Benign paroxysmal vertigo, where vomiting and sudden onset of dizziness precedes a headache is often a difficult peripheral vestibular disease which is frequently missed or misunderstood. Patients often display exaggerated nausea and vomiting, leading to incorrect diagnosis by doctors due to lack of specific knowledge on the physiology and pathophysiology of nausea and vomiting in this context. Recent studies have revealed that a majority of patients with benign paroxysmal vertigo are, in fact, suffering from primary irritable bowel syndrome or IBS and as a result the correct diagnosis is missed.
IBS is also known as spastic colon or mucous colitis. It is an inflammation of the large colon or large bowel, usually caused by trauma or other causes like infection, inflammatory bowel disease (IBD) or allergies. The symptoms are: abdominal pain, diarrhea or constipation, bloating, abdominal swelling, cramping, nausea and vomiting. The most common cause of IBS is structural abnormalities of the large intestine like polyps, adhesions or hernias, retrograde menstruation, or congenital abnormalities in the gut wall muscles. IBS is also related to changes in neurotransmitters in the brain like serotonin and noradrenalin. Some other causes of IBS include irritable bowel syndrome, gastroenteritis, celiac disease, fibromyalgia and hyperactivity/impulsivity.
A number of patients who suffer from benign paroxysmal vertigo also present with a number of serious and disturbing symptoms like vomiting, nausea, a feeling of being sick, numbness in the hands and feet, blurred vision and even a feeling of being in a daze. As these patients may not have a distinct history of migraine headaches, the exact cause of the symptoms may not be known. Studies show that there is an increased risk of developing IBS if the patient suffers from gastroenteritis. It is therefore advisable for patients to get a proper diagnosis of the condition before starting any treatment. Some of the diseases that can trigger a migraine headache include an infection in the upper gastrointestinal tract, allergic reactions, certain foods, alcohol, and caffeine.
Some patients with benign paroxysmal vertigo also have the complex disorder of BPPV (Benign Peripheral Paroxysmal Vaginitis). BPPV is a condition that causes inflammation and irritation of the internal organs like the lungs, stomach, intestines and the reproductive organs. It is characterized by an inflammation of the lower back, the genitals and the mouth.
Benign paroxysmal positional vertigo is closely associated with the abnormal movement of the eyeballs. Patients with the disorder experience the sensation of floating or moving around. Some of the common symptoms of BPPV are nausea, vomiting, loss of appetite, blurred vision and headaches. The episodes usually last for about thirty minutes and are frequently provoked by bending over, lying down or sneezing. Patients with the disease can also suffer from urinary tract infections.
Patients suffering from BPPV can also suffer from migraine headaches. The symptoms are quite similar to that of a normal migraine and are experienced in one or both eyes. Patients may also experience nausea, vomiting, visual disturbances, weakness in the legs, dizziness and muscle fatigue. BPPV is associated with a high risk of complications such as seizures and blindness. Therefore, it is very important to undergo a detailed neurological evaluation for any patients suspected of having this condition.
A large percentage of patients with BPPV do not exhibit any abnormalities at the neurological level. In fact, there are several types of patients who present with symptoms such as dizziness and lightheadedness without hearing loss for several weeks or months before progressing to more severe episodes of loss of balance and nausea. A neurological exam is the only way to diagnose BPPV.
Treatment for BPPV involves the use of medication and medical procedures that can relieve the symptoms. However, more permanent treatment is required in order to prevent the condition from developing into a more serious condition. A recent development in the field of neurology is the use of transcranial magnetic stimulation (TMS). This procedure has shown promise in treating patients suffering from BPPV without hearing loss or other severe symptoms.