Vertigo is the term used for a spinning sensation or a feeling that the world is moving around you. The cause of this sensation often lies in the balance organ in the inner ear or in the balance nerve, but it could also come from conditions in the brain. Maintaining posture and balance, however, is a very complex process involving not only the balance organ and it’s central connections to the brain and cerebellum (the part of the brain concerned with automated movements), but also sensory input from the eyes, neck, spine, weight bearing joints and foot-sole sensation as well as muscle activity in the neck, torso and legs. The problem becomes particularly complex if more than one of these systems are affected simultaneously.
Diagnosis and treatment of vertigo can be easy and straightforward if the pattern conforms with classically described conditions, but it can also be extremely difficult if the symptoms are atypical. Diagnosis relies to a large extent on the history: the exact symptoms and pattern of the disease. It is therefor crucial to give exact and detailed information when you visit your ENT specialist, yet keep information to the point.
Before visiting your ENT specialist, consider the following points:
* How would I describe my symptoms (what exactly does it feel like)?
* When exactly did my symptoms start for the very first time?
* How did it change between then and now? Is it increasing in degree, staying the same or improving?
* Have I had similar symptoms in the past?
* Are the symptoms constantly present or does it come and go?
* If it comes and goes, does it only vary in degree, or does it come in “attacks” (feeling fairly normal in between)?
* If it comes in attacks, how frequent are the attacks and how long do they last?
* Is there anything (like diet, exercise, emotional factors, fatigue, specific movements, specific positions of my head, lying down or standing up, eyes open or eyes closed) which causes the symptoms to increase (or decrease) or which elicits an attack?
* Has my hearing been affected in this time as well, or is my hearing being affected during attacks?
* Do I have any other symptoms, especially during attacks (ringing in my ears, fullness in my ears, headache, nausea, pain in my neck)?
* What medication (if any) have I tried and what was the effect?
(Once you have made an appointment, you can, if you wish, complete the Vertigo questionnaire and submit it. It will be sent directly to Dr. Eras van der Walt’s email and will be treated in strict confidentiality).
(As u reeds ‘n afspraak gemaak het, kan u die Vertigo vraelys voltooi en stuur. Dit word direk na Dr. Eras van der Walt se persoonlike epos adres gestuur en word streng vertroulik hanteer).
Because of the complexity of this problem and considering the multitude of conditions which could cause the problem, you should be prepared for a longer than average visit and possibly a higher than average consultation fee, as well as some follow-up visits. You should also be prepared to be sent for further tests and examinations which may be required, e.g. a hearing test (because balance and hearing are often affected by the same disease process), an MRI of the brain and a VNG (a series of tests aimed at isolating different portions of the balance organ to identify the part which is not functioning well).
One last thought: if you should read about your symptoms, be careful not to jump to conclusions regarding a diagnosis or treatment. Also be wary of friends or family offering solutions because they have had “exactly the same thing”. There is a minefield of almost similar conditions and it can be quite difficult to identify your specific disease.
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