Vertigo is a condition that affects up to 10% of the general population and can affect 20-40% of the population throughout their lifespan at any given time. It can be seen with any age group but increases in frequency with age. The ratio of women to men is 3 to 1.
Vertigo patients complain of dizziness that increases with positional changes such as sitting up after lying in bed, sudden turning, or looking up (peripheral vertigo). The symptoms may be experienced in a transient fashion and usually improve after remaining still for several seconds to minutes.
There is a more severe but rarer form of vertigo that is caused by specific lesions to the brainstem and is described as unrelenting (central vertigo), but this is less common. These symptoms may be accompanied by nausea, vomiting, and double vision. Excessive fluid accumulation in the inner ear (Meniere’s disease) may be the cause of the symptoms. Trauma, diabetes, and inflammatory conditions may also be contributors.
The diagnosis is made clinically by taking the patient’s history and performing a thorough neurological examination. Treatment is most commonly done with medications, but vestibular exercise testing and repositioning of the gyroscopic mechanism of the ear reduce both the frequency and intensity and have longer-term benefits.
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