Vertigo-associated disorders
Vertigo is a sensation of motion or spinning that is often described as dizziness.
Dizziness
Dizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...
Read Article Now Book Mark ArticleVertigo is not the same as being lightheaded. People with vertigo feel as though they are actually spinning or moving, or that the world is spinning around them.
Vertigo
Rotational head movements cause the fluid in the cupula of the semicircular canal to bend the hair cells. The hair cells, in turn, send a signal to your brain that you are experiencing motion. Vertigo can occur when these hair cells are still sending signals of motion, even though you may be perfectly still, giving you the illusion of movement.
Causes
There are two types of vertigo, peripheral and central vertigo.
Peripheral vertigo is due to a problem in the part of the inner ear that controls balance. These areas are called the vestibular labyrinth, or semicircular canals. The problem may also involve the vestibular nerve. This is the nerve between the inner ear and the brain stem.
Peripheral vertigo may be caused by:
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Benign positional vertigo (benign paroxysmal positional vertigo, also known as BPPV)
Benign positional vertigo
Benign positional vertigo is the most common type of vertigo. Vertigo is the feeling that you are spinning or that everything is spinning around you...
Read Article Now Book Mark Article - Certain medicines, such as aminoglycoside antibiotics, cisplatin, diuretics, or salicylates, which are toxic to the inner ear structures
- Injury (such as head injury)
- Inflammation of the vestibular nerve (neuronitis)
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Irritation and swelling of the inner ear (labyrinthitis)
Labyrinthitis
Labyrinthitis is irritation and swelling of the inner ear. It can cause vertigo and hearing loss.
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Meniere disease
Meniere disease
Ménière disease is an inner ear disorder that affects balance and hearing.
Read Article Now Book Mark Article - Pressure on the vestibular nerve, usually from a noncancerous tumor such as a meningioma or schwannoma
Central vertigo is due to a problem in the brain, usually in the brain stem or the back part of the brain (cerebellum).
Central vertigo may be caused by:
- Blood vessel disease
- Certain drugs, such as anticonvulsants, aspirin, and alcohol
-
Multiple sclerosis
Multiple sclerosis
Multiple sclerosis (MS) is an autoimmune disease that affects the brain and spinal cord (central nervous system).
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Seizures (rarely)
Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
Read Article Now Book Mark Article - Stroke
- Tumors (cancerous or noncancerous)
- Vestibular migraine, a type of migraine headache
Migraine
A migraine is a type of headache. It may occur with symptoms such as nausea, vomiting, or sensitivity to light and sound. In most people, a throbbi...
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Symptoms
The main symptom is a sensation that you or the room is moving or spinning. The spinning sensation may cause nausea and vomiting.
Depending on the cause, other symptoms can include:
- Problem focusing the eyes
- Dizziness
- Hearing loss in one or both ears
- Loss of balance (may cause falls)
- Ringing in the ears
- Nausea and vomiting, leading to loss of body fluids
If you have vertigo due to problems in the brain (central vertigo), you may have other symptoms, including:
- Difficulty swallowing
- Double vision
- Eye movement problems
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Facial paralysis
Facial paralysis
Facial paralysis means that a person is no longer able to move some or all of the muscles on one or both sides of the face.
Read Article Now Book Mark Article - Slurred speech
- Weakness of the limbs
Exams and Tests
Examination by the health care provider may show:
- Problems walking due to loss of balance
- Eye movement problems or involuntary eye movements (nystagmus)
Nystagmus
Nystagmus is a term to describe uncontrollable movements of the eyes that may be:Side to side (horizontal nystagmus)Up and down (vertical nystagmus)R...
Read Article Now Book Mark Article - Hearing loss
- Lack of coordination and balance
- Weakness
Tests that may be done include:
- Blood tests
- Brainstem auditory evoked potential studies
-
Caloric stimulation
Caloric stimulation
Caloric stimulation is a test that uses differences in temperature to diagnose damage to the acoustic nerve. This is the nerve that is involved in h...
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Electroencephalogram (EEG)
Electroencephalogram (EEG)
An electroencephalogram (EEG) is a test to measure the electrical activity of the brain.
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Electronystagmography
Electronystagmography
Electronystagmography is a test that looks at eye movements to see how well nerves in the brain are working. These nerves are:Vestibular nerve (eigh...
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Head CT
Head CT
A head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
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Lumbar puncture
Lumbar puncture
Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. CSF acts as a cushion, protecting the b...
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MRI scan of head and MRA scan of blood vessels of the brain
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
Read Article Now Book Mark ArticleMRA
Magnetic resonance angiography (MRA) is an MRI exam of the blood vessels. Unlike traditional angiography that involves placing a tube (catheter) int...
Read Article Now Book Mark Article - Walking (gait) testing
The provider may perform certain head movements on you, such as the head-thrust test. These tests help tell the difference between central and peripheral vertigo.
Treatment
The cause of any brain disorder causing vertigo should be identified and treated when possible.
To help resolve symptoms of benign positional vertigo, the provider may perform the Epley maneuver on you. This involves placing your head in different positions to help reset the balance organ.
Epley maneuver
The Epley maneuver is a series of head movements to relieve symptoms of benign positional vertigo. Benign positional vertigo is also called benign p...
Read Article Now Book Mark ArticleYou may be prescribed medicines to treat symptoms of peripheral vertigo, such as nausea and vomiting.
Physical therapy may help improve balance problems. You'll be taught exercises to restore your sense of balance. Exercises can also strengthen your muscles to help prevent falls.
Prevent falls
If you have a medical problem or you are an older adult, you may be at risk of falling or tripping. This can result in broken bones or even more ser...
Read Article Now Book Mark ArticleTo prevent worsening of symptoms during an episode of vertigo, try the following:
Symptoms during an episode of vertigo
Dizziness is a word used by people to describe a variety of symptoms. You may feel lightheaded, woozy, unsteady, or like you might faint. Dizziness ...
Read Article Now Book Mark Article- Keep still. Sit or lie down when symptoms occur.
- Gradually resume activity.
- Avoid sudden position changes.
- Do not try to read when symptoms occur.
- Avoid bright lights.
You may need help walking when symptoms occur. Avoid hazardous activities such as driving, operating heavy machinery, and climbing until 1 week after symptoms have disappeared.
Other treatment depends on the cause of the vertigo. Surgery may be suggested in some cases.
Possible Complications
Vertigo can interfere with driving, work, and lifestyle. It can also cause falls, which can lead to many injuries, including hip fractures.
Fractures
If more pressure is put on a bone than it can stand, it will split or break. A break of any size is called a fracture. If the broken bone punctures...
Read Article Now Book Mark ArticleWhen to Contact a Medical Professional
Contact your provider for an appointment if you have vertigo that does not go away or interferes with your daily activities. If you have never had vertigo or if you have vertigo with other symptoms (such as double vision, slurred speech, or loss of coordination), call 911 or the local emergency number.
Reviewed By
Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156(3_suppl):S1-S47. PMID: 28248609 www.pubmed.ncbi.nlm.nih.gov/28248609.
Chang AK. Dizziness and vertigo. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 15.
Crane BT, Minor LB. Peripheral vestibular disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 167.
Kerber KA, Baloh RW. Neuro-otology: diagnosis and management of neuro-otoligical disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 22.
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