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Vertigo: Not Just About Dizzy Spells

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  • 1 day ago
  • Balvinder Sandhu

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Vertigo: Not Just About Dizzy Spells
On a near daily basis, 63-year-old Mr Chew experiences grogginess, blurry vision, and a spinning sensation. Sometimes, even while standing and waiting for the lift, he’d feel like his whole body was swaying. It may seem like a simple dizzy spell, but it’s actually vertigo. Eventually, it got to a point that he decided to see a doctor.
They ran some tests – including one where I had to lie down with goggles to track my eye movements – and found that my eyes were 'jumping', which pointed to a balance issue caused by a small crystal in the ear being out of place,
he recalls.

"They also said the water level in my ears were not equal."

Mr Chew, who prefers to remain anonymous, had experienced vertigo. Contrary to what most people think, vertigo isn’t a condition but actually a symptom.
Dr Yuen Heng Wai, otorhinolaryngologist at Mount Elizabeth Hospital, says the presence of vertigo indicates that there is a “malfunction” of the balance organs in our body.
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The balance organs are in our skull, specifically in the ear bone or temporal bone – there is one on each side. This organ is known as the labyrinth,
he explains.

"It is made up of three semi-circular canals and the vestibule, each of which contains fine hair sensory cells that detect and respond to body and head movement and acceleration in different planes. Therefore, vertigo is usually exacerbated by body or head movement."

Dr Yuen adds that vertigo is often accompanied by cold-sweat, nausea, vomiting, palpitation, and raised blood pressure.
This is because the body is primed to interpret vertigo (and dizziness) as a dangerous or threatening symptom and reacts by activating the sympathetic (fight/flight) and purging mechanisms,
he says.

"Patients therefore tend to feel better when they lie down and keep still."

Vertigo is not just a dizzy feeling
Vertigo is not simply about being dizzy.
Vertigo: Not Just About Dizzy Spells - Ng Zhao Xiang, senior physiotherapist at Sengkang General Hospital
Ng Zhao Xiang, Senior Physiotherapist, Sengkang General Hospital
Credit: Sengkang General Hospital
Ng Zhao Xiang, senior physiotherapist at Sengkang General Hospital, shares that vertigo is a false sensation of rotation or spinning, either of oneself or the surrounding environment.
This differs from dizziness, which is a broader term encompassing various sensations including light-headedness, unsteadiness, and feelings of faintness.
While there is no specific risk group for developing vertigo, you could have a higher chance of experiencing it in certain circumstances.
Vertigo: Not Just About Dizzy Spells - Dr Yuen Heng Wai, Otorhinolaryngologist at Mount Elizabeth Hospital
Dr Yuen Heng Wai, Otorhinolaryngologist, Mount Elizabeth Hospital
Credit: Yuen Heng Wai
Patients who have a history of migraine, or are on certain medication – such as some antibiotics that are ototoxic (damaging to the inner ear) – and patients who engage in activities that involve putting their heads in abnormal positions for prolonged periods (such as yoga), are at risk of having vertigo.
Shares Dr Yuen,
The good news is that vertigo is treatable. Mr Chew started treatment for vertigo about a year ago. Part of it involved him learning vestibular rehabilitation exercises – simple head and body movements to help with balance.
The physiotherapist recommended doing them for three minutes, twice a day,
he explains.

"But wanting to recover faster, I started doing them more frequently, even during short breaks at work. After just one week, the groggy feeling and spinning sensations disappeared."

One month later at his follow-up appointment, his doctor told Mr Chew that he had recovered and was surprised by his fast progress.
The role of physiotherapy

Physiotherapy is one of the common ways to deal with vertigo, says Ng.

Vertigo and dizziness can stem from multiple causes,
he explains.

"Physiotherapy plays a crucial role in both diagnosis and treatment, particularly when the underlying cause is related to vestibular dysfunction."

Vertigo: Not Just About Dizzy Spells - Experiencing vertigo
He adds that the two most frequently encountered conditions in clinical practice are Benign Paroxysmal Positional Vertigo (BPPV) and vestibular neuritis.
For BPPV, treatment involves specific repositioning manoeuvres to alleviate symptoms. In cases of vestibular neuritis, the therapeutic approach focuses on gaze stabilisation exercises and balance rehabilitation protocols.
While pharmacological interventions may be prescribed during acute episodes of vertigo, these primarily provide symptomatic relief rather than addressing the underlying pathology,
says Ng.
Although BPPV may resolve spontaneously over several weeks, patients may experience significant balance impairment and unsteadiness during daily activities during this period,
he adds.

"Therefore, prompt medical intervention is strongly recommended to expedite recovery and prevent potential complications."

Dr Yuen adds that vertigo is treated according to its cause and many causes of vertigo can be diagnosed with a good history and physical examination.
In the case of BPPV – a condition in which particles from a specific part of the inner ear is dislodged (e.g. from head trauma) and ends up in a different part of the inner ear – treatment involves particle repositioning manoeuvres. These can be done in the clinic and, post-procedure, some medication might be prescribed to prevent recurrence.
For vestibular neuritis – which doesn’t have a clearly known cause – the vestibular organ on one side malfunctions and the patient experiences vertigo with movement.
Dr Tay says that treatment involves symptomatic anti-emetics (a drug that reduces nausea and vomiting), initial bedrest but graduated activities after 48 hours. Some medications are useful too.
Patients with Meniere’s disease also experience vertigo and effective treatment include oral medication diuretics or intratympanic (within the middle ear) injections.
Dr Yuen mentions that, in the case of patients with migraine who also develop vertigo, treating the underlying migraine usually resolves the vertigo.
As someone who has experienced vertigo, Mr Chew advises anyone who feels dizzy to find a safe place to sit and rest – even if you’re busy.

"I also want people to know that recovery takes self-determination. I followed the exercises the doctor gave me but I went beyond that, doing them more often because I really wanted to get better – and it made a difference."

Dr Yuen stresses that a good diagnosis and targeted treatment are very effective in treating vertigo.
If vertigo is accompanied by other symptoms – such as weakness or numbness of limbs, slurring of speech, blurring of vision, severe headache – it might indicate a more serious condition. Early medical attention is necessary,
he states.
This article is part of a series on invisible disabilities, an umbrella term that refers to types of disabilities, chronic conditions, or medical/neurological conditions that are not immediately apparent to others. We seek to understand more about these invisible disabilities and how we, as loved ones or as general members of society, can better support others going through it.

Also read:

Balvinder Sandhu

Balvinder Sandhu

A published author who lives in Melbourne but stays in touch with her Singapore roots and way of life.

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