Vertigo: Spin in your head and sway in stride

MUMBAI: He that is giddy thinks the world turns around. Little did the writer know that this could be used to describe vertigo — a frequent health enigma encountered in modern metro lifestyles. Adapted from Latin, vertigo means a whirling or spinning movement in which the patient inappropriately experiences the perception of motion. A symptom complex comprising of recurring short spells of acute giddiness associated with change in posture (arising from a lying position or straightening up after bending ), it can be associated with nausea, vomiting and ear symptoms.

A common symptom, afflicting one fourth of the population at some stage or the other but more with increasing age and twice more frequent in women.

Usually ascribed to a malfunction of the labyrinthine system— the balancing apparatus in the inner ear, vertigo can emanate from various causes. While viral afflictions are the commonest (associated with cold, cough and blocked ears), conditions like cervical spondylosis, excess alcohol intake, head injury and use of certain drugs can precipitate vertigo. Of course, central causes in the brain affecting the balancing centre can result in vertigo along with other paralytic symptoms.

Ranging from occasional mild spinning in the head, to a violent rollercoaster like shake requiring immobilization and support, vertigo can be repetitive and chronic in susceptible patients. When associated with severe vomiting and tinnitus (ringing sound in the ear), it is called Meniere's disease.

In today's humdrum life, vertigo is also stress induced. Whether it is the constant posturing in front of the laptop or the incessant use of cellphone or even the perennial adrenaline-fuelled mental overdrive, patients keep experiencing inexplicable giddiness.

A transient but notable cause of vertigo is motion sickness which can be due to winding roads and even fast and long drives. Vertigo from jet-lag is often self limiting. Exposure to loud, nearly deafening music or sound for a sustained period (discos, sitting at a show in front of monstrous speakers or even working without rest in the engine room etc) can surely knock the stuffing out of your balancing system.

Quite often patients convalescing from prolonged illnesses in bed ( orthopaedic injuries, long fevers and surgical cases), experience giddiness when they resume activity and often the acclimatization can be frustrating till the imbalance wears off.

Most available drugs are targeted at correcting the fluid movement in the semicircular canals in the ear. Quite often, chronic patients seem to find solace in regularly taking these drugs. In addition, neck and postural exercises, muscle toning and even yoga can play a role in alleviation. Obviously expelling the precipitating factor is paramount in treatment. One assumes that both patient and doctor have initially ruled out other causes of giddiness like blood pressure etc.

A trivial but irritating symptom, vertigo can often be the 'David' in a Goliath's life and take away his free mobility. Vertigo patients need meticulous treatment and persevering care for no amount of "Mardaani" can tame this 'Chakkar' easily.

(Dr Hemant Thacker is a consultant physician & cardiometabolic specialist at south Mumbai Hospitals. Email address: dochpt@gmail.com)

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