Equilibrium disorders

It is essential to distinguish vertigo from vertiginous sensation, a feeling of being on a boat.

True vertigo is more like being on a merry-go-round: the room turns around.

Feelings of imbalance can have various causes, although the most common are vascular problems and treatment side effects. Vertigo can be classified as:

• Peripheral vertigo if it originates in the inner ear, the organ whose vestibular compartment serves to perceive and maintain the sense of balance.

• Central vertigo due to disturbances of the brain and central nervous system.

Peripheral vertigo's common causes:

• Paroxysmal positional vertigo: caused by a dislocation of otoliths (micro-calculi in the fluids that flow through the vestibular septum of the inner ear).

• Vestibular neuritis: caused by an inflammation of the balance nerve or nerve nuclei, often viral.

• Meniere's disease: is an imbalance of the inner ear's hydro-electrolytic homeostasis, typically manifests itself by recurrent and sometimes disabling vertigo, associated with fluctuating or persistent hearing disorders.

• Migraine-associated vertigo, in which recurrent episodes of vertigo are variably correlated or interpenetrate with typical migraines. Treatment requires the combined work of the competent ENT and neurologist.

The foundation of a correct diagnosis is anamnesis (collecting the patient's history of symptoms with care). Furthermore, a clinical vestibular examination, supported by instrumental or radiological investigations, will assist the patient with the most appropriate therapeutic plan.

Therapy

According to the patient and the vertigos type, the therapeutic measures may include medication, positioning or postural exercises, or specialized physiotherapy.