DR Piyush Kumar Anshu

What is vertigo and dizziness and how do they differ?

Dizziness can be a challenging sensation to articulate, but it typically entails a perception of spinning, swaying, tilting, or an imminent loss of balance or consciousness. Additionally, dizziness can induce feelings of lightheadedness, giddiness, or difficulty maintaining a straight gait.

One prevalent form of dizziness is “vertigo,” which can give the impression that either you or the environment is in motion, even when you are stationary. Vertigo can arise from various underlying issues associated with the inner ear or brain.

What are the symptoms of vertigo?

If you have vertigo, you may feel like you are:

●Spinning (or the room is spinning around you)

●Tilting or swaying

●Off balance

The sensations may be intermittent, varying in duration from seconds to minutes, hours, or even days. Movements like turning one’s head, shifting positions (such as standing up or rolling over in bed), coughing, or sneezing could exacerbate the symptoms. In addition, depending on the root cause of the vertigo, other symptoms may manifest, such as

●Nausea or vomiting

●A headache or sensitivity to light and noise

●Double vision, trouble speaking or swallowing, or weakness

●Shortness of breath, sweating, or a racing heartbeat

If you think you may have vertigo, see your doctor. It will help if you can describe how long your symptoms last, what triggers the symptoms, and any other problems you are having. These clues can help point to the cause of your vertigo.

Why vertigo occurs?

Vertigo generally occurs when there is a disruption in the vestibular system, which regulates balance and comprises components of the inner ear and nervous system. Various ailments can impact the vestibular system, ranging from mild to severe, with some potentially posing a grave risk to one’s life.

What is the connection between vertigo and inner ear problems?

Some diseases of inner ear can present with vertigo. They are

Benign paroxysmal positional vertigo –Benign paroxysmal positional vertigo (BPPV) is a type of vertigo that occurs due to displaced calcium deposits in the inner ear. It is characterized by brief episodes of vertigo lasting from a few seconds to under a minute, often triggered by specific head movements. In most cases, BPPV resolves on its own, but it can be treated with a procedure called “canalith repositioning,” where a healthcare provider maneuvers the head to relocate the misplaced calcium deposits. This procedure, also known as the Epley maneuver, typically results in an immediate or delayed improvement in symptoms. Patients may be instructed to perform similar movements at home to manage recurrent symptoms. You can know more about this here-

Benign Paroxysmal Positional Vertigo

Meniere’s disease – Meniere’s disease is a chronic condition associated with an accumulation of fluid in the inner ear. It leads to recurring episodes of vertigo, hearing loss, tinnitus, and a sense of fullness in the ear, often affecting only one ear. Vertigo can be severe, lasting several minutes or hours, and accompanied by nausea and vomiting. Even after the episode, patients may experience a lingering feeling of imbalance that can last for days. Although Meniere’s disease is a lifelong condition, non-surgical treatments can be effective in managing symptoms in approximately 90 percent of patients.

Vestibular neuritis – Vestibular neuritis, also known as labyrinthitis, is believed to be caused by a viral infection that triggers inflammation around the nerve responsible for maintaining balance. Symptoms of vestibular neuritis include sudden and severe vertigo, nausea, vomiting, difficulty walking or standing up, and in some cases, hearing loss in one ear. Symptoms typically last for several days and gradually improve, although some patients may continue to experience residual dizziness or balance problems for several months. Permanent hearing loss can occur in some cases.

Is there a link between vertigo and migraines?

Vestibular migraine — Migraine can be a cause of episodes of vertigo. Most, but not all, people with vestibular migraine also have typical migraine headaches and other migraine symptoms (such as visual aura or light sensitivity) that can either accompany the spells of vertigo or occur separately. The duration of vertigo is variable, but most episodes last several minutes to a few hours.

Preventive treatments for migraine headache can also be helpful for vestibular migraine.

Can head injuries or trauma lead to vertigo?

●Head injury – Head injuries can affect the vestibular system in a variety of ways and lead to vertigo.

What other problems can cause vertigo?

●Medications – Some medications can affect the function of the inner ear or brain and lead to vertigo. Rarely, some medications can actually damage the inner ear.

●Problems affecting the brain – Stroke or transient ischemic attack (TIA), bleeding in the brain, or multiple sclerosis can also cause vertigo. There are usually other symptoms besides vertigo that occur with these brain problems.

Is vertigo a sign of a more serious underlying health condition?

You should seek help immediately if you have dizziness or vertigo along with any of the following:

●New or severe headache

●Fever higher than 100.4ºF (38ºC)

●Seeing double or having trouble seeing clearly

●Trouble speaking or hearing

●Weakness in your arm or leg

●An inability to walk without assistance

●Passing out

●Numbness or tingling

●Chest pain

●Vomiting that will not stop

In addition, you should seek help immediately if you have vertigo that lasts for several minutes or more if you:

●Are an older adult (60 years or older)

●Have had a stroke in the past

●Have risk factors for stroke (eg, high blood pressure, diabetes, or smoking)

What to expect when visiting a doctor for vertigo symptoms?

Doctor during consultation tries to find out the cause of vertigo by performing physical examination which consist of examining

●Your eyes – You might be asked to follow an object with your eyes, or focus on something while moving your head from side to side.

●Your balance and gait – This involves watching you walk, to see if you lean or tilt to one side, as well as checking your balance while you stand still.

●Your hearing – Your doctor will check your hearing in both ears.

Depending on what they find during your examination, your doctor might do additional tests. They might include an imaging test, such as magnetic resonance imaging (MRI), to look at the structure of your brain.

How is vertigo treated?

Vertigo can be a troublesome condition for many, but it is usually not a sign of a serious underlying problem. Treatment for vertigo is aimed at addressing the underlying cause if possible, managing symptoms, and promoting recovery.

If the cause of vertigo can be identified, disease-specific treatments may be recommended by your doctor. These treatments can range from medications and procedures to lifestyle changes. Depending on the underlying condition, treatment may focus on either resolving the vertigo or managing the condition to slow its progression and improve overall prognosis. Some common disease-specific treatments are described in the previous section.

For individuals experiencing severe or prolonged episodes of vertigo, regardless of the cause, medications may be prescribed to alleviate symptoms such as vomiting.

What medication help with vertigo symptoms?

Medications may include:

●An antihistamine, such as the prescription medicine meclizine or nonprescription medicines like dimenhydrinate  or diphenhydramine . These medicines are also commonly used to treat or prevent motion sickness.

●Prescription ant nausea medicines, such as ondansetron, promethazine), or metoclopramide.

●Prescription sedative medicines, such as diazepam, lorazepam or clonazepam. These medicines are commonly used to treat anxiety, but can also help relieve vertigo.

Most of these medicines make you sleepy, and you should not take them before you work or drive. You should only take prescription medicines to treat severe vertigo symptoms, and you should stop the medicine when your symptoms improve (usually within a day or two). Continuing to take these medications can interfere with long-term recovery.

Are there any exercises or physical therapy techniques that can help with vertigo?

Vestibular rehabilitation — Most people with vertigo feel better if they keep their head still. However, lying still and not moving your head can actually delay recovery in the long term. Vestibular rehabilitation can help people recover from vertigo that is caused by a problem within the vestibular system.

Vestibular rehabilitation works by helping your brain adjust its responses to changes in the vestibular system. It can also help train your eyes and other senses to “learn” how to adapt. This therapy is most helpful when it is started as soon as possible after you develop vertigo.

During rehabilitation, you will work with a physical therapist who will teach you exercises you can do at home. For example, you might start by focusing on an object with a blank background and move your head slowly to the right and left and up and down. You would perform this exercise for several minutes two to three times per day.

How can I prevent falls and injuries during a vertigo episode?

If you have trouble standing or walking because of vertigo, this increases your risk of falling. This is particularly a concern for older adults, as falls can lead to serious complications, such as a broken hip. Talk to your doctor, nurse, or therapist if you are worried about falling. To reduce the risk of falls, remove hazards in your home, such as loose electrical cords, slippery rugs, and clutter; wear sturdy shoes; and avoid walking in unfamiliar areas that are not lighted.

This set of exercises, called the Brandt & Daroff exercises, is used to treat the disturbing problem of benign positional vertigo.

They are specifically designed to treat those cases in which the cause is considered to be clumps of debris (like fine sediment) collecting in one of the canals of the inner ear.

The exercises disperse this debris away from the delicate balance membrane.

Rules

• Perform 3 times daily (if possible).

• Take about 10 minutes each time.

• Usually do 5 or more times to each side.

• They are beneficial only if dizziness is reproduced.

• Take antisickness tablets if nausea is a problem.

Method

1. Sit on the edge of bed; turn your head slightly to the left side (about 45°). Lie down quickly on the right side (ensure the back of the head rests on the bed). Wait for either 20 to 30 seconds or for any dizziness to settle.

2. Sit up straight. Wait for 20 to 30 seconds or for any dizziness to settle.

3. Repeat on the other side: turn the head slightly to the right side before lying down quickly on your left side.

Note:

• It doesn’t matter on which side you lie down first.

• Turn your head away from the side on which you lie down.

• It is important to reproduce dizziness with the exercises.

• If the exercises are done regularly, the symptoms should settle over a period of several days but this may vary from 3 to 4 days to weeks.

Steps for this excercise can be seen here

What are the precautions one must take before performing these excercises?

Precautions and contraindications to be aware of when performing Brandt & Daroff exercises:

Severe Dizziness: If you are experiencing severe dizziness, it may not be safe to perform these exercises. It’s important to seek medical advice before starting any new exercise program.

Neck or Back Pain: If you have neck or back pain, it’s important to speak with your doctor before performing these exercises, as they may worsen your symptoms.

Recent Head Injury: If you have recently suffered a head injury, it’s important to wait until you have fully recovered before starting these exercises.

Inner Ear Infection: If you have an inner ear infection, it’s important to wait until the infection has cleared before performing these exercises.

Cardiovascular or Respiratory Issues: If you have a history of cardiovascular or respiratory issues, it’s important to speak with your doctor before starting these exercises, as they may be more difficult for you.

It’s important to perform the exercises slowly and smoothly to avoid any sudden movements that could worsen your vertigo symptoms. If you experience any dizziness or discomfort during the exercises, stop and seek medical advice.

Are there any other methods and how they compare with Brandt & Daroff exercises?

The Epley and Semont techniques are alternative exercises used to alleviate vertigo symptoms.

While it is acceptable to attempt the Brandt-Daroff exercises at home, it is crucial that your doctor demonstrates how to perform the Epley and Semont maneuvers correctly before attempting them independently.

Your doctor may advise against performing the Epley maneuver at home due to its potential to compress arteries and induce vomiting.

Compared to other similar exercises, many individuals find the Brandt-Daroff exercises to be easier to perform at home and safer for those with back or spine injuries.

For some individuals, the Epley and Semont maneuvers are slightly more effective than the Brandt-Daroff exercises and take less time to complete.

To know more about this condition and discuss treatment options you can book appointment with doctor.

Book an appointment

Connect to my clinic

• Note –This is a condensed summary of diagnostic, therapeutic, and medication information and is not intended to be exhaustive. It serves as a guide to aid in understanding potential diagnostic and treatment options and should not be considered a complete source of information. It does NOT encompass all details regarding conditions, treatments, medications, side effects, or potential risks that may be relevant to a particular individual. It is not a substitute for professional medical advice, which is based on a doctors assessment of a patient’s unique health status after examining them. To receive comprehensive information about their health, medical queries, and treatment options, including the risks and benefits of medication use, patients should consult a doctor. This information does not guarantee the safety, efficacy, or approval of any treatment or medication for a specific patient.

What is benign paroxysmal positional vertigo (BPPV)?

BPPV, or positional vertigo, is a spinning sensation of the head (vertigo) brought on by a certain position of the head, usually sudden changes of position. The word “benign” means that it is not life-threatening and does not cause permanent damage to the ear or brain.

What is the cause of BPPV?

In most people the cause is unknown, but it can follow accidents causing neck or head injuries.

There are tiny pieces of floating debris ( calcium carbonate crystals) in the balance centre of the inner ear (the labyrinth). These little bits of sediment somehow upset the balance centre when disturbed.

What are the common triggers for BPPV?

Common triggers of BPPV include sudden head movements, such as rolling over in bed, looking up or down, or bending over. It can also occur after a head injury, as a result of aging, or as a complication of other inner ear problems.

What are the symptoms of BPPV?

• Dizziness: A brief attack of severe dizziness (vertigo), usually for about 10 to 30 seconds, that comes on a few seconds after a certain head movement
• Nausea: The spinning sensation of vertigo can cause feelings of sickness and nausea.
• Headaches: Some people with BPPV may experience headaches during or after an episode of vertigo.
• Ear ringing (tinnitus): BPPV can sometimes cause ringing or noise in the ears.
• Visual disturbances: Some people with BPPV may experience changes in vision, such as blurring or double vision, during episodes of vertigo.

The head movements that provoke an attack can be:

• tilting the head backwards

• changing from a lying to a sitting position

• lying on one ear or the other

• turning the head to the side with the neck injury

How long do the bouts of BPPV last?

Each attack usually lasts less than 30 seconds but can last 60 seconds or so. The attacks tend to come in bursts but usually settle within a few weeks and most people are able to return to work within a week. The bouts tend to come back after months or years, but some people only ever have one attack.

What are the effects of BPPV?

There are usually no ill effects in the long run. Unlike some other causes of severe dizziness, there is usually no vomiting, tinnitus (ringing in the ears) or deafness. The affected person has to be careful with driving.

Who gets BPPV?

Although it can occur at all ages, the elderly are affected most. It is the most common cause of vertigo in the elderly. Women are twice as likely as men to get it. BPPV is a surprisingly common problem.

How is BPPV diagnosed?

BPPV is diagnosed through series of test which will determine the cause of vertigo.

1. Medical history: Your doctor will ask about your symptoms, when they started, and if you have a history of head injury, ear disease, or other medical conditions.
2. Physical examination: Your doctor will examine your eyes, ears, nose, and throat to look for signs of infection, injury, or other conditions that could cause vertigo.
3. Dix-Hallpike test: This test involves rapidly moving your head into specific positions to see if it triggers vertigo. This test can help confirm the diagnosis of BPPV.
4. Other tests: Your doctor may perform other tests, such as an audiogram (hearing test), a vestibular evoked myogenic potential test (VEMP), or a balance test, to rule out other conditions that could cause vertigo.

If BPPV is suspected, your doctor may refer you to a specialist for further evaluation and treatment.

How is BPPV treated?

The treatment of benign paroxysmal positional vertigo (BPPV) typically involves a series of procedures designed to move the dislodged calcium crystals back to where they belong in the inner ear. Some of the most common treatment options for BPPV include:

1. Particle repositioning maneuver: This procedure involves a series of specific head movements designed to move the dislodged calcium crystals back to their proper place in the inner ear. This maneuver is also known as the “Epley maneuver.”
2. Brandt-Daroff exercises: This is a series of repetitive movements that can help reduce symptoms of vertigo and improve balance.
3. Vestibular rehabilitation: This is a type of physical therapy that can help improve balance and reduce the symptoms of vertigo.
4. Medications: In some cases, medications, such as antihistamines, anticonvulsants, or sedatives, may be prescribed to help relieve symptoms of vertigo.

It is important to note that BPPV can sometimes recur and that multiple treatments may be needed to resolve symptoms completely. In addition, some people may require ongoing vestibular rehabilitation to help improve their balance and reduce the risk of falls.

How long does it take to recover from BPPV?

The attacks tend to come in bursts but usually settle within a few weeks and most people are able to return to work within a week. The bouts tend to come back after months or years, but some people only ever have one attack.

However, some people may experience ongoing symptoms, even after treatment. In these cases, additional treatments or ongoing vestibular rehabilitation may be necessary to manage symptoms.

It is important to follow your doctor’s recommendations and to continue with any recommended treatments to ensure the best possible outcome.

Can BPPV come back after treatment?

Yes BPPV can come back after treatment if there is recurrent of dislodgement of debris in the inner ear.

What can be done to prevent BPPV?

Following steps can be taken to prevent BPPV from recurring

Avoid head and neck trauma: Head and neck trauma can increase the risk of BPPV, so it is important to take steps to protect your head and neck from injury. This can include wearing helmets when participating in sports or activities that carry a risk of head injury.

Maintain good posture: Maintaining good posture can help reduce the risk of BPPV, as poor posture can put strain on the neck and inner ear.

Avoid sudden head movements: Sudden movements, such as turning your head quickly, can trigger BPPV in some people, so it is important to avoid sudden head movements, if possible.

Avoid exposure to irritants: Exposure to irritants, such as chemicals or pollutants, can increase the risk of BPPV, so it is important to avoid exposure to irritants, if possible.

Vestibular rehabilitation: Vestibular rehabilitation, which is a type of physical therapy, can help improve balance and reduce the risk of falls, which can help prevent BPPV from recurring.

Can BPPV be cured?

BPPV can be treated, but it is not considered a curable condition. While particle repositioning maneuvers or other treatments can help resolve symptoms, there is a risk of recurrence, especially in older individuals or those with underlying health conditions.

However, with proper treatment and management, most people with BPPV are able to reduce the frequency and severity of symptoms and improve their quality of life. In some cases, vestibular rehabilitation or other forms of physical therapy can help improve balance and reduce the risk of falls, which can help prevent recurrence of BPPV symptoms.

Are there any lifestyle changes that can help manage BPPV symptoms?

Yes, there are several lifestyle changes that can help manage the symptoms of benign paroxysmal positional vertigo (BPPV):

• Avoid sudden head movements: Sudden movements, such as turning your head quickly, can trigger vertigo in some people, so it is important to avoid sudden head movements, if possible.
• Maintain good posture: Maintaining good posture can help reduce the symptoms of vertigo and improve balance.
• Stay hydrated: Staying hydrated can help reduce the symptoms of vertigo, as dehydration can worsen symptoms.
• Avoid triggers: Certain activities or substances, such as alcohol or caffeine, can trigger vertigo in some people, so it is important to identify and avoid triggers, if possible.
• Exercise regularly: Regular exercise, such as walking or swimming, can help improve balance and reduce the risk of falls, which can help manage the symptoms of BPPV.
• Manage stress: Stress can exacerbate the symptoms of BPPV, so it is important to find ways to manage stress, such as through meditation, yoga, or exercise.

What is tension headache?

A tension headache is a tight, constricting pain that covers the majority of the head and is often brought on by stress or tension. It is also known as a tension-type headache or a muscle contraction headache. It is the most common form of headache. Two out of every three people will experience a tension headache at some point in their lives. Many sufferers do not realize that the headaches are associated with tension until it is pointed out to them. There may be tenderness in the muscles of the head, neck, or shoulders. Unlike migraines, tension-type headaches are usually not associated with other symptoms like nausea, vomiting, or sensitivity to sound or light.

What is the cause of tension headache?

Overactivity of muscles of the scalp, forehead and neck causes tension headache. A dull ache or tightness in these areas, like a tight band around the head or a heavy weight on top, results from this overactivity.

Trigger factors

• Increased tension or stress (both mental and physical),

for example:

––excessive worry

––all work—no play

––long periods of study, typing or other sustained concentration

––perfectionism

• Increased tension in the neck muscles, for example:

––poor posture

––injuries to the cervical spine (neck)

• Repressed hostility, anger or frustration

• A poor, scrappy diet, for example eating on the run

(combined with stress)

What is the treatment?

The key to treatment is to attend to lifestyle adjustments including diet, exercise, attention to posture of the neck and stress management.

Self-help

The best treatment is to modify your lifestyle in order to eliminate or reduce the trigger factors. For example:

• Learn to relax your mind and body.

• During an attack, relax by lying down in a hot bath or spa with a warm dry cloth (or even a cold wet cloth) over the aching area.

• You could attend special relaxation courses such as yoga or meditation classes.

• Be less of a perfectionist; do not be a slave to the clock.

• Do not bottle things up. Stop feeling guilty. Approve of yourself. Express yourself and your anger.

• If your neck is aching, massage or mobilisation followed by special exercises should help.

For more information on this topic visit http://drpiyushneurologist.com/neck-pain/

Medication

A mild painkiller such as ibuprofen or paracetamol can help stop the pain, but avoid stronger drugs (including tranquillisers) unless directed by your doctor. Mild pain relievers are also available in combination with caffeine, which enhances the medication’s effect; an example is acetaminophen, aspirin, and caffeine . This combination may be recommended if a pain reliever alone does not relieve the headache.

Am I using too many medicine for my headache? How to know and when to see a doctor?

Pain relievers should not be used too often because overuse can lead to medication-overuse headaches or chronic daily headaches. If your headache responds to a pain reliever, you should continue taking these with each headache. However:

●Do not use pain relievers more than nine days per month on average or more than two doses per episode.

●If a pain reliever does not control your headache, talk to your health care provider for other suggestions.

Why is doctor telling me to take medicines daily? What precaution should I take while taking these medicines?

Preventive therapy is recommended for people with tension-type headaches that are frequent or long lasting or have a significant impact on a person’s ability to do their normal activities.

Antidepressant medicines called tricyclics (TCAs) are often used to help prevent frequent tension headaches. Examples of TCAs include amitriptyline (used most commonly), nortriptyline, and protriptyline. The dose of TCAs used for people with headaches is typically much lower than that used for treating depression. It is believed that these drugs reduce pain perception when used in low doses, although it is not exactly clear how the medicines work.

It is common to feel tired when you start taking TCAs; this is not always an undesirable side effect since it can help improve sleep if you take TCAs in the evening. Your health care provider may recommend taking amitriptyline or nortriptyline two hours before bedtime to prevent morning grogginess. If morning grogginess occurs, then the medication could be taken even earlier (around dinnertime). TCAs are generally started in low doses and increased gradually. Their full effect may not be seen for weeks to months.

Is it possible to prevent tension headaches?

Yes, it is possible to prevent tension headaches by implementing the following strategies:

Practice stress management techniques: Find healthy ways to cope with stress, such as deep breathing, meditation, or yoga.

Maintain good posture: Keep your back straight, your head up, and your shoulders relaxed to prevent muscle tension in the neck and head.

Exercise regularly: Regular physical activity can help reduce stress and tension.

Get enough sleep: Aim for 7 to 9 hours of sleep each night and maintain a consistent sleep schedule.

Avoid triggers: Keep track of activities or circumstances that trigger headaches, and avoid or minimize them as much as possible.

Limit alcohol and caffeine: Excessive alcohol and caffeine intake can contribute to headaches, so it’s best to limit their consumption.

Stay hydrated: Drink plenty of water to avoid dehydration, which can cause headaches.

It’s important to note that everyone is different and what works for one person may not work for another. It may take some experimentation to find the best strategies for preventing tension headaches in your particular case.

Are there any home remedies for tension headaches?

Yes, here are some home remedies for tension headaches:

Practice relaxation techniques: Try deep breathing, meditation, or yoga to help relax the muscles and reduce stress.

Apply heat or cold: Use a warm towel or ice pack on the affected area to help relieve pain.

Massage: Gently massage the temples, neck, and shoulders to help release muscle tension.

Stay hydrated: Drink plenty of water to avoid dehydration, which can contribute to headaches.

Avoid triggers: Identify and avoid triggers such as lack of sleep, hunger, stress, and eye strain.

Exercise regularly: Regular physical activity can help reduce tension and stress.

Get enough sleep: Maintaining a consistent sleep schedule can help prevent tension headaches.

Note: If the headaches persist or worsen, it is recommended to consult a doctor.

When should a person see a doctor for a tension headache?

You should see a doctor if your headaches:

1. Are frequent and interfere with your daily activities
2. Are severe and last for an extended period of time
3. Are accompanied by other symptoms such as fever, neck pain, vision changes, or confusion
4. Are causing significant distress or affecting your quality of life
5. Are not relieved by over-the-counter pain medication or home remedies
6. Have started suddenly or have changed in pattern or intensity
7. Are accompanied by other symptoms such as light sensitivity, nausea, or vomiting

If your headache is sudden, severe, or accompanied by other symptoms, seek medical attention right away, as these could be signs of a more serious condition. A doctor can help diagnose the cause of your headaches and recommend the best treatment plan.

Are tension headaches a chronic condition?

If headache is present for more than 15 days per month for at least three months then it is called chronic tension headache. For chronic tension-type headache, effective treatment involves the use of daily preventive medications (eg, tricyclic antidepressants), behavioral therapies, physical therapy, and lifestyle changes (eg, regular exercise and dietary changes).

To know more about this condition and discuss treatment options you can book appointment with doctor

Book an appointment

Connect to my clinic

What is idiopathic intracranial hypertension?

Idiopathic intracranial hypertension refers to a condition where the pressure inside the skull is increased without a clear underlying cause, thus the name “idiopathic” which means of unknown origin.

This increase in pressure causes headaches and vision loss.

What causes idiopathic intracranial hypertension?

The exact cause of idiopathic intracranial hypertension is unknown, hence the name “idiopathic.”. But idiopathic intracranial hypertension is more common in females and people who have obesity.

Certain medicines seem to make some people more likely to get idiopathic intracranial hypertension. These medicines include tetracycline, high doses of vitamin A, and growth hormone.

What are the symptoms of idiopathic intracranial hypertension?

The symptoms include:

●Bad headaches – Some people say the worst pain is right behind their eyes.

●Short periods of vision loss – This can happen in 1 or both eyes. It usually lasts a few seconds and might happen once in a while or several times a day.

●Dimming of vision

●Trouble seeing things at the edge of your line of sight

●Double vision

●Seeing flashing lights

●Noises inside your head – The noise might sound like rushing water or wind. It often pulses in time with your heartbeat and can come and go.

In rare cases, people with idiopathic intracranial hypertension lose their vision forever.

It is important to note that symptoms may vary in severity and frequency and that some individuals with idiopathic intracranial hypertension may not experience any symptoms at all.

Will I need tests?

Yes. Tests can include:

●Eye exam – An eye doctor will use special tools to look for swelling at the back of your eye, near the optic nerve . Most people with idiopathic intracranial hypertension have swelling of the optic nerve. The optic nerve connects the eye to the brain.

●Visual field test – This test checks how well you can see things that are at the edges of your line of sight. The test will be repeated from time to time to check your optic nerves.

●MRI or CT scan – These are imaging tests that take pictures of the inside of your brain. Your doctor can use them to check if a tumor or other problem is causing your symptoms.

●Lumbar puncture – During this procedure, a doctor puts a needle into your lower back to measure the fluid pressure inside your skull. A lumbar puncture is sometimes called a “spinal tap.”

How is idiopathic intracranial hypertension treated?

Treatment for idiopathic intracranial hypertension typically involves managing the symptoms and reducing the pressure inside the skull. This can be achieved by

●Weight loss – If you are overweight, your doctor will recommend healthy ways to lose weight. If you are very overweight and cannot lose weight through changing your diet and exercise habits, your doctor might recommend medicines or weight-loss surgery.

●Medicines – Your doctor might prescribe medicines that help lower the amount of spinal fluid your body makes. Spinal fluid is the fluid that surrounds the brain and spinal cord. They might also recommend medicines used to prevent and treat headaches.

●Surgery – Doctors only do surgery if losing weight and taking medicines don’t help enough or problem at hand is serious enough to cause permanent damage

The kinds of surgery include:

•Shunting – In this surgery, a doctor puts a device called a “shunt” into a fluid-filled space inside your brain. The shunt is connected to a tube that is placed under your skin and that empties into your belly. The shunt helps drain the extra spinal fluid from your brain and can relieve the pressure.

•Optical nerve sheath fenestration – In this surgery, a doctor cuts a tiny, window-like hole in the tissue that covers the optic nerve. This helps lower pressure on the nerve to help save your vision.

Can idiopathic intracranial hypertension lead to permanent vision loss?

Idiopathic intracranial hypertension can lead to vision loss, and in some cases, the vision loss can be permanent. Early diagnosis and treatment are important to prevent and manage vision loss in people with idiopathic intracranial hypertension. Regular eye exams and monitoring of symptoms can help identify vision problems early and allow for prompt treatment. In severe cases, vision loss may not be reversible, but prompt treatment can help prevent further vision loss and prevent other complications. If you have any vision worsening please refer to your doctor as quickly as possible.

What is my doctor monitoring for in my follow up visits?

1. Visual symptoms: Regular eye exams should be performed to monitor for changes in vision, such as blurred or double vision, and to detect any vision loss early.
2. Pressure inside the skull: Regular neurological exams and imaging tests (such as lumbar puncture or MRI) may be performed to monitor the pressure inside the skull.
3. Body weight: People with IIH should monitor their body weight and work with their healthcare provider to maintain a healthy weight, as being overweight or obese is a risk factor for IIH.
4. Medication use: People taking medications for IIH should monitor for any side effects and report any changes to their doctor.
5. Symptoms: People with IIH should monitor their symptoms, such as headaches and neck pain, and report any changes to their doctor.

What diet should I take if I am suffering from Idiopathic Intracranial hypertension?

A diet to manage idiopathic intracranial hypertension may involve reducing sodium intake and maintaining a healthy weight. Some specific dietary recommendations for people with this condition may include:

• Limiting foods high in salt and sodium, such as processed foods and fast food
• Choosing fresh fruits, vegetables, and whole grains
• Eating lean protein sources, such as chicken, fish, and legumes
• Drinking plenty of water to stay hydrated
• Avoiding carbonated drinks and high-sugar beverages

It is important to speak with your doctor or registered dietitian before making any major dietary changes, as they can help create an individualized plan that is safe and effective. Additionally, some people with idiopathic intracranial hypertension may need to limit their fluid intake and follow a low-fluid diet, so it’s important to discuss this with doctor.

Can idiopathic intracranial hypertension be cured?

There is no cure for idiopathic intracranial hypertension, but the condition can be managed with medical treatment and lifestyle changes. The goal of treatment is to reduce the pressure inside the skull and prevent further vision loss and other complications. In some cases, the condition may resolve on its own, but this is not always the case.

What is the prognosis for people with idiopathic intracranial hypertension?

The prognosis for people with idiopathic intracranial hypertension varies and depends on a number of factors, including the severity of symptoms, the presence of any underlying medical conditions, and the effectiveness of treatment. With proper treatment and management, most people with idiopathic intracranial hypertension are able to manage their symptoms and prevent further vision loss. In some cases, the condition may resolve on its own, but this is not always the case. Regular monitoring and treatment are important to manage symptoms and prevent complications.

In severe cases, vision loss may be permanent, and there is a risk of other complications, including chronic headaches, neck pain, and tinnitus. It is important to discuss the prognosis with your doctor.

To know more about this condition and discuss treatment options you can book appointment with doctor

Book an appointment

Connect to my clinic

Q When should I see a doctor for neck pain?

In most cases, neck pain can be treated conservatively with over-the-counter pain medications, ice, heat, massage, and strengthening and/or stretching exercises at home. If you still have pain or restrictions in your movement after a few weeks of conservative treatment, see your doctor for further evaluation.

Q What things I can do to relieve my neck pain at home?

To relieve neck pain you can take Acetaminophen or a nonsteroidal antiinflammatory medication (NSAID) such as ibuprofen or naproxen may help relieve mild to moderate neck pain.

Q What if my pain is not controlled with these medications?

If your pain is not relieved with NSAIDs or acetaminophen, or if you have severe muscle spasm, your doctor might prescribe a muscle relaxant. If this is not sufficient and your pain continues to be severe, they may also consider prescribing tramadol, a stronger pain medication, for a short time. Because tramadol is an opioid medication, it is associated with the risk of dependence or addiction; for this reason, doctors are cautious about prescribing it and often start with the smallest dose for the shortest time possible.

If pain continues beyond six weeks despite treatment with tramadol (or in people who cannot or should not take tramadol), or if pain is disrupting sleep, certain antidepressant medications may be recommended

Q Does using Ice at the sore area will relieve pain?

For some people, ice applied to the sore area can help relieve neck pain. In general, for acute injuries, ice is recommended as the initial treatment, especially if swelling is present.

You can also relieve muscle tightness by placing a bag of ice, bag of frozen vegetables, or a frozen towel to the painful area. The cold source should be wrapped in a thin dry cloth layer before it is placed on the neck to protect the skin. The ice or cold pack should be left in place for 15 to 20 minutes to deeply penetrate the tissues; this can be repeated every two to four hours until symptoms improve.

Q While using ice what should one be careful about?

Skin damage can result from excessive use of ice, especially in people with poor skin sensation; it’s a good idea to inspect your skin each time you apply ice. Look for changes in pigmentation (for example, lighter- or darker-colored areas) and let your doctor know if you notice any problems.

Q Can applying heat also help in relieving pain?

Heat can also help to reduce neck pain in some people. Apply moist heat for 10 to 15 minutes with a shower, hot bath, or moist towel warmed in a microwave. If you use a heated towel, be careful not to overheat, as this can cause skin injury.

Now let us talk about the exercise which you can do at your home to relieve the neck pain

You can help restore and preserve your range of motion with exercises that stretch and strengthen the neck muscles. Range of motion exercises and stretching may help decrease pain from muscle injury.

Q When is the best time to perform these excercises?

 It is best to perform stretching exercises when the muscles are warm, such as after the application of heat, or after a few minutes of cardiovascular warm-up exercises. Exercises can be done in the morning to relieve stiffness and again at night before going to bed.

Exercises are most effective if you do them twice a day, in the morning and before bed.

Before doing stretching or strengthening exercises, it’s a good idea to warm your neck and upper back muscles by taking a warm bath or shower or applying a heating pad or moist, warm towel.

Q How frequently should you do the exercise?

Exercises are most effective if you do them twice a day, in the morning and before bed.

Q When should I not trying to do these exercise, can they increase the pain?

If you have had a serious neck injury, do not try any new exercises or stretches before talking to your doctor.

Also, do not attempt these exercises if you have a pinched nerve in your neck, especially if there is pain or numbness into the arm and hand, unless recommended by a doctor.

While these exercises can dramatically improve symptoms of a pinched nerve, they can actually make the problem worse if done improperly.

Q what are the different neck exercises that I can do at home to relieve the pain?

●Neck rotation – Slowly look to the right. Hold for a few seconds. Look straight ahead and rest for a few seconds. Repeat 10 to 15 times, then perform on the left side.

●Neck tilting – Look straight forward, then tilt the top of your head to the right, trying to touch your right ear to your right shoulder (without raising your shoulder). Hold for a few seconds, then return your head to the center. Repeat 10 to 15 times, then perform on the left side.

●Neck bending – Tilt your head forward and try to touch your chin to your neck using a nodding motion. Hold for a few seconds, breathe in gradually, and exhale slowly with each exercise. Exhaling with the movement helps relax the muscles. Repeat 10 to 15 times. Relax your neck and back muscles with each neck bend.

●Shoulder rolls – In a sitting or standing position, hold your arms at your sides. Roll your shoulders backwards 10 to 15 times, moving in a rhythmic, rowing motion. Proper neck alignment posture is important during this exercise. Rest, then roll your shoulders forwards 10 to 15 times.

●Scapular retraction – While seated, hold your head in a neutral position and draw your shoulder blades backward (toward each other). Hold for 10 seconds, then relax. Repeat 10 to 15 times.

●Deep neck flexor strengthening – Lie on your back, on a flat surface, then draw your chin down (toward your chest) and inwards while contracting the deep muscles of your neck. For initial exercises, keep your head in contact with the ground and just “tuck.” Hold for five seconds, then relax. Repeat 10 to 15 times.

●Chest wall stretches – Stand in a doorway and hold your arms out to your sides with your elbows bent and your palms facing out. Place your elbows against the door frame, slightly below shoulder level. Then lean your chest forward while keeping your head in a neutral position as you slowly stretch your shoulder and chest muscles. Hold the stretch for 20 to 30 seconds, and repeat 10 to 15 times.

Q One must also reduce bad posture to decrease neck pain. What are common advise regarding posture maintainance?

You can help prevent or reduce neck pain by doing activities and using positions that emphasize a neutral neck position and minimize tension across the supporting muscles and ligaments. Extremes of range of motion and positions that cause constant tension should be minimized or avoided.

It may help to:

●Avoid sitting in the same position for prolonged periods of time. If you work at a desk, try to take periodic five-minute breaks throughout the day. Avoid looking up or down at a computer monitor; adjust it to your eye level. Visual changes or new glasses prescriptions can also affect the way you hold your head and neck to read.

●Avoid putting pressure on your upper back with things like backpacks, over-the-shoulder purses, or carrying children. Alternatives may include wheeled backpacks or cases and having a child walk or ride in a stroller.

●Avoid doing overhead work for prolonged periods at a time.

●Maintain good posture by holding your head up and keeping your shoulders back and down. Try to keep your neck in line with your body and avoid hunching forward. Pay attention to your neck and arm position when you are using your phone.

●Use the car or chair arm rests to keep your arms supported. Find the optimal seated alignment in your car for your entire spine and make sure the head rest is at a comfortable position for your neck.

●Sleep with your neck in a neutral position by using a small pillow under the nape of your neck (if you sleep on your back) or sleeping with enough pillows to keep your neck straight in line with your body (if you sleep on your side). If you sleep on your back, putting a pillow under the knees can help to flatten the spine and relax the neck muscles. Avoid sleeping on your stomach with your head turned to one side.

●Carry heavy objects close to your body rather than with outstretched arms.

Q Does massage or acupuncture help in relieving neck pain?

While there is limited evidence for therapies like massage and acupuncture in the treatment of neck pain, some people find that they are helpful (at least in the short term), and they are unlikely to be harmful.

Massage — Massage can be helpful for relieving muscle spasm. There are different types of massage, and people have different preferences about the technique and amount of pressure used. If you want to try massage, it’s best to seek out a licensed massage therapist with experience in treating people with neck pain.

Acupuncture — Acupuncture involves inserting very fine needles into specific points, as determined by traditional Chinese maps of the body’s flow of energy. Many acupuncturists have experience in treating people with neck pain; if you would like to try this, always consult your doctor before trying.

Q Does reducing stress can relieve my neck pain?

Emotional stress can increase neck tension and interfere with or delay the recovery process. Reducing stress may help to prevent neck pain from recurring. Relaxation techniques can relieve musculoskeletal tension. An example of a relaxation exercise is to take a deep breath in, hold it for a few seconds, and then exhale completely. Breathe normally for a few seconds, and then repeat.

Other activities that may help to reduce stress include meditation, mindfulness-based stress reduction programs, cognitive behavioral therapy, or progressive muscle relaxation.

Q What are mindfulness-based stress reduction programs? What benefit does it produce?

Some people also find that “mindfulness-based stress reduction” helps. This involves attending a program virtually or in-person to practice relaxation and meditation techniques with someone trained in this approach. It may be helpful in improving your ability to relax, cope with stress, and help manage your pain.

Q What is Cognitive behavioral therapy?

People with chronic neck pain may benefit from something called cognitive behavioral therapy (CBT). CBT involves learning about your condition (including addressing any misconceptions and fears that you may have about your pain), learning how to develop a more positive way of thinking, and setting activity goals and working toward those goals. CBT techniques may be performed by a psychologist or other trained professional.

Q Will yoga help in pain relieving?

Some people find activities with a mind-body focus, such as Tai Chi and yoga, to be beneficial. Whatever exercise program you follow, the goal is not only to improve pain but to help you regain function and be able to do your normal daily activities. In addition, staying active can help reduce stress and anxiety.

Q How good is physical therapy to relieve the pain?

Depending on your situation, your doctor might recommend working with a therapist or athletic trainer to develop an individualized exercise program. This typically involves a combination of stretching, strengthening, and stabilizing exercises. A physical therapist can teach you exercises that you can continue to do at home between treatments

Q Should I try spinal manipulation for my neck pain?

“Spinal manipulation” is a technique sometimes used by chiropractors, physical therapists, doctors, massage therapists, and others to relieve neck or back pain; it can be effective when used in conjunction with exercise. Manual therapy and joint mobilization are gentle types of manipulation that can help improve joint and soft tissue movement and flexibility.

While some people find that spinal manipulation helps with their pain, some studies have found that treatments that include quick “thrusting” of the neck are associated with a possible risk of serious injury. Aggressive manipulation or adjustments to the cervical spine should be avoided in people with certain conditions including cervical stenosis, cervical spondylotic myelopathy, or cervical radiculopathy.

Q What is trigger point injection? Is it recommended?

This involves injecting a local anesthetic medication (such as lidocaine) into the muscles at specific areas of tenderness. Some doctors may also do something called “dry needling” in nearby muscle fibers when doing the trigger point injection.

Trigger point injections may be recommended if conservative treatments do not significantly improve pain. However, there is no good evidence that trigger point injections help to reduce pain or speed healing in the long term. Trigger point injections with steroids into the neck muscles are not recommended due to the risk of injury to the muscles and lack of additional benefit.

Q What is the role of cervical collar?

A soft cervical collar is a piece of foam covered with fabric that is worn around the neck to support the head. While occasional brief use of a collar may be helpful in certain situations (for example, if you have periods of increased pain that interfere with sleep), long-term or routine use is discouraged as this may delay recovery or allow the neck muscles to weaken.

Q Does electrical stimulation always helps?

Transcutaneous electrical nerve stimulation (TENS) is a treatment that involves applying a mild electric current to the skin with the goal of decreasing pain and increasing mobility and strength. Evidence for its efficacy is mixed; your doctor can talk to you about this approach if you are interested in trying it.

Q When should I think of surgery to relieve my neck pain?

Surgery may have a role in relieving symptoms related to a pinched nerve caused by a herniated disc (cervical spondylotic myelopathy or cervical radiculopathy) if conservative therapy is not effective.

To know more about this condition and discuss treatment options you can book appointment with doctor

Book an appointment

Connect to my clinic

What is trigeminal neuralgia?

Trigeminal neuralgia (TN) is a condition that causes sudden and severe pain in parts of the face.

The trigeminal nerve, a nerve that connects the brain to the face, is the source of TN.

What are the symptoms of trigeminal neuralgia?

Attacks of TN are characterised by stabbing, severe pain in the cheek, lower face, or eye area. The pain typically only affects one side of the face and lasts for a few seconds to several minutes. Attacks could take place repeatedly. Often, certain movements or activities make the pain attacks happen. These can include:

●Touching the face

●Chewing

●Talking

●Brushing the teeth

●Smiling or frowning

●Cold air on the face

TN can also cause muscle spasms in the face, along with pain.

Who is at risk for trigeminal neuralgia?

It is found more often in women than in men (ratio 1.74:1) and is most common from 50 to 69 years of age[5]. Hypertension, arteriosclerotic vascular changes, aging, individual sensitivity, and familial history are important risk factors for trigeminal neuralgia

What are Triggers of pain for trigeminal neuralgia?

 Some common triggers include eating, talking, brushing teeth, cold, shaving and light touches to the face.  If you can’t figure out what’s causing your pain, it may be helpful to keep a pain diary in which you record key details of your environment and activity in order to look for common threads among different symptom flare-ups. It is very important that you identify these common triggers in your case and try best to avoid them.

Will I need tests?

Maybe. Your doctor  should be able to tell if you have TN by learning about your symptoms and doing an exam.

They might do tests to get more information about your TN or what’s causing it. These tests can include an MRI or CT scan of your brain. These are imaging tests that can create pictures of your brain

Can a blood test detect trigeminal neuralgia?

No , trigeminal neuralgia is not detected by blood tests.

How is trigeminal neuralgia treated?

TN is usually treated with medicine. Doctors  use different types of medicines to treat TN. Most often doctors prescribe a type of medicine normally used to prevent seizures. The one used most often to treat TN is called carbamazepine . There are several others, too. These medicines quiet the nerve signals that cause pain in TN.

For most people, the medicine helps reduce the number of TN attacks they have and makes their pain less severe. But if medicines don’t help enough or cause too many side effects, your doctor might talk with you about other treatment options. These include different types of surgical procedures that quiet the nerve and make it less likely to fire. These surgical treatments might help with symptoms, but side effects sometimes happen, including numbness or pain in the face.

Is trigeminal neuralgia lifelong?

Trigeminal neuralgia is usually a long-term condition. Episodes may last for weeks to months followed by pain free intervals. Painful episodes may recur. There could be variation in severity of painful episode with time.

Which fruit is good for nerves?

Berries, peaches, cherries, red grapes, oranges and watermelon, among others, are loaded with antioxidants, which help to decrease inflammation and reduce nerve damage. Plus, grapes, blueberries and cranberries have been found to be full of a powerful anti-inflammatory compound

Is there something I can do to relieve my pain ?

While home remedies may not be capable of completely curing trigeminal neuralgia symptoms, they can be very useful for reducing severity of pain

Many people find relief from trigeminal neuralgia pain by applying heat to the affected area. You can do this locally by pressing a hot water bottle or other hot compress to the painful spot.

Cold may also help relieve the pain, although you’ll obviously want to avoid this remedy if you’re one of the many trigeminal neuralgia sufferers for whom cold triggers symptoms.

 You can use an ice pack wrapped in a thin towel or pillowcase to numb the painful area. Keep the cold in contact with the affected area for about 30 seconds or until the area begins to feel numb.

Some trigeminal neuralgia sufferers find that switching between the hot and cold compresses helps more.

While many people find that a light touch — often as light as a gentle breeze wafting over their skin — can trigger trigeminal neuralgia symptoms, they also find that applying pressure to the area can help relieve symptoms. Use your entire hand to press on the affected area. You may need to apply a reasonable amount of pressure in order to get results.

To know more about this condition and discuss treatment options you can book appointment with doctor

Book an appointment

Connect to my clinic