Ear
The room spins when I move my head
Vertigo and dizziness treatment in KPHB, Hyderabad
The commonest cause of vertigo is fixed with a manoeuvre in the chair, not a medicine.
Does this sound like you?
- The room spins when you turn over in bed or look up
- Attacks of spinning lasting seconds, or minutes, or hours
- Dizziness with ringing or blocked hearing in one ear
- Unsteady on your feet since an ear infection or a cold
- Nausea with the spinning
Vertigo treatment at Sinocare ENT Hospital, KPHB Colony, Kukatpally, starts with the story of the attacks and a set of movements in the chair. Vertigo is the feeling that you or the room is moving when neither is. It is frightening, and it is usually the inner ear, which is the organ of balance as well as hearing. The commonest cause is a mechanical one. It is corrected at the hospital by moving the head in a set way (a positioning manoeuvre). Most of the other causes settle with time and the right treatment. The visit is about telling the causes apart, because they are treated differently.
What it usually is
Positional vertigo (BPPV) is the most common. It is brief, intense spinning on turning over in bed, looking up or bending down, lasting seconds. Tiny crystals in the inner ear have drifted into the wrong canal. It is diagnosed by moving the head in a set way in the chair, and it is treated the same way.
Vestibular neuritis is a viral inflammation of the balance nerve. It is a single, severe spinning attack lasting days, often after a cold. Then comes a slow recovery over weeks.
Ménière’s disease gives attacks lasting hours, with a blocked feeling, ringing, and hearing that goes up and down in one ear.
Vestibular migraine gives dizziness with or without headache, often in people who have had migraine before.
Blood pressure, medicines, anaemia, anxiety and neck problems all cause dizziness that is not spinning. The history usually separates them.
What happens at the first visit
Most of the diagnosis is in the story: how long the attacks last, what brings them on, what comes with them. Then the ears are examined, and a hearing test is done at the hospital in KPHB. The ear that causes vertigo often hears differently. The eyes are watched for the flicker that the inner ear produces. For positional vertigo, the head is moved through a set sequence in the chair. If that brings on the spinning, the diagnosis is made, and the treatment follows in the same sitting. A scan is arranged where the picture does not fit the inner ear.
How vertigo is treated, and what is tried first
- The repositioning manoeuvre for positional vertigo, done in the chair, which moves the crystals back where they belong. One or two sessions settle most cases.
- Short courses of anti-sickness and balance medicines for a sudden (acute) attack. They are stopped early, because taking them for long slows the brain’s own recovery.
- Balance exercises after neuritis, which are the actual treatment. The brain relearns balance by being asked to.
- Salt, caffeine and stress, for Ménière’s disease, alongside medicines for the attacks.
- Treating migraine where that is the cause.
When to come in sooner
Vertigo with any of the following is seen the same day, or in an emergency department if it is out of hours:
- A sudden severe headache, or the worst headache of your life
- Weakness, numbness, slurred speech, double vision, or difficulty swallowing
- Inability to stand or walk at all
- Sudden hearing loss in one ear
- Vertigo after a head injury
If an operation is ever needed
Very rarely. Vertigo is treated at the hospital and with exercises. Surgery is kept for two unusual cases. One is Ménière’s disease that has not responded to everything else. The other is an ear infection that has spread to the balance organ. Those conversations happen only after the rest has been tried.
Questions patients ask
Is it a stroke?
Usually not, and the examination looks for the signs that would say otherwise. The warning signs above are the ones to act on immediately.
Why does turning over in bed set it off?
That is the signature of positional vertigo: the crystals move in the canal as the head turns. It is the one that the manoeuvre fixes.
Will the tablets cure it?
The tablets settle an attack. They do not fix positional vertigo, and taken for weeks they slow recovery from the other causes. The manoeuvre and the exercises are the treatment.
Will it come back?
Positional vertigo can, and the manoeuvre works again when it does. Neuritis rarely comes back. Ménière’s comes and goes and is managed over years.
Is giddiness the same as vertigo?
Not quite. Vertigo is the feeling of movement, you or the room spinning. Giddiness or light-headedness without spinning has other causes. The story of the attacks is what tells them apart.