Country music singer Wynonna Judd, 58, was scheduled to sing with Kelsea Ballerini at this year’s 2022 New Year’s Eve Live: Nashville’s Big Bash, but suffered a bout of vertigo, which prevented her from performing. Judd wrote in a post on social media, “I was looking so forward to singing with my dear @kelseaballerini tonight. Instead, I am on the bus struggling with an extreme bout of vertigo and am unable to perform. Nashville, I am absolutely heartbroken and so sorry to have let you all down tonight. Kelsea, I look forward to stepping onstage with you in February, better than ever!!!!”
What Is Vertigo?
Vertigo is a feeling of spinning. It is usually caused by irritation of the inner ear. While it can be very distressing and uncomfortable, most causes are relatively harmless, Dr. William Buxton, MD, board-certified neurologist, and director of Neuromuscular and Neurodiagnostic Medicine and of Fall Prevention at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California, explains. It needs to be distinguished from other forms of dizziness, such as feeling lightheaded (often caused by cardiac or vascular problems, potentially serious) or wobbly (which can be caused by a wide range of problems from the brain to nerves and muscles in the legs, ranging from mild to serious). If the vertigo is solely due to a problem in the inner ear, individuals should not have symptoms other than hearing-related symptoms, Dr. Buxton adds. However, if other symptoms, such as double vision, difficulty swallowing or sudden balance loss are present, individuals should seek urgent medical attention as those combinations can represent a stroke or other serious brain problem.
Causes of Vertigo
In terms of vertigo from a solely inner ear perspective, there are two common causes. The most common is Benign Paroxysmal Positional Vertigo (BPPV). We have crystals in our ears that move when we move, telling our brains that we are moving. However, these crystals sometimes fall out of place (usually with age or after trauma), causing our brains to think we are spinning when we are not. This is usually triggered by lying down with one’s head turned to one side or the other, Dr. Buxton states. There are maneuvers (Dix-Hallpike testing, for example) physicians can perform in the office to test for the condition, and if testing is positive, treatment (Eppley maneuver) can be performed immediately. After treatment, individuals should sleep upright (such as in a recliner or supported upright at the waist with pillows) for two nights. Once someone is treated they can do exercises at home, but should only do so if symptoms recur, Dr. Buxton explains. There are some situations, such as an artery or skeletal problems in the neck, in which maneuvers may need to be modified, so don’t try the maneuvers before seeking the advice of a physician. Another common cause is vestibular neuronitis, an infection of the inner ear (usually viral). In addition to vertigo, individuals often experience nausea and vomiting. This can last for days, and in severe cases, symptoms may rarely persist after the initial infection. Evaluation by a physician is essential to rule out other causes of the symptoms. Treatment is aimed at managing symptoms with medications for nausea and with meclizine, a mild sedative that helps reduce the feeling of spinning. Staying hydrated is essential and sometimes requires intravenous fluids, Dr. Buxton adds. A less common cause of vertigo is Meniere’s, a disorder in which there is excessive fluid in the labyrinth, or inner ear. In addition to vertigo, it can cause tinnitus (ringing in the ears) and hearing loss, Dr. Buxton states. It tends to come in attacks lasting a few days that can lead to hearing loss over time. The tinnitus is usually more of a hum or roar than a high-pitched sound. This also needs a detailed medical evaluation. Treatment begins with a reduction of salt intake, and over time, most patients need to take a diuretic (or water pill).
Symptoms of Vertigo
The primary symptomatic complaint is dizziness that typically worsens with head movement, Dr. Ilan Danan, MD, M.Sc., sports neurologist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, California, explains. It is often described by patients as a spinning sensation, with the room or objects around them moving about. It can be associated with increased sweating, nausea and vomiting. “As a symptom, vertigo is often diagnosed clinically with a thorough history and clinical examination,” says Dr. Danan. “Certain clinical tests and observations such as head impulse testing or the Dix-Hallpike maneuver can be helpful when assessing for vertigo. On certain occasions, additional testing such as imaging, or tests of the auditory (hearing) or vestibular (balance) systems may be indicated.”
Treatment Methods
Treatment options for vertigo are entirely dependent on the underlying cause. For symptomatic relief, vestibular rehabilitation therapy as well as medications such as meclizine have been shown to be effective, Dr. Danan explains. If one were to experience an episode of vertigo, the most important thing to do is to see a neurologist for further evaluation. This will ensure that the underlying cause has been determined and preventative measures for future events can be addressed. Next up: Feeling Dizzy? Here Are 11 Possible Reasons Why Your World Is Spinning
Sources
William Buxton, MD, board-certified neurologist and director of Neuromuscular and Neurodiagnostic Medicine and of Fall Prevention at Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, CAIlan Danan, MD, M.Sc., sports neurologist at the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA
