Monday, April 8, 2013

3 Minute Consult: Vertigo in Women

Springtime is upon us, pollen is in the air wreaking havoc on those of us with allergies.  Another common ailment I have been noticing with increasing frequency is vertigo in young, middle and older aged women.  Today I wanted to share some of what I have found and add my own thoughts.

Vertigo attacks occur more frequently in women and can increase with age.  It is a subtype of 'dizziness' categorized by a whirling, spinning sensation.  It affects the vestibular system (inner ear) through altering fluid balance. 

The main type of peripheral vertigo is benign paroxysmal positional vertigo.  Symptoms of BPPV include nausea, vomitting, fullness, pain or ringing of the ears, and imbalance.  It is due to calcium carbonate crystals in the inner ear becoming unbalanced.  The crystals can be realigned by a medical professional through the Epley maneuver.  However, crystals can shift again and it would have to be performed again.

This is much more common than central vertigo which is caused by injury occuring in the brain or brainstem ie. stroke, trauma, tumors, multiple sclerosis, migraine headaches and many others.

Since most people experience mild, yet persistent symptoms most folks just treat symptoms as they occur.  The drug of choice for vertigo is meclizine (brand: Antivert).  It is technically an antihistamine like Benadryl or Claritin, but it its claim to fame is its anticholinergic properties.  Meaning it is really, really, really DRYING of all secretions.  Think dry mouth, dry eyes, dry EARS!  It is believed that by decreasing the fluid in the inner ear meclizine renders some benefit.  It also has the added benefit of decreasing nausea and not so great for daytime, but great at night side effect of drowsiness.

So just to be prepared if you notice your vertigo symptoms occur more frequently during certain times of the year or under certain stressors you can pre-medicate to prevent symtoms.  Chlorpheniramine would be a great choice to provide anticholinergic effects without being as sedating as meclizine and is also a great antihistamine.  So if you have seasonal allergies you could also follow this advice for preventing allergy symptoms before they start!