“Vertigo experience can be disturbing & debilitating”

Prof Michael Strupp, Professor of Neurology, Department of Neurology and German Center for Vertigo and Balance Disorders, Hospital of the Ludwig Maximilians University, Munich, Germany, and Dr Jejoe Karankumar, Director, Medical Affairs, Abbott India share their views

Globally, 1 in 10 people are estimated to be affected by vertigo – a balance disorder that results in a sudden and unpleasant sensation that can make people feel like the world is spinning around. In India, it roughly affects over 9.9 million people.
In an exclusive interview, the global vertigo expert, Prof Michael Strupp, Professor of Neurology, Department of Neurology and German Center for Vertigo and Balance Disorders, Hospital of the Ludwig Maximilians University, Munich, Germany, and Dr Jejoe Karankumar, Director, Medical Affairs, Abbott India shared their views on the disease scenario with BioVoice News.

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How is Vertigo impacting the normal lives of people globally and in India?
 Prof. Michael Strupp: Vertigo is a symptom of many different underlying diseases affecting 1 in 10 people worldwide. In India, over 9.9 million people are estimated to experience vertigo. While dizziness affects nearly everyone at some point, vertigo is different – and makes one feel like the world is spinning around.
The experience can be disturbing and debilitating, upsetting balance and impeding daily life. For instance, a sudden attack can be alarming, severely affecting one’s balance and thus increasing the risk of falls and fractures. Its symptoms can lead to a 12-fold increased risk of falling, namely in the elderly. Additionally, things that people often take for granted, like grocery shopping, working, and visiting friends can be very difficult for people with vertigo and dizziness. In some cases, people with vertigo also report issues with concentration and memory loss or ‘brain fog.’
Vertigo also disrupts lifestyles, with one study highlighting that 27% report changing jobs, 21% give up work completely, 50% report reduced efficiency at work, 35% develop family difficulties and 50% develop difficulties with travel.
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Which segments of the population are most affected and why?
Prof. Michael Strupp: Vertigo and dizziness can happen at any age, but is more commonly observed in the elderly, with about 30% of people over 60 years and 50% over 85 years of age experiencing vertigo and dizziness.
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How is vertigo burden amplifying the loneliness or social isolation felt by the elderly, and does it manifest across different phases of a woman’s life?
Prof. Michael Strupp: India’s elderly population (60 years and above) is expected to touch 194 million by 2031. As vertigo and dizziness increase the risk of falls and fractures which affect quality of life, it can also induce a fear of falling. This can subsequently trigger psychological issues like depression and anxiety. They may also experience panic attacks and agoraphobia (fear of being in situations where escape is difficult/help might be difficult to reach). This can make the elderly more inclined to stay at home and lose social contact with others, and this social isolation may amplify loneliness observed in this group.
Dr. Jejoe Karankumar: Vertigo is also more common in women than men and affects them across different phases of their lives. For example, some women report increased vertigo patterns before their monthly menstrual cycle. A study also suggested a unique relationship between the menstrual cycle and an inner ear condition that involves ringing in the ear (tinnitus) or loss of hearing linked to Ménière’s disease in some women. Similarly, during perimenopause women are subject to unstable fluctuations of ovarian hormone levels which may trigger migraines – and vertigo is strongly linked to migraines.
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What are the key triggers for Vertigo and how can we control these from manifesting?
Dr. Jejoe Karankumar: If a patient is suffering from vestibular migraine, it is important for people to recognize and avoid triggers such as irregular sleep, and foods and drinks such as chocolate, red wine and certain cheese or herbs – which can be made easier by keeping a food diary. Further, daily exercises and walking improve your general balance and in case there is vestibular problem patients are better prepared.
Additionally, one should limit their salt, caffeine, alcohol, and tobacco intake, as well as eliminate potential stressors as vertigo episodes can be triggered when one is feeling anxious.
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What are the possible impactful solutions for Vertigo management?
Dr. Jejoe Karankumar: To effectively manage vertigo, one key step is to get diagnosis promptly to prevent it from worsening and affecting one’s independence. At Abbott, we are committed to educating people by raising awareness on vertigo and are supporting doctors with a range of informative materials. We drive initiatives like enabling access to specialized diagnostic tools, such as M glasses, which help doctors visualize a patient’s eyes more clearly. Further, Abbott carries out Robotic Head Workshops to help doctors understand eye movements.
Dr. Strupp: Once the cause of vertigo is known, doctors can recommend ways to manage it for long-term relief. The options include physical therapy, medication, psychotherapy, or surgery – rarely, in some cases. Treatment depends on the diagnosis and the severity and frequency of symptoms. This is also supported with lifestyle changes and vestibular exercises, like head and eye movements and marching exercises for stance and gait that promote vestibular rehabilitation or compensation. For vertigo management, it’s also important to promote adherence to medicine and regimen, as people sometimes don’t properly follow doctor’s advice.
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Your views on the current healthcare scenario in India? Do you see any visible improvements over the last one decade?
Dr. Jejoe Karankumar: In the past couple of years, there have been various advancements that have shaped today’s new-age healthcare ecosystem. Sustainable future starts with health – and there has been continuous work to address India’s disease burden across therapies.
At Abbott, we endeavour to anticipate changing consumer and patient needs and put them at the centre of everything we do, while tackling pressing healthcare challenges with holistic, high-quality, and trusted medicines and solutions and credible information. For instance, we have been actively working to build patient education and also support practitioners on vertigo management in India.