Vertigo

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The only vertigo office in Latvia, where you can receive a consultation from highly qualified specialists (neurootorhynolaryngologist and neurologist). The diagnosis is determined by using modern equipment: audiometer, tympanometer, as well as the only head impulse test examination device in Latvia.

If you have recurring episodes of vertigo, immediately consult your physician. It is important to determine the cause of vertigo in order to apply an appropriate therapy or control method that will improve the quality of life, health and well-being.

Vertigo

Vertigo (vertigo and pseudovertigo) is one of the most common complaints that people have, when they visit their general practitioner. Epidemiology data bear evidence that vertigo is reported by 20-25% of residents. This symptom is especially common among elderly people. However, only 15% of patients with complaints of vertigo are referred by general practitioners to specialists – neurologists or otorhinolaryngologists (ENT).

It is important for the physician to be able to differentiate between vestibular (vertigo) and non-vestibular (pseudovertigo) by determining the impairment of anatomical structures that causes it, the cause thereof, because therapy and results depend on this. It must be remembered that vertigo is one of the least homogeneous symptoms that requires precise examination.

Most common causes of vertigo

Causes of peripheral vestibular syndrome at the level of labyrinth (parts of inner ear): benign paroxysmal positional vertigo, Meniere’s disease, vestibular neuritis, neurolabyrinthitis (after viral infection), labyrinthitis (secondary, in the event of mastoiditis or otitis media), kinetoses, vertigo after ear surgeries, vascular (blood supply) disorders in the labyrinth – ischaemia in the labyrinth artery basin, haemorrhage, perilymphatic fistula, traumatic injuries of auditory ossicles and other traumatic injuries, developmental abnormalities and congenital diseases, ototoxic/vestibulotoxic medications, tumours.

Causes of peripheral vestibular syndrome at the level of vestibular nerve: infections, reaction to inflammation in adjacent tissue, tumours, cysts, nerve compression caused by an artery or a vein. The symptoms that resemble the symptoms of trigeminal neuralgia – short-term (lasting for a few seconds to several minutes) seizures of systematised vertigo.

Most frequent causes of central vestibular vertigo: acute ischaemic disorders of cerebral circulation, brainstem encephalitis, brainstem tumours, brainstem trauma and consequences thereof, degenerative diseases of the CNS, pathologies of craniospinal junction, for instance, Arnold-Chiari malformation.

Most common causes of non-vestibular vertigo

  • Visual vertigo: rapid paralysis of eyeball muscles, pronounced signs of refraction, defects of optical fields cataract, macular degeneration.
  • Presyncope vertigo: orthostatic hypotension and hypotension of other origin, cardiogenic diseases (heart arrhythmias, cardiac failure, pronounced aortic stenosis), hypotensive and psychoactive medications, hypovolemia, changes in blood composition (anaemia, hypoglycaemia, hypocapnia), vasovagal syncope.
  • Psychogenic vertigo: hyperventilation due to anxiety, affective cognitive disorders.
  • Balance co-ordination disorders: polyneuropathies, ataxias.
  • Cortical vertigo: epileptic activity in temporal cortex.

Ultrasound of blood vessels of the head and neck
24 h blood pressure monitoring
Examination of autonomous nervous system
Head impulse test examination
Audiometry