What Causes Vertigo And How Can Radiotherapy Help?

Vertigo is a common but much misunderstood condition, with many possible causes and, as a result, a lot of different treatments.

A feature of the wide range of possible causes is the different severity of them and the wide variance in their longevity. Some causes may be temporary, while others might be chronic and potentially deteriorating conditions that require more extensive treatment. Radiotherapy can be among the vertigo treatment options in some cases.

Diagnosed correctly, vertigo is a condition of imbalance and dizziness caused by something interfering with the workings of the inner ear, which has its most obvious role in hearing, but also controls balance. When this is disrupted, a loss of balance and disorientation can be the result. This may be accompanied by other symptoms, which can aid in causal diagnosis.

Common Causes Of Vertigo

Among the most mundane causes are ear infections. Labyrinthitis affects the inner ear and can be a standalone infection, or a consequence of chickenpox, measles or hepatitis. This occurs because of the inflammation of nerves, such as the vestibular nerve, that are important in the control of balance.

Fortunately, this will only last as long as the infection, so once this clears up, the problem should go away.

In other instances, vertigo can be caused by other external factors, such as a stroke, migraines, heart arrhythmia, dehydration, diabetes or even a brain tumour.

In such cases, the medical priority will be to treat these issues, which can then provide relief for vertigo symptoms. This will range from major surgery or radiotherapy for brain tumours through to simply drinking more water to tackle dehydration. In some cases, even ginger tea and Vitamin D supplements can help.

Meniere’s Disease

A more persistent problem is Meniere’s disease, which is one of the conditions that we can help to treat. It is caused by a build up of fluid, which changes the pressure in the ear.

This also causes tinnitus, which manifests in whooshing, tapping or buzzing sounds in the ear. Between 15 and 25 per cent of sufferers have the condition in both ears.

Radiotherapy is not standard treatment for this condition. Usual care involves low-salt diet, diuretics, vestibular suppressants during attacks, intratympanic steroids/gentamicin and vestibular rehab.

Surgery only takes place in refractory cases (endolymphatic sac decompression, vestibular nerve section).

Acoustic Neuromas

Often, the cause of vertigo is an acoustic neuroma, also known as a vestibular schwannoma, a kind of benign (non-cancerous) tumour that resides in the inner ear. A characteristic of benign tumours is that they grow more slowly than malignant (cancerous) tumours, so it may take a long time to grow large enough to cause symptoms.

When this does happen, it can place pressure on the vestibular nerve, which interferes with signals between the brain and ear, disrupting balance and sometimes causing other problems, such as a loss of hearing.

How Radiotherapy Works

Radiotherapy treats the underlying lesion (such as vestibular schwannoma), which may contribute to vertigo. The goal here is tumour control to help stabilise or improve symptoms (including vertigo), but this is not guaranteed.

Side-effects for cranial SRS/FSRTinclude fatigue, transient headache, temporary balance change, hearing fluctuation or tinnitus and rare facial/trigeminal nerve effects.

Crucially, every sufferer needs to have the problem and its cause diagnosed quickly. There is a world of difference between temporary vertigo caused by an ear infection and a chronic condition like Meniere’s disease, or the presence of an acoustic neuroma or other tumour that might have multiple further consequences.

The Treatment We Can Offer

At Queen Square Radiosurgery Centre, vertigo related to vestibular schwannoma or selected skull-base lesions is commonly managed with stereotactic radiosurgery (Gamma Knife) or fractionated stereotactic radiotherapy. These approaches aim to arrest tumour growth and maximise hearing and facial nerve preservation.

Stereotactic radiotherapy involves using devices designed to direct intense beams of radiation at very specific sites, such as tumours. This minimises radiation exposure for surrounding healthy tissue, which is a top priority when sensitive organs, including brain tissue, are adjacent to the location.

By pinpointing a tumour in your brain or ear that is causing vertigo and other problems, we can provide great relief from symptoms.

Learn more about our advanced radiotherapy treatments for vertigo on the Queen Square website.