New Delhi: Vertigo is often dismissed as a fleeting sense of dizziness, but for those suffering from chronic vertigo, it can be debilitating and life-altering. While most cases stem from inner ear disturbances, long-term vertigo can have significant neurological consequences, affecting balance, cognition, and mental well-being. Despite its prevalence, vertigo remains widely misunderstood, often misdiagnosed, or overlooked in neurological evaluations.
In an interaction with News9Live, Dr Avinash Kulkarni, Consultant Neurologist, Gleneagles BGS Hospital Kengeri, Bengaluru, spoke about vertigo and its causes.
Understanding Vertigo and Its Causes
Vertigo is not a disease but a symptom of an underlying issue affecting the vestibular system, which controls balance and spatial orientation. It creates a false sense of movement, making individuals feel like they are spinning or swaying even when still.
Common causes of vertigo include:
- Benign Paroxysmal Positional Vertigo (BPPV): Displaced inner ear crystals causing brief but intense dizziness.
- Vestibular Migraine: Neurological migraines triggering episodes of vertigo.
- Meniere’s Disease: Inner ear disorder causing vertigo, hearing loss, and tinnitus.
- Vestibular Neuritis/Labyrinthitis: Inflammation of the vestibular nerve due to viral infections.
- Cervicogenic Vertigo: Neck-related dizziness from spinal misalignments or muscle tension.
Neurological Impact of Long-Term Vertigo
When vertigo persists for weeks or months, the brain struggles to compensate, leading to neurological adaptations that may further disrupt balance and coordination. The vestibular system, which integrates signals from the inner ear, eyes, and muscles, can become dysregulated, affecting multiple brain regions.
- Impaired Balance and Coordination: Chronic vertigo forces the brain to rely more on visual and proprioceptive cues rather than the vestibular system, leading to gait disturbances, unsteady movements, and an increased risk of falls. The cerebellum, responsible for motor coordination, may experience functional changes, impacting reflexes and movement control.
- Cognitive Dysfunction: Many patients with long-term vertigo report brain fog, difficulty concentrating, and memory problems. The cerebral cortex and hippocampus, which process spatial awareness and memory, may experience dysfunction due to persistent vestibular disturbances. Studies suggest that prolonged vertigo can contribute to vestibular cognitive impairment, affecting problem-solving skills and multitasking abilities.
- Anxiety and Depression: Vertigo is strongly linked to mental health disorders, with many patients experiencing chronic anxiety, panic attacks, and depression. The limbic system, which regulates emotions, is closely connected to the vestibular system, meaning prolonged dizziness can trigger heightened stress responses. The fear of unpredictable vertigo attacks often leads to avoidance behaviors, social withdrawal, and reduced quality of life.
- Vestibular Compensation and Neural Plasticity: The brain attempts to adapt to chronic vertigo through a process called vestibular compensation, where other sensory systems take over balance control. However, if adaptation is incomplete, patients may develop persistent dizziness and motion sensitivity. This incomplete compensation can lead to maladaptive neural plasticity, making symptoms more resistant to treatment.
Diagnosis and Treatment Strategies
Neurologists and vestibular specialists use a combination of clinical exams, imaging, and vestibular function tests to diagnose the root cause of chronic vertigo. Treatment depends on the underlying condition but may include:
- Vestibular Rehabilitation Therapy (VRT): Customized exercises to retrain the brain’s balance system.
- Medications: Vestibular suppressants, migraine treatments, or diuretics for Meniere’s disease.
- Canalith Repositioning Maneuvers: Techniques like the Epley maneuver for BPPV.
- Cognitive Behavioral Therapy (CBT): Managing anxiety and psychological distress linked to vertigo.
- Lifestyle Modifications: Reducing caffeine, salt, and stress to prevent vertigo episodes.
Conclusion
Long-term vertigo is more than just dizziness—it’s a complex neurological disorder affecting balance, cognition, and emotional well-being. The brain’s struggle to adapt can lead to lasting impairments, making early diagnosis and intervention critical. Neurologists play a key role in identifying the root cause and guiding patients toward effective treatment strategies. By understanding the neurological impact of vertigo, we can shift the perception of this condition from a minor inconvenience to a serious medical issue requiring specialized care.
Vertigo is characterised by dizzy spells and when chronic, it can result in debilitating symptoms. Know the long term implications of the condition. Health Conditions Health News: Latest News from Health Care, Mental Health, Weight Loss, Disease, Nutrition, Healthcare
