Vertigo: Its Causes, Symptoms, and Treatments

Vertigo is a false sensation movement that makes you believe that the surroundings are spinning or tilting even when you're standing still. It is a symptom related to the inner ear and sometimes to the brain.

This article will discuss the complexities of vertigo, its causes, typical symptoms, and courses of treatment, including certain medications such as the Cintigo tablet (Cinnarizine).

Symptoms of Vertigo

What Does Vertigo Feel Like:

Vertigo is defined as a false sense of movement of yourself and your surroundings. The main symptoms of vertigo defined as a dizziness with the primary sensations accompanied by other symptoms such as imbalance, nausea and sweating. It is caused by the mismatch sensory signal sent to the brain.

Common Vertigo symptoms:

Some of the common vertigo symptoms are:

• Loss of Balance: An individual find it difficult to standing or walk.
• Spinning sensation: Feeling like the environment is spinning around even when you’re sitting or standing still.
• Nystagmus: Abnormal or jerking eye movements.
• Sweating: Cold sweats during an episode.
• Nausea and Vomiting: Symptoms of severe motion sickness during an acute attack.
• Auditory Disturbances (Hearing issues): Ringing in the ears or loss of hearing in the same ear.
• Aural fullness: The sensation of pressure or a stuffy feeling inside the ear.

A vertigo episode can vary from a few seconds and can last up to hours or even days, depending on the underlying cause.

Common Causes Of Vertigo

An individuals sense of balance depends on a complex interrelationship that occurs between the inner ear, eyes, and sensory nerves. Vertigo occurs when these systems give conflicting signals to the brain.

Generally, vertigo is categorized into two types depending on the etiology. These categories are: Peripheral and Central.

Peripheral Vertigo (Inner Ear):

This is the most common type of vertigo. It results from problems in the inner ear balance mechanism.

1. Benign Paroxysmal Positional Vertigo (BPPV): It is a condition that accounts for the highest rate of vertigo cases. Small calcium crystals, called canaliths, are dislodged from their normal location in the inner ear and enter the semicircular canals. This disrupts the movement of fluid, sending confusing signals to the brain. BPPV is usually triggered by specific head movements, such as rolling over in bed.
2. Meniere's disease: A chronic condition caused by the buildup of fluid, called endolymph, within the inner ear; its symptoms include episodes of severe vertigo, hearing loss that fluctuates, tinnitus, and pressure in the ear.
3. Vestibular neuritis or labyrinthitis: These are usually caused by viral infections, such as a cold or flu, which cause inflammation of the inner ear nerves responsible for balance. Labyrinthitis also affects the hearing nerve by inflaming the entire inner ear labyrinth.

Central Vertigo (Brain-Related Problems):

Though less common, Central Vertigo can be potentially more serious. Central Vertigo results from problems in the brainstem or cerebellum, the back part of the brain that coordinates balance.

1. Vestibular Migraines: It is a neurologic condition that causes dizziness and spinning sensation. Sometimes even without a headache.
2. Stroke or TIA (Transient Ischemic Attack): Balance centers may be affected by a sudden interruption of blood flow to the brain.
3. Multiple Sclerosis (MS): MS can cause damage to the myelin sheath surrounding nerves related to balance.

Navigating Vertigo Treatment

The treatment of vertigo requires diagnosis of the underlying cause. What works for BPPV will not work in the case of a migraine.

Physical Maneuvers and Therapy

If you have BPPV, treatment isn't necessary though, required in some cases. The Epley maneuver (canalith repositioning procedure) is the main treatment. A doctor or physical therapist guides your head through a series of positions to try to move the loose calcium crystals into a chamber of your ear where they will not cause symptoms.

Vestibular Rehabilitation Therapy, or VRT, is another option. It aims to "retrain" the brain to make up for problems that cause imbalance.

Lifestyle Changes

Lifestyle modifications can minimize the frequency of attacks for conditions such as Meniere's disease:

• Avoiding the intake of salt reduces fluid retention in the ear.
• Avoid caffeine and alcohol.
• Managing stress levels.

The Role of Vertigo Medication: Focus on Cinnarizine (Cintigo)

While maneuvers are preferred for BPPV, vertigo medicine is an important approach for many acute attacks caused by diseases such as Meniere's, labyrinthitis, or vestibular migraines. These vertigo medications suppress vestibular signals and help diminish nausea.

One such medicine recommended by medical experts is Cinnarizine.

What is Cinnarizine (Cintigo)?

Cinnarizine is an antihistamine and a calcium channel blocker, known by many brand names, including Cintigo tablet. It is considered a first in line pharmacotherapy for vertigo treatment.

How does it work?

Cinnarizine has antihistamine properties and acts by interfering with signal transmission from the inner ear to the vomiting center in the brain. Additionally, as a calcium channel blocker, it not only improves blood flow to the inner ear-the labyrinth-but also serves to prevent the constriction of blood vessels. This dual action helps to reduce the sensation of spinning and the associated nausea.

Important Considerations for Cintigo (Cinnarizine)

While effective for many, medications like the Cintigo tablet are just not suitable for everyone.

• Prescription: Cinnarizine requires a prescription in most states.
• Side effects: The most frequent adverse reaction is drowsiness. It may also cause dry mouth or weight gain if used for a long period.
• Safety: Because of its sedative effects, patients are advised to avoid driving or using heavy machinery.
• Interaction: Cinnarizine can interact with other drugs, especially sedatives or alcohol.

Note: Do not take, stop, or change dosage of a vertigo medicine like Cintigo without consulting your doctor.

When to Seek Immediate Medical Care

While many cases of vertigo are benign (for example, BPPV), vertigo can sometimes indicate a medical emergency, such as a stroke.

If vertigo is accompanied by the following, seek immediate medical attention:

• Sudden, severe headache
• Double vision or loss of vision.
• Slurred speech.
• Weakness or numbness in an arm or leg.
• Difficulty walking
• Fever

Frequently Asked Questions

Q: What causes Vertigo?

A: Vertigo is most commonly caused by inner ear issues such as Benign Paroxysmal Positional Vertigo (crystal displacement), vestibular neuronitis (nerve inflammation), labyrinthitis (inflammation from viruses), or Meniere's disease (fluid buildup).

Q: What is the difference between dizziness and vertigo?

A: Dizziness is a general term used to describe a feeling of lightheadedness, unsteadiness, or faintness. Vertigo is a type of dizziness that causes a false sensation of movement- either you feel like you are spinning or the room is spinning around you.

Q: What are the types of vertigo?

A: Vertigo is generally categorized into two types: Peripheral and Central. Peripheral is the most common type and results from problems in the inner ear balance mechanism while central vertigo can result from problems in the brainstem or cerebellum.

Q: Can stress be a cause of vertigo?

A: Stress is typically not the direct cause by itself, but it can be a trigger and/ or exacerbate conditions that trigger vertigo. For example, stress is considered one of the major migraine causes and may also affect symptoms of Meniere's disease.

Q: Is Cintigo tablet the best medication for all types of vertigo?

A: No. While Cintigo tablets are effective for certain types of vertigo, particularly those involving vestibular inflammation or blood flow issues (like Meniere's or labyrinthitis), and for motion sickness, it is generally not the primary treatment for BPPV, which is best treated with physical maneuvers like the Epley maneuver.

Q: Can I treat vertigo at home?

A: During an acute attack, lie down in a quiet, dark room. Avoid sudden head movements. Stay hydrated. While there are home versions of the Epley maneuver for BPPV, it is highly recommended to have a professional perform it first to ensure it is done correctly and to confirm the diagnosis.

Q: What are some vertigo exercises?

A: Some of the Vertigo exercises are:

• Brandt-Daroff Exercises
• Epley Maneuver
• Head movement
• Walking
• Eye exercises

Q: Is vertigo permanent?

A: Rarely. Most cases of vertigo are treatable. Labyrinthitis usually resolves in weeks. BPPV can often be fixed in one or two clinic visits. Meniere disease is chronic but manageable with lifestyle changes and medication.

Relevant Sources for Further Reading

Mayo Clinic: Dizziness and Vertigo - Symptoms and Causes.

The Vestibular Disorders Association (VeDA): Educational resources on vestibular conditions.

National Health Service (NHS) UK: Information on Vertigo and Cinnarizine.

Cleveland Clinic: Benign Paroxysmal Positional Vertigo (BPPV).