The Vertigo Unit of the Hospital Costa del Sol treats around 850 patients annually in a specific consultation carried out by the Otorhinolaryngology (ENT) area of the Marbella center, whose objective is the diagnosis and treatment of vertigo and balance disorders.
Is about complex patients since, as they have detailed, the cause can be difficult to diagnose taking into account the variability of pathologies that, in addition to ear problems, can cause these symptoms that are so limiting and that affect people’s quality of life so much.
For the head of the service and specialist in Otorhinolaryngology, Manuel Olivathis complexity comes supervening because the patient “have difficulty describing your symptoms and, sometimes, vertigo is embedded within a spectrum of other pathologies”. In this sense, sufficient time is needed for an in-depth study and ample space to be able to introduce stretchers and carry out tests, he explained.
The hospital explained in a statement that between 20 and 30% of primary care consultations are usually related to vertigo, dizziness or balance disorders. In general, vertigo is more frequent in women than in men, in a ratio of 60/30, respectively. The causes that can cause vertigo are many and varied, although in this consultation the professionals focus mainly on those related to the ear.
In this sense, heThe most frequent processes are benign paroxysmal positional vertigo (common disorder that causes brief episodes of vertigo in response to changes in head position), Ménière’s disease (inner ear disorder that causes episodes of dizziness and hearing loss), and vestibular neuritis (involvement of the vestibular nerve considered one of the main causes of a vestibular syndrome with acute vertigo).
Nevertheless, there are also other diseases such as vestibular migrainecertain dysfunctions of the temporomandibular joint, drug side effects, brain infarctions or ischemia, brain tumors, etc., which have little or nothing to do with ear problems and can cause vertigo/dizziness/balance disorders.
On the other hand, psychological problems (psychogenic vertigo and Persistent Postural-Perceptual Dizziness or PPPD) also constitute a very important group of patients. Sometimes the patient’s psychology is what causes the symptoms, leading to their magnification, due to stress, or some other cause. However, in most cases there is a real underlying pathology, although the psychological conditions of the patient can camouflage, mix the symptoms or even distort and complicate the diagnosis.
Problems related to vertigo They represent a very important decrease in the quality of life of those who suffer from them.. Its affectation can range from vertigo so you can have a moderate crisis of about 30 minutes, a few times a month; even those patients who may have an internal, disabling crisis, lasting hours and several times a week. In the words of this head of service: “Fortunately, the latter are the least frequent, but they can destroy the patient’s life.”
In this case, you added that “many of them also have their hearing affected, progressively losing it in one or both ears and they are accompanied by tinnitus, a continuous intense beeping sound that there is no way to eliminate. Sometimes it is controlled with headphones and sometimes it is not. Hearing problems also influence, and a lot, the patient’s relationships with the rest of the environment of her “.
In general, for this expert, the best way to avoid and improve this type of pathology is “like everything in health, lead a healthy life, Mediterranean diet, regular exercise and avoid stress. In cases of vestibular migraine it is also recommended to avoid some foods rich in tyramine such as chocolateaged cheeses or shellfish, and alcohol, food additives or caffeine, which could precipitate crises.”
Some of these pathologies have different levels of severity that have been studied using scientific methods that analyze qualitative data. For example, with Melière’s disease, the American Academy of ENT developed a scale to functional level of the disease based on the degree of functional involvement of the disease in the daily life of the patient from a level 1 (the disease does not affect me at all) up to level 6 (I have been off work for more than 1 year due to this illness). This and other questionnaires to numerically assess the impact of vertigo are also available in this Costa del Sol Hospital consultation.
In addition, this consultation offers all kinds of treatments that They range from information and advice when it comes to banal and sporadic pathology. In these cases, it is only necessary to adequately inform the patient because their problem is not serious and to offer possible diagnostic/therapeutic alternatives on how to deal with the disease. Drug treatment is also offered.
Likewise, there are physical and rehabilitative treatments. One of the most common causes of vertigo is Benign Paroxysmal Positional Vertigo. Its treatment consists of doing some maneuvers in the consultation to manage to mobilize some particles lodged in one of the semicircular canals.
According to Manuel Oliva, “It is surprising, because in the most favorable cases, the patient can leave the consultation completely cured. On other occasions, it is necessary to teach the patient to correctly use their balance system, or what is left of it, in order to lead a life as normal as possible”. For this treatment, this consultation has the help of the Rehabilitation service and the balance rehabilitation protocols.
Another treatment option is vertigo surgery that is carried out when the cause lies in one of the ears and cannot be controlled with conservative measures. In these cases, surgery is used to destroy the malfunctioning ear. Since a sensory organ is lost, it has to be complemented by subsequent balance rehabilitation.
Finally, psychotherapy is also a first-order treatment. In some cases, the patient has a significant underlying psychiatric pathology. In Oliva’s words, “in some cases we have detected attempted suicide in the consultation that had not been manifested with other specialists and, therefore, the participation of a psychiatrist and/or psychologist is needed,” he concluded.