In some people with vertigo—in particular those who also have hearing loss—doctors may recommend an MRI scan to obtain a closer look at the inner ear and surrounding structures.
MRI of the brain shows relevant findings in a reasonable proportion of patients presenting with acute vertigo, which helps in making a correct diagnosis and planning appropriate treatment.
MRI is preferred over CT due to its superiority in visualizing the posterior fossa, which is often the location for a central etiology of vertigo. MRI will rule out acute and chronic ischemic disease, cerebellopontine lesions such as vestibular schwannomas and meningiomas, as well as multiple sclerosis.
When patients present to the ED with dizziness, oftentimes the provider will order a computed tomography (CT) scan to rule out serious medical problems, such as intracranial bleeding or stroke.
Head movement testing.
If your doctor suspects your vertigo is caused by benign paroxysmal positional vertigo, he or she may do a simple head movement test called the Dix-Hallpike maneuver to verify the diagnosis.
Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic. Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit.
Brain scans produce detailed images of the brain. They can be used to help doctors detect and diagnose conditions, such as tumours, causes of a stroke or vascular dementia.
Physicians should consider neuroimaging studies in patients with vertigo who have neurologic signs and symptoms, risk factors for cerebrovascular disease, or progressive unilateral hearing loss.
More specifically, a brain or head MRI can show if there are any abnormalities in your brain or the surrounding tissues, including, but not limited to: Inflammation and swelling. Structural issues. Abnormal growths or masses.
In a general sense, vertigo-associated disease is commonly treated using vestibular blocking agents or VBAs. These include medications such as antihistamines (promethazine or betahistine), benzodiazepines (diazepam or lorazepam), or antiemetics (prochlorperazine or metoclopramide).
Generally, see your doctor if you experience any recurrent, sudden, severe, or prolonged and unexplained dizziness or vertigo. Get emergency medical care if you experience new, severe dizziness or vertigo along with any of the following: Sudden, severe headache. Chest pain.
The inner ear and canalith repositioning
Benign paroxysmal positional vertigo may go away on its own within a few weeks or months. But, to help relieve BPPV sooner, your doctor, audiologist or physical therapist may treat you with a series of movements known as the canalith repositioning procedure.
This is especially true if an individual experiences frequent vomiting and becomes dehydrated. Less commonly, tumors that develop in the cerebellum—the part of the brain that controls movement—may cause vertigo, a condition characterized by balance problems and room-spinning sensations.
Most of the time, vertigo is nothing to write home about and will often clear on its own. If you experience dizzy spells or the sensation of feeling off-balance, you may have vertigo without knowing. However, if the world around you is spinning while you're sitting still, it could point to a more serious condition.
Central vertigo is due to a problem in the brain, usually in the brain stem or the back part of the brain (cerebellum). Central vertigo may be caused by: Blood vessel disease. Certain drugs, such as anticonvulsants, aspirin, and alcohol.
If you have been experiencing vertigo for more than a day or two, it's so severe that you can't stand or walk, or you are vomiting frequently and can't keep food down, you should make an appointment with a neurologist.
Many people who suffer from dizziness, imbalance, or vertigo have trouble finding out why. Dizziness and vertigo are not actually “diagnoses,” they are symptoms of a diagnosis.
No evidence has been found to suggest there's a risk, which means MRI scans are one of the safest medical procedures available.
One of the common neurological causes is benign paroxysmal positional vertigo (BPPV). This occurs when a small crystal of calcium in the ear moves, signaling to the brain that the body is spinning or swaying, even though it is not.
These episodes are triggered by a rapid change in head movement, such as when you turn over in bed, sit up or experience a blow to the head. BPPV is the most common cause of vertigo. Infection. A viral infection of the vestibular nerve, called vestibular neuritis, can cause intense, constant vertigo.
Can the symptoms of vertigo be confused with the symptoms of other diseases or conditions? Yes, this is a common occurrence. Usually they are mistaken because of use of the word dizziness. Dizziness can refer to lightheadedness, which is not vertigo and is commonly produced by vascular problems.
When To Seek Vertigo Emergency Care. Vertigo emergency care is recommended if you are experiencing new, severe dizziness or vertigo with any of the following symptoms: sudden, severe headache. shortness of breath.