Vertigo is a feeling that the world is spinning around. People with extreme vertigo feel nauseous, often vomit, and talk about lying down and holding onto the carpet to keep from falling off the earth. Many patients complain of dizziness rather than of a true whirling sensation. A whirling sensation is usually associated with an identifiable labyrinthine etiology.
The patient who complains of being dizzy may have a clear-cut and identifiable significant disorder, but often the diagnosis may remain obscure. Dizziness takes a long time to evaluate, and may require a complete history, physical and laboratory examination. Time spent on the history will help direct the physician in decisions regarding testing and treatment. Failure to be thorough will result in a missed diagnosis.
Physicians in different specialties have different experiences with vertigo. A medical officer at hospital, for example, may cite the leading causes of vertigo as cardiac arrythmia and orthostatic hypotension.
A neurologist might consider multiple sclerosis the most common cause, while a head and neck surgeon might believe that Meniere’s disease or vestibular neuronitis is most common. A general practitioner may believe most causes are idiopathic or functional. Each of these physicians reflects the nature of his or her own practice.
For each of my patients who complains of dizziness vertigo and imbalance are believed to be due to spasm of perticular muscle of neck that have postural function;
Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction. This type of vertigo is rarely serious and can be treated.