Vertigo is a condition where people experience a sensation of the environment around them moving or spinning. The severity of the attacks can vary from barely noticeable to situations where people struggle to control their balance.
While there are various causes of vertigo, Dr Mohamed Fawzy Moustafa Ahmed, Consultant Ear, Hearing and Balance and Director of Hearing and Balance Clinic, Dubai Hospital, DHA, says vertigo is a relatively common complaint in Dubai. “Before the age of 40, incidents of vertigo can affect up to 20 per cent of the population. After 40, it can affect up to 40 per cent and after 60, vertigo can affect up to 60 per cent of people, so it’s a common problem.”
Dr Fawzy explains that the most important thing for people who are experiencing symptoms is to seek medical advice as early as possible.
With BPPV, there are small calcium carbonate crystals in the inner ear that are damaged. The main causes are aging, viral infection in the inner ear, head trauma or calcium or vitamin D deficiency.
“It is important to visit a Hearing and Balance Clinic as early as possible if someone is showing symptoms of vertigo — if it affects your hearing for too long, the damage will not be reversible. With early intervention, we can control the symptoms without any damage to hearing.
“If the pressure of the liquid in the ear is high for too long, then the cochlea can become damaged.”
There are two main causes of vertigo. Around 60 per cent of cases are caused by issues in the inner ear, while 40 per cent of cases are related to other health issues in the body such as migraine, a thyroid problem, hypertension, diabetes, high cholesterol, anaemia or issues with your muscles and joints.
Dr Fawzy explains that the most common condition in the inner ear is benign paroxysmal positional vertigo (BPPV).
“With BPPV, there are small calcium carbonate crystals in the inner ear, which are damaged. The main four causes are aging, a viral infection in the inner ear, a head trauma, or a calcium or vitamin D deficiency that can damage the crystals.
“When calcium carbonate cells within the inner ear keep moving to different parts of the vestibular [balance organ], this causes the patient to experience severe vertigo. Whenever people move their head in a certain direction, such as when they roll over in bed, pick up an object from the ground, or when they turn their head if someone is calling them from behind — they will experience a severe spinning sensation that lasts for seconds and often this can also cause nausea. There usually aren’t any other audiological symptoms.”
For cases of BPPV vertigo, Dr Fawzy says that a specific treatment is required, which usually doesn’t need medication. “We treat BPPV with a canalith repositioning manoeuvre.” The doctor stimulates the crystals through vibration and relocates them to their original place. “The manoeuvre lasts no more than two minutes. The patient’s symptoms will completely subside without medication,” he says.
“It is a permanent cure but there is also a possibility of recurrence. There is a recurrence rate of around 30 per cent, but if the patient follows instructions, such as not sleeping on the affected side for one week or avoid radical movements during the day, this will help them avoid recurrence.”
There are also other diseases that affect the inner ear and make patients feel dizzy. The second most common cause of vertigo in the ear is Ménière’s disease. It is a condition where the pressure of the fluid in the inner ear becomes high. When the pressure is high, it can affect the cochlea.
“The patient will complain of four symptoms. They will describe episodic attacks of severe vertigo, and the vertigo is associated with hearing loss in one ear. There will also be ringing or tinnitus inside the ear and a blockage or sensation of fullness inside the ear,” says Dr Fawzy. Ménière’s disease is relatively common, affecting around 1.5 per cent of the population, but it’s also treatable.
DHA launched the Hearing and Balance clinic in 2011 and although there was initially a long waiting list, this has been significantly reduced and the team now treat around 30 patients each day. He advises any patient who is experiencing balance issues to visit an ENT clinic first, as the majority of cases of vertigo are related to the inner ear.
“Most ear disorders are treatable. If people suffered from vertigo, previously they would visit doctors such as cardiologists, thinking they had a problem with their blood pressure, or they visit a neurologist, suspecting there is some neurological disorder but in the case of vertigo, the most common cause is related to the ear, which is why my advice for people suffering from dizziness is to visit an ENT clinic.”