paroxysmal Positional Vertigo) is very common after the age of 60. Patients recovering from BPPV also experience dullness. Some refer to it as 'brain fog', which improves and disappears within a few days.
2. The vertigo in cases of BPPV is triggered by changes in position against gravity and hence is maximum on lying down, getting up and on looking down or up (top-shelf vertigo). If you do have a component of mild or atypical BPPV, it may be easily controlled by Brandt Daroff exercises, Semont's maneuver or the other liberatory maneuvers. A DizzyFix device may be used at home.
3. BPPV related vertigo does not occur on walking while the head is kept steady or with slow movements of the head. BPPV accounts for 20% of peripheral vertigo and hence should be ruled out.
4. Ask your doctor to do the following tests:
a. Dix Hallpike test
b. Head impulse test
c. Skew deviation test.
d. Cerebellar & Gait tests
e. Visual vertical estimation
This is besides the routine ear (including audiometry & caloric testing), eye (nystagmus & VNG: videonystagmography) besides routine general check-up (for example, BP, hemogram, cervical spondylosis, acid reflux and so on).
5. Vertigo may be multifactorial, however central (brain related) giddiness in not fatigueable hence will last all day. When you prop up our head on two pillows, the horizontal semicircular canal (one of the three semicircular canals of the balance system on each side) becomes horizontal (this normally slopes backwards by 30 degrees). This helps stabilize the system.
6. If you can follow up with the results of the above tests, further treatment options may be discussed.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
Most likely to be BPPV.
Detailed Answer:
Hi,
Thank you for your query,
1. This is most likely to be BPPV. BPPV (Benign Paroxysmal Positional Vertigo) is very common after the age of 60. Patients recovering from BPPV also experience dullness. Some refer to it as 'brain fog', which improves and disappears within a few days.
2. The vertigo in cases of BPPV is triggered by changes in position against gravity and hence is maximum on lying down, getting up and on looking down or up (top-shelf vertigo). If you do have a component of mild or atypical BPPV, it may be easily controlled by Brandt Daroff exercises, Semont's maneuver or the other liberatory maneuvers. A DizzyFix device may be used at home.
3. BPPV related vertigo does not occur on walking while the head is kept steady or with slow movements of the head. BPPV accounts for 20% of peripheral vertigo and hence should be ruled out.
4. Ask your doctor to do the following tests:
a. Dix Hallpike test
b. Head impulse test
c. Skew deviation test.
d. Cerebellar & Gait tests
e. Visual vertical estimation
This is besides the routine ear (including audiometry & caloric testing), eye (nystagmus & VNG: videonystagmography) besides routine general check-up (for example, BP, hemogram, cervical spondylosis, acid reflux and so on).
5. Vertigo may be multifactorial, however central (brain related) giddiness in not fatigueable hence will last all day. When you prop up our head on two pillows, the horizontal semicircular canal (one of the three semicircular canals of the balance system on each side) becomes horizontal (this normally slopes backwards by 30 degrees). This helps stabilize the system.
6. If you can follow up with the results of the above tests, further treatment options may be discussed.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thank you
Should I see a GP or Ears/Nose/Throat doctor?
Should I see a GP or Ears/Nose/Throat doctor?
Brief Answer:
ENT Specialist/ Neurologist / Neurotologist
Detailed Answer:
Hi,
Thank you for your query,
1. You need to consult an ENT Specialist or a Neurologist dealing in vertigo cases.
2. A Neurotologist looks into both ENT and Neurology cases.
3. Kindly let me know the progress.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
ENT Specialist/ Neurologist / Neurotologist
Detailed Answer:
Hi,
Thank you for your query,
1. You need to consult an ENT Specialist or a Neurologist dealing in vertigo cases.
2. A Neurotologist looks into both ENT and Neurology cases.
3. Kindly let me know the progress.
I hope that I have answered your query. If you have any further questions, I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
