Dizzy spells can be a sign of vertigo, caution UAE doctors

Abu Dhabi: A sudden feeling of nausea when looking at electronic billboards, or unsteadiness when getting out of bed may seem like commonplace sensations to many. Such discomfort is, in fact, a common complaint reported during many doctor visits in the UAE, but patients are often unaware that they may actually be experiencing vertigo.

Doctors have highlighted that the condition can often be resolved with treatment, and that patients should seek medical help.

The symptoms are often conflated with simple dizziness, but Dr Heinz Reichmann, neurologist at the German Neuroscience Centre, said patients with vertigo have a distinct impression that the world is spinning.

“Dizziness means some unsteadiness and lightheadedness. Vertigo occurs when the patient has the impression that the world is circling around him, which is combined with nausea and vomiting,” the doctor explained.

“Vertigo is impairs the quality of life tremendously since patients can hardly walk or drive, and have an awful nausea and vomiting sensation,” Dr Reichmann said.

“We run a dedicated vertigo clinic at Aster Speciality Clinic, Discovery Gardens…and have successfully treated more than 2,400 patients suffering from vertigo in the last four years,” Dr Pawar said, offering hope.

One of the most common types of vertigo is vestibular, which can occur as a result of infections, inner ear problems, calcium debris in ear canals, or because of neurological issues like a traumatic brain injury.

Patients experience dizziness spontaneously after changing the position of the head, or while moving their head. They experience headaches with irritation ton light and sounds, with nausea and vomiting. They also face difficulties in focussing and concentrating, and are irritated by screens. They may also have motion sickness, transient ringing and ear blockages.

“But this kind of migraine is treatable, and gets better with lifestyle modification and preventive medication,” Dr Pawar said.

The second most common type of vertigo is benign paroxysmal positional vertigo (BPPV), which occurs when when tiny calcium crystals called otoconia come loose from their normal location on the utricle, a sensory organ in the inner ear. If the crystals become detached, they can flow freely in the fluid-filled spaces of the inner ear, including the semicircular canals (SCC) that sense the rotation of the head. The otoconia will not cause a problem when located in canal, until the person’s head changes position, such as when looking up or down, going from lying to seated or lying to seated in bed, or when rolling over in bed. They then move to the lowest part of the canal, which causes the fluid to flow within the SCC, stimulating the balance nerve and causing vertigo and jumping eyes.

“Fortunately, most cases of BPPV can be treated with the help of positioning manoeuvres, without the need for medication,” Dr Pawar said.

Persistent postural perceptual dizziness (PPPD) is the third most common cause of dizziness.

“This severely impairs the quality of life of the patients. Patients experience from dizziness and unsteadiness daily for more than three months, and the sensation fluctuates throughout the day. It also increases during upright postures like sitting, standing or walking, when moving the head, or when exposed to moving visual stimuli like traffic, patterns or graphic. Patients feel better when lying down and after exercise,” Dr Pawar explained.

The treatment of this kind of dizziness requires medication, vetibular physiotherapy and counselling.

Dr Pawar stressed that vertigo is a symptom, and not a diagnosis.

“Identification of the correct underlying cause by experts, and providing specific management, can help reduce patients’ suffering and improve their quality of life. For instance, there are some types like BPPVbthat are mainly treated with repositioning manouevres. In other cases, medication and vestibular rehabilitation therapy may be integral. If the cause of vertigo is stroke, multiple sclerosis, or tumours, we have to treat the underlying disease,” the doctor explained.

A pair of specialised goggles may also be used to help certain patients.

“Some patients may benefit from virtual vestibular rehabilitation therapy (VVRT) goggles, which help treat balance issues. These goggles can create a virtual environment for patients with fear of heights, crowded places, dizziness while driving. They help desensitise patients to these stimuli, and can thus help restore balance, Dr Pawar said.