Ask Dr. Pat

Ask Dr. Pat: Vertigo, Cause and Treatment

Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

Dr. Patricia Yarberry Allen is a collaborative physician who writes a weekly “Medical Monday” column for Women’s Voices for Change.  (Search our archives for her posts, calling on the expertise of medical specialists, on topics from angiography to vulvar melanoma.)

For this week’s subject, the concerns of a woman who is experiencing vertigo symptoms, Dr. Pat turns for expertise to another Dr. Allen—her son Baxter, a Board-certified neurologist, graduate of New York Presbyterian Hospital Neurology Residency program and Clinical Neurophysiology Fellow at New York Presbyterian Hospital. Dr. Baxter Allen has been involved in head trauma research for the last five years and will be a Neurocritical Care fellow at UCLA starting in July 2017.

 

 

Dear Dr. Pat,

I woke up with strange dizziness four months ago that was accompanied by nausea and vomiting. The room felt like it was spinning every time I moved. I had never experienced anything like this and was really frightened. I am 42 and have always been really healthy.  I saw my GP right away and he said I probably had an attack of vertigo brought on by a bad cold that I had suffered through six weeks before. He did tell me that dizzy spells like this were common and nearly always went away. He prescribed an antihistamine, along with rest, and sure enough, my symptoms disappeared. However, this vertigo came back two weeks later and still comes and goes with no special warning. My GP said he didn’t have any other treatments to recommend and that I would have to see someone at the university medical center for further evaluation. I have to travel quite a distance to see a specialist and wondered if there is anything that can really be done to solve this. It is really affecting my quality of life. By the way, what causes this anyway? Can something really be done to make this better?

Rebecca

 

Dr. Baxter Allen Responds:

Dear Rebecca,

The symptoms of vertigo are always unsettling. Patients often describe them like this: “The room is spinning; but I’m sitting still on my couch. I feel like I am on a boat, rocking in the ocean; even though I’m nowhere near either. When I try to walk, it’s like I’m drunk; except I haven’t had a glass of wine in weeks.”

These are some of the more common descriptions doctors hear from patients suffering from vertigo. Vertigo has many causes; can be brief or chronic; completely benign, or, much less commonly, the first symptom of something serious, like a stroke.

When a doctor sees a patient complaining of dizziness, it’s important to figure out which category it falls under:

  • Vertigo, the most common form, is the sensation of movement when not moving, or significantly exaggerated feelings with minimal movement.
  • Lightheadedness, or “pre-syncope,” is feeling like you’re going to faint or pass out; usually occurs with quick changes in position while dehydrated, or with cardiovascular disease.
  • Disequilibrium is the feeling of being off balance or “tilted” toward one side, and is generally accompanied by frequent falls in one direction.
  • Non-specific dizziness is used to as a catch-all when the symptoms are vague or don’t fit neatly into one category or another.

 

600px-Blausen_0329_EarAnatomy_InternalEarSource: Wikimedia Commons

 

Next Page: Causes of Vertigo

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