Understanding Vertigo and its Diagnosis
Vertigo is a type of dizziness that involves a sensation of spinning or movement, which can lead to difficulty in balance and orientation. The condition can be debilitating and can interfere with daily activities of a person. Vertigo is not a disease, per se, but a symptom that can result from various underlying medical conditions. Therefore, it is essential to diagnose the underlying etiology of the vertigo to determine the treatment course.
The diagnosis of vertigo involves a careful assessment of medical history, physical examination, and specialized tests, with a focus on identifying the root cause of the symptoms. In this article, we will discuss who can diagnose vertigo and other essential aspects of the diagnosis process.
Medical Professionals Who Can Diagnose Vertigo
Various medical professionals can diagnose vertigo, depending on the underlying cause and severity of symptoms. These professionals are:
- Primary Care Physicians: Primary care physicians are the first point of contact for patients seeking medical attention for vertigo. They can diagnose vertigo resulting from benign paroxysmal positional vertigo (BPPV), Meniere’s disease, migraines, and other common causes of vertigo. If the underlying cause remains unsolved, they may refer the patient to a specialist for further evaluation.
- ENT (Ear, Nose, and Throat) Specialists: ENT specialists have a special interest in vertigo because several conditions, such as Meniere’s disease, involve the inner ear. They can perform videonystagmography (VNG) and other specialized tests to determine the underlying cause of vertigo, such as vestibular neuritis or labyrinthitis. They may also prescribe medications or recommend vestibular rehabilitation therapy (VRT) to alleviate symptoms.
- Neurologists: Neurologists specialize in diagnosing and treating diseases of the brain and nervous system. They can diagnose vertigo caused by migraines and other neurological conditions. They can perform specialized tests like magnetic resonance imaging (MRI) or computed tomography (CT) scan to rule out brain tumors, strokes, or other brain disorders as potential causes of vertigo.
- Physical Therapists: Physical therapists can perform vestibular rehabilitation therapy (VRT) to alleviate symptoms of vertigo. They can also teach patients exercises to improve their balance and mitigate the risk of falls.
Medical History and Physical Examination
The diagnosis of vertigo begins with a complete medical history and physical examination, which provides valuable insights into the symptoms and underlying cause of vertigo. During the examination, the doctor may perform the following tests:
- Dix-Hallpike Test: The Dix-Hallpike test is a simple test that involves the patient lying flat on their back with their head overhanging the edge of the table. The doctor then quickly moves the patient’s head to one side and observes for any nystagmus (involuntary eye movement). This test is commonly used to diagnose cases of BPPV.
- Romberg Test: The Romberg test evaluates a patient’s balance by asking them to stand with their feet together and their eyes closed while the doctor observes their sway.
- Hearing Tests: The hearing test is performed to rule out hearing loss as a cause of vertigo.
- Blood Tests: Blood tests can detect any underlying medical conditions, such as anemia, that may cause vertigo.
Specialized Tests for Diagnosis of Vertigo
If the medical history and physical examination suggest that the patient has vertigo, the physician may perform specialized tests to determine the underlying cause. These tests include:
- Videonystagmography: VNG is a diagnostic test that evaluates the vestibular system’s function and involves recording eye movements with video cameras as a patient performs different head movements. It can diagnose conditions such as BPPV, vestibular neuritis, and labyrinthitis.
- Magnetic Resonance Imaging (MRI): An MRI may be recommended if the physical examination shows signs of central nervous system (CNS) involvement, such as facial weakness, double vision, or headache.
- Computed Tomography (CT) Scan: CT scans can detect small lesions that may cause vestibular symptoms and rule out other causes, such as a stroke or brain tumor.
- Rotational Chair Tests: These tests assess the vestibular system’s function by exposing the patient to different rotational speeds while measuring their eye movements. They are useful in diagnosing conditions such as bilateral vestibulopathy and Meniere’s disease.
When to Seek Medical Attention for Vertigo?
One should seek medical attention if they experience:
- Sudden onset or severe vertigo
- Difficulty walking or maintaining balance
- Chest pain or shortness of breath
- Loss of consciousness or fainting
- Fever or severe headache
The diagnosis of vertigo involves a careful assessment of medical history, physical examination, and specialized tests, including VNG, MRI, and CT scan. The diagnosis of the underlying cause is essential to determine proper treatment. Various medical professionals, including primary care physicians, ENT specialists, neurologists, and physical therapists, can diagnose vertigo.
- Kim, H., & Kim, J. (2017). Diagnosis of Vertigo: Clinical Approach. Seminars in neurology, 37(5), 505-515.
- Bhattacharyya, N., Gubbels, S. P., Schwartz, S. R., & et al. (2017). Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngology–Head and Neck Surgery, 156(3_suppl), S1-S47.
Frequently Asked Questions (FAQs)
- Q1. Can an optometrist diagnose vertigo?
- Q2. Can anxiety cause vertigo?
- Q3. Can allergies cause vertigo?
- Q4. Can dehydration cause vertigo?
- Q5. Can a chiropractor diagnose vertigo?
No, optometrists are not trained to diagnose vertigo. If you experience vertigo, you should seek medical attention from a primary care physician, ENT specialist, neurologist, or physical therapist.
Yes, anxiety can cause vertigo in some cases, such as panic disorder or generalized anxiety disorder. If you experience vertigo along with anxiety or emotional distress, you should seek medical attention to determine the underlying cause.
Yes, allergies can cause vertigo in some cases, particularly if they affect the inner ear. If you experience vertigo along with seasonal allergies, you should seek medical attention from an ENT specialist to determine the underlying cause.
Yes, dehydration can cause vertigo in some cases. Dehydration can cause dizziness, light-headedness, and difficulty in balance, which can result in vertigo. Drinking plenty of fluids can alleviate symptoms of dehydration-induced vertigo.
No, chiropractors are not trained to diagnose vertigo. If you experience vertigo, you should seek medical attention from a primary care physician, ENT specialist, neurologist, or physical therapist.