Vertigo Treatment in Singapore

What is Vertigo?

Vertigo is a feeling of off balance. It is a sensation of spinning when you are actually not. The extent at which you feel this sensation can be quite extreme – it is either barely noticeable, or so severe that you cannot keep your balance and do your everyday tasks. This feeling happens suddenly and can last anywhere from a few seconds to much longer.

What causes Vertigo?

Vertigo can present itself in two forms: Peripheral Vertigo, and Central Vertigo.

Peripheral Vertigo is more common than Central Vertigo, and is often linked to an issue with the balance mechanisms of the inner ear. This can be caused by:

• Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes, usually affecting people aged 50 and above. It involves intense, recurrent attacks of vertigo lasting several seconds. During which, you may feel nauseated, although vomiting is rare. You may also feel your eyes slightly moving uncontrollably.
  BBPV may appear to occur for no reason but it normally happens during specific head movements. Lightheadedness and a loss of balance can last for up to hours after the attack.
• Labyrinthitis is an inner ear infection usually caused by a virus such as the common cold or flu. During an inner ear infection, the information sent from the infected ear to the brain is very different from the information sent from the uninfected ear and your eyes. These conflicting signals can cause vertigo and dizziness, sometimes accompanied by nausea, vomiting, hearing loss, tinnitus, and sometimes fever and ear pain.
• Vestibular neuronitis, also known as vestibular neuritis, is another type of inner ear viral infection. This infection causes the nerve connecting the ear to the brain to become inflamed. It usually happens suddenly, sometimes accompanied by unsteadiness, nausea, and vomiting. It can last a few hours or days but would typically take anywhere between three to six weeks to settle completely.
• Severe vertigo is sometimes caused by Ménière's disease, an inner ear disorder caused by abnormal inner ear fluid pressure. Vertigo caused by Ménière's disease happens suddenly, accompanied by nausea and vomiting, and can last for hours or days. The cause of Ménière's disease itself is unknown, but symptoms can be controlled by diet and medication. Besides vertigo, this condition can also result in hearing loss, tinnitus and a plugged feeling in your ear.
• Vertigo may be a side effect of some types of medication. If the prescribed medication is causing vertigo, your doctor may prescribe an alternative.

Unlike Peripheral vertigo, Central vertigo is caused by problems in parts of your brain. This can be caused by migraines, multiple sclerosis, acoustic neuroma, a brain tumour, a transient ischaemic attack or a stroke, and certain types of medication.

What are the symptoms of Vertigo?

Instead of a condition, vertigo is a symptom and it most likely points to an issue with your inner ear. Hence, it is more often than vertigo occurs in combination with other symptoms such as nausea and vomiting, tinnitus, headaches, motion sicks, problems with balance, a plugged sensation in the ear, and nystagmus (a condition in which eyes move side to side uncontrollably).

Is Vertigo painful?

An episode of vertigo can cause immense discomfort and heavily disrupt your daily life in extreme cases. However, it does not cause pain directly although the underlying condition which resulted in vertigo could be painful.

Who is at risk of Vertigo in Singapore?

Certain factors increase your risk of vertigo. For example, if you are a woman above the age of 50, your chances of suffering from vertigo are higher. If you have experienced a previous episode of vertigo, that itself makes you vulnerable to subsequent episodes. Vertigo can also be hereditary.

In other cases, suffering a head injury or an ear infection, or any medication condition that affects your ears or balance would also make you more susceptible to vertigo. Certain medications also list vertigo as a side effect.

How is Vertigo diagnosed in Singapore?

Your doctor will ask you about your symptoms and carry out a physical examination. One or a combination of the following tests may be conducted, supported by imaging tests such as X-rays or MRI scans.

• A Romberg test measures how well you are able to balance while standing with your feet together and eyes closed
• A Fukuda-Unterberger test measures how well you are able to march on the spot while maintaining balance
• A head-thrust test measures how well your eyes are able to follow the doctor’s nose as the doctor moves around
• A Dix-Hallpike test tests for BBPV, which is a possible cause for vertigo

Some of these tests are conducted in a dark room to trigger vertigo.

Vertigo Treatment in Singapore

Vertigo treatment plan will depend on the type and cause of your vertigo. In most cases, vertigo would go away on its own but you will be advised to rest and prescribed medication to address the underlying cause of your vertigo.

If vertigo is the result of an inner ear problem, vestibular rehabilitation may help reduce the symptoms by strengthening your other senses, so they can compensate for vertigo episodes.

If you have been diagnosed with BBPV, your doctor will teach you canalith repositioning manoeuvres to move the calcium deposits, which are responsible for vertigo, from the ear canal into an ear chamber where they will be absorbed into the body.

Surgery only becomes an option if none of these treatments work or if your symptoms become unmanageable.