From the Guidelines
Aural vertigo is a type of dizziness caused by inner ear problems, specifically a disruption in the vestibular system, which is responsible for maintaining balance and spatial orientation, as defined by the American Academy of Otolaryngology-Head and Neck Surgery Foundation 1. The most common form of aural vertigo is benign paroxysmal positional vertigo (BPPV), where calcium crystals in the inner ear become dislodged and move into the semicircular canals, causing false signals about head movement to be sent to the brain. Other causes of aural vertigo include:
- Meniere's disease
- Vestibular neuritis
- Labyrinthitis Symptoms of aural vertigo typically include:
- Spinning sensations
- Unsteadiness
- Nausea
- Sometimes hearing changes or tinnitus Treatment of aural vertigo depends on the underlying cause, but may include:
- Vestibular rehabilitation exercises
- Medications like meclizine or diazepam for symptom relief
- Specific maneuvers like the Epley maneuver for BPPV These treatments work by either repositioning the displaced crystals, reducing inflammation, or helping the brain compensate for the abnormal signals from the inner ear, as recommended by the clinical practice guideline for BPPV 1. It is essential to see a healthcare provider for proper diagnosis, as treatment approaches vary based on the specific condition causing the symptoms, and to improve the quality of care and outcomes for patients with aural vertigo, as emphasized by the American Academy of Otolaryngology-Head and Neck Surgery Foundation 1.
From the Research
Definition and Characteristics of Aural Vertigo
- Aural vertigo, also known as benign paroxysmal positional vertigo (BPPV), is a condition related to the inner ear that causes brief, intense episodes of vertigo triggered by specific head movements 2, 3, 4, 5, 6.
- The condition is characterized by the presence of calcium particles (otoconia) in the canals of the inner ear, which can cause abnormal stimulation of the hair cells in the ear, leading to vertigo 2, 3, 4.
Association with Meniere's Disease
- BPPV can be associated with Meniere's disease, a disorder of the inner ear that affects balance and hearing 2, 3, 4, 5, 6.
- Studies have shown that patients with Meniere's disease are more likely to experience BPPV, and that the condition can affect the same ear as the Meniere's disease 5, 6.
- The presence of Meniere's disease can also affect the treatment and outcome of BPPV, with some studies suggesting that patients with Meniere's disease may require more therapeutic sessions and have a higher rate of recurrence 2, 3, 4.
Clinical Features and Treatment
- The clinical features of BPPV associated with Meniere's disease can differ from those of idiopathic BPPV, with a higher percentage of female patients, longer duration of symptoms, and more frequent involvement of the horizontal semicircular canal 3, 4.
- Treatment of BPPV typically involves the canalith repositioning procedure, which can be effective in relieving symptoms, but may require more attempts in patients with Meniere's disease 2, 3, 6.