Vertigo occurs less frequently in childhood than in adulthood.

If present, howev
er, it can be caused by a variety of peripheral and central vestibular syndromes
that pose a diagnostic challenge
Basically most of the vestibular or non-vestibular disorders that cause dizzines
s or vertigo also occur in the elderly, some less frequently (e.g. basilar migra
ine or motion sickness), others more frequently (e.g. benign paroxysmal position
ing vertigo or vascular vertigo). One might question whether this topic still wa
rrants a separate chapter.
the frequency of diziness and balance problem increase with advancing age to bec
ome the most common presenting complaint in patients older than 75
Vertigo is a symptom, rather than a condition itself. It's the sensation that yo
u, or the environment around you, is moving or spinning.
This feeling may be barely noticeable, or it may be so severe that you find it d
ifficult to keep your balance and do everyday tasks.
Attacks of vertigo can develop suddenly and last for a few seconds, or they may
last much longer. If you have severe vertigo, your symptoms may be constant and
last for several days, making normal life very difficult.
Other symptoms associated with vertigo may include:
loss of balance
which can make it difficult to stand or walk
feeling sick or being sick
dizziness
THERE IS COMPELLING EVIDENCE THAT FREE-FLOATING endolymph particles in the poste
rior semicircular canal underlie most cases of benign paroxysmal positional vert
igo (BPPV). Recent pathological findings suggest that these particles are otocon
ia, probably displaced from the otolithic membrane in the utricle. They typicall
y settle in the dependent posterior canal and render it sensitive to gravity. We
ll over 90% of patients can be successfully treated with a simple outpatient man
oeuvre that moves the particles back into the utricle. We describe the various t
echniques for this manoeuvre, plus treatments for uncommon variants of BPPV such
as that of the lateral canal. For the rare patient whose BPPV is not responsive
to these manoeuvres and has severe symptoms, posterior canal occlusion surgery
is a safe and highly effective procedure.
vestibular neuronitis inflammation of the vestibular nerve, which runs into the
inner ear and sends messages to the brain that help to control balance
Vertigo occurs less frequently in childhood than in adulthood. If present, howev
er, it can be caused by a variety of peripheral and central vestibular syndromes
that pose a diagnostic challenge (Beddoe 1977; Eviatar and Eviatar 1977; Blayne
y and Colman 1984; Brandt and Bchele 1984; Balkany and Finkel 1986; Britton and B
lock 1988; Eviatar 1994; Bower and Cotton 1995). Inasmuch as most vertigo syndro
mes in childhood also manifest in adults, they are described in more detail else
where in the relevant chapter. While considerable effort is expended to prevent
hearing loss in children, concurrent or subsequent vestibular disorders are ofte
n ignored because vertiginous crises in childhood are usually attributed to prob
lems of behaviour or lack of coordination (Tusa et al. 1994). As children often
lack the communication skills to give an accurate account of their spells, the d
istinction between vertigo, dizziness and imbalance becomes less obvious (Bower
and Cotton 1995).