Dizziness spells: Understand causes, symptoms, and remedies
Chronic vertigo, a disorienting sensation of spinning dizziness, is a common issue among older adults. This condition can stem from a variety of causes, making accurate diagnosis crucial for effective treatment.
Peripheral vestibular disorders, such as Benign Paroxysmal Positional Vertigo (BPPV) and Menière's disease, are among the most frequent causes. BPPV occurs when calcium carbonate crystals in the inner ear become dislodged and touch sensory hair cells, resulting in spinning dizziness. Menière's disease, on the other hand, causes a buildup of fluid in the inner ear, leading to attacks of vertigo, ringing in the ears, and hearing loss.
Neurological disorders, vascular issues, and medication side effects also contribute to chronic vertigo in the elderly. Ischemic stroke (especially in the posterior circulation), Parkinson’s disease, and migraine-related vertigo are examples of neurological disorders that can cause persistent dizziness. Vascular conditions like orthostatic hypotension and postprandial hypotension can also lead to dizziness and vertigo symptoms. Medication side effects from drugs for blood pressure, diuretics, antiseizures, and psychiatric medications often cause or worsen dizziness.
Other contributing factors include neck problems, psychiatric disorders, and systemic illnesses such as diabetes, hypertension, and cardiovascular disease.
Treatment for chronic vertigo in older adults depends on the underlying cause. For BPPV, repositioning maneuvers such as the Epley maneuver are the mainstay to relocate displaced otoliths in the inner ear, often with good prognosis. For Menière’s disease, a combination of dietary changes, medications to reduce fluid retention, and sometimes surgery may be used. Vestibular rehabilitation therapy is beneficial in many causes, focusing on balance retraining and compensation for vestibular loss.
Management of vascular causes involves controlling blood pressure and addressing orthostatic or postprandial hypotension. Reviewing and adjusting medications to minimize side effects that exacerbate dizziness is also crucial. Treating neurological causes such as stroke or Parkinson’s disease involves specific neurological therapies alongside symptomatic management of vertigo. For psychiatric contributors, treating depression or anxiety can reduce dizziness symptoms.
Keeping a journal of symptoms and surrounding environment can help doctors understand the cause of persistent dizziness. Simple tests like the Dix-Hallpike test or Romberg test may be carried out during diagnosis. In some cases, pressure pulse treatment involving fitting a device to the ear may help resolve vertigo.
It's essential to note that vertigo can occur at any age, but it is common in people aged 65 or over. While vertigo itself is not necessarily hereditary, it could be a symptom of various hereditary conditions and syndromes. Scientists have discovered genes associated with vertigo that play a role in inner ear development, maintenance, and problems.
In summary, chronic vertigo in older adults is often multifactorial, involving peripheral vestibular disorders like BPPV and central neurological or vascular causes. Effective treatment requires accurate diagnosis and a multidisciplinary approach combining repositioning maneuvers, medical management of comorbidities, medication review, and vestibular rehabilitation. Over-the-counter antihistamines can help reduce symptoms of vertigo and motion sickness for some individuals.
- In addition to being common among older adults, vertigo, a sensation of spinning dizziness, can also be a symptom of certain hereditary conditions and syndromes, as scientists have discovered genes associated with vertigo that play a role in inner ear development and maintenance.
- Mental health is another aspect to consider in the management of chronic vertigo, as psychiatric disorders such as depression and anxiety can potentially contribute to, or worsen, dizziness symptoms.
- Beyond peripheral vestibular disorders like BPPV and Menière’s disease, chronic vertigo in the elderly can be caused by neurological disorders, vascular issues, or medication side effects.
- For individuals with bipolar disorder, it is crucial to balance their health-and-wellness, as long-term stress and poor management of mental health can increase the risk of developing NSCLC (non-small cell lung cancer) or experiencing vertical symptoms.
- Treatment for breast cancer patients who experience dizziness as a side effect of chemotherapy or radiation therapy may involve predictive measures such as adjusting medication dosages, utilizing ginger supplements to alleviate nausea, or engaging in physical activity to improve balance and reduce symptoms of dizziness.
