MERF runs a sophisticated Vestibular laboratory with the latest VideoOculography (from Interacoustics-Denmark), one of the few in India with a dedicated team under Dr. Sathiya Murali, Consultant ENT Surgeon to assess, evaluate and treat patients with dizziness and balance dysfunction. Vestibular Evoked Myogenic Potentials (VEMP) is one of the latest facilities for assessment of vertigo. It is very useful for assessing the various causes of vertigo such as Meniere's disease, vestibular schwannoma, aminoglycoside ototoxicity.

MERF is one of the very few centres in the country which performs surgery for vertigo – Trans labrynthine vestibular nerve section,Trans labrythine acoustic neuroma surgery,Vestibular neurectomy & Endolymphatic sac surgery.

Vertigo Overview

Vertigo is the feeling that you or your environment is moving or spinning. It differs from dizziness in that vertigo describes an illusion of movement. When you feel as if you yourself are moving, it's called subjective vertigo, and the perception that your surroundings are moving it is called objective vertigo. Unlike nonspecific lightheadedness or dizziness, vertigo has relatively few causes.

Causes of vertigo

Vertigo can be caused by problems in the inner ear or brain.
• Benign paroxysmal positional vertigo(BPPV) is the most common form of vertigo and is characterized by the sensation of motion initiated by sudden head movements or moving the head in a certain direction. This type of vertigo is rarely serious and can be treated.
• Vertigo may also be caused by inflammation within the inner ear (labyrinthitis or vestibular neuritis), which is characterized by the sudden onset of vertigo and may be associated with hearing loss. The most common cause of labyrinthitis is a viral or bacterial inner ear infection.
• Meniere's disease is composed of a triad of symptoms including episodes of vertigo, ringing in the ears (tinnitus), and hearing loss. People with this condition have the abrupt onset of severe vertigo and fluctuating hearing loss as well as periods in which they are symptom-free.
• Acoustic neuroma is a type of tumor of the nerve tissue of the ear that can cause vertigo. Symptoms include vertigo with one-sided ringing in the ear and hearing loss.
• Vertigo can be caused by decreased blood flow to the base of the brain. Bleeding into the back of the brain (cerebellar hemorrhage) is characterized by vertigo, headache, difficulty in walking. Walking is also extremely impaired.
• Vertigo is often the presenting symptom in multiple sclerosis. The onset is usually abrupt, and examination of the eyes may reveal the inability of the eyes to move past the midline toward the nose.
• Head trauma and neck injury may also result in vertigo, which usually goes away on its own. Cervical vertigo can be caused by neck problems such as impingement of blood vessels or nerves from neck injuries.
• Migraine, a severe form of headache, may also cause vertigo. The vertigo is usually followed by a headache. There is often a prior history of similar episodes but no lasting problems.
• Complications from diabetes can cause arteriosclerosis (hardening of the arteries) which can lead to lowered blood flow to the brain, causing vertigo symptoms.

When to Seek Medical Care?

• Any signs and symptoms of vertigo should be evaluated by a doctor. The majority of cases of vertigo are harmless. Although vertigo can be debilitating, most causes are easily treated with medications. Have a doctor to check for new signs inorder to rule out rare, potentially serious, or life-threatening conditions.
• Certain signs and symptoms of vertigo may require evaluation in a hospital's emergency department, such as:
• Double vision
• Headache and intractable vomiting
• Weakness
• Difficulty in speaking
• Abnormal eye movements
• Altered level of consciousness
• Difficulty in walking, lack of coordination, or weakness of the arms and/or legs

Vertigo Diagnosis

Besides a thorough clinical examination and audiological tests we use the state of art Video Nystagmography (VNG) to evaluate the causes of vertgo/giddiness.

How does VNG Work?

VNG is a complete diagnostic system for recording, analyzing and reporting involuntary eye movements, called nystagmus, using video imaging technology. Hi-tech video goggles with infrared cameras are used. On an average we perform 180 tests/year. The main advantage of this procedure is that,it helps us to differentiate between the central and peripheral causes of vertigo . It also assesses the cochlear reserve which inturn would help us decide the nature of surgery to be performed for intractable vertigo.