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Neurology (Expert Forum)
vertigo
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vertigo
by sherrie31274, May 21, 2007 12:00AM
hi, i am 33 years old with what i am told vertigo. i would like to know if this ever will go away. i drive a school bus for work and now i am to scared to drive. i am not sure why this is happening but last night when i was sleeping i became dizzy and woke up. very scary!!! i am also starting to get more frequent headaches and my ears feel like theres something in there and i hear crackling. i also am more fatigued! i have three young kids so this is very hard to handle while raising my children. please, any info is better then no info thank you... sincerely, sherrie
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jun 14, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
Vertigo has two basic causes, central(brain) and peripheral(ear). Damage to a part of the brain involved in balance and vestibular function (the cerebellum or brainstem) such as a stroke, multiple sclerosis, or tumor can cause central vertigo. This type of vertigo is constant and is not affected by head position. I would recommend that you get an MRI of your brain to rule out central vertigo, but from the symptoms that you describe it sounds more like peripheral (ear) related vertigo.
Peripheral vertigo affects the vestibular centers that are located adjacent to the ear. The most common form is benign positional paroxysmal vertigo (BPPV), which is caused with an otolith(like a small stone) breaks off in the semicircular canals of the vestibular system and confuses the brain with mixed signals. There are maneuvers of head turning (Eply maneuver) to try and silence these otoliths. Peripheral vertigo generally worsens with head movement, and rolling over in bed is often enough to produce nausea and vomiting during an attack. Peripheral vertigo can also be caused by viral infections of the ear, tumors pressing on the nerves of the the vestibular system (called CP anlge tumors, schwanomas, gliomas and meningiomas). I would recommend that you see a neurologist to be evaluated further for your vertigo.
I hope this has been helpful.
Vertigo has two basic causes, central(brain) and peripheral(ear). Damage to a part of the brain involved in balance and vestibular function (the cerebellum or brainstem) such as a stroke, multiple sclerosis, or tumor can cause central vertigo. This type of vertigo is constant and is not affected by head position. I would recommend that you get an MRI of your brain to rule out central vertigo, but from the symptoms that you describe it sounds more like peripheral (ear) related vertigo.
Peripheral vertigo affects the vestibular centers that are located adjacent to the ear. The most common form is benign positional paroxysmal vertigo (BPPV), which is caused with an otolith(like a small stone) breaks off in the semicircular canals of the vestibular system and confuses the brain with mixed signals. There are maneuvers of head turning (Eply maneuver) to try and silence these otoliths. Peripheral vertigo generally worsens with head movement, and rolling over in bed is often enough to produce nausea and vomiting during an attack. Peripheral vertigo can also be caused by viral infections of the ear, tumors pressing on the nerves of the the vestibular system (called CP anlge tumors, schwanomas, gliomas and meningiomas). I would recommend that you see a neurologist to be evaluated further for your vertigo.
I hope this has been helpful.
1....Get an MRI brain scan with and without contrast
2...If this is normal, proceed to a major academic (university) hospital clinic and see an ENT who specializes in dizziness and ear disorders. If you have not had an MRI, this doctor will probably order one for you. He can then conduct highly specialized testing to determine the specific cause of your vertigo.