Vertigo is the sensation of spinning or dizziness, often accompanied by nausea and vomiting, that occurs as a result of problems within the brain or the inner ear. People with vertigo feel as if their surroundings are moving although no movement is actually occurring. Vertigo is one of the most common health problems in the United States; it affects many adults during their lifetimes.
Symptoms of Vertigo
A typical vertigo patient has a sudden onset of symptoms, which occur intermittently, and last for a few seconds to a few minutes. Symptoms of vertigo may include:
- Temporary hearing loss
- Ringing in the ears
It is important for patients with vertigo to take special precautions to prevent injury to themselves or others.
Causes of Vertigo
Not all causes of vertigo are known, but there are two types of the condition that have specific causes.
Peripheral vertigo is caused by problems with the vestibular labyrinth, the part of the inner ear that controls balance. There also may be problems with the vestibular nerve, which connects the inner ear to the brainstem. Peripheral vertigo can be caused by:
- Certain medications
- Ear infections
- Inner-ear inflammation
- Head injury
- Blood circulation disorders that affect the inner ear or brain
Central vertigo is caused by problems within the brain. Problems may be associated with the brainstem or the cerebellum. Additional symptoms of central vertigo may include slurred speech, facial paralysis or blurred vision. Central vertigo may be caused by:
- Certain medications
- Multiple sclerosis
- Migraine headaches
Diagnosis of Vertigo
Diagnosing vertigo can be a complicated procedure. Because dizziness and vertigo are symptoms of many conditions, it is often hard to pinpoint their exact cause. Depending on symptoms, a series of audiologic, vestibular and movement tests may be performed. These diagnostic tests may include:
- Hearing tests
- Neurological tests
- Blood tests
- Electronystagmogram (measures eye movement/muscle control)
- MRI scan
- Posturography (tests balance)
Treatment for Vertigo
Treatment for vertigo depends on its cause. Treating the underlying cause eliminates balance problems for many people. Any underlying disorders associated with the brain must be addressed immediately. Other treatment options to help to relieve symptoms may include:
- Balance-training exercises
- Lifestyle changes (such as limiting alcohol and caffeine)
- Antibiotics for ear infections
- Anti-vertigo and anti-nausea medications
A vestibular rehabilitation therapist can assist patients by developing individualized treatment plans that combine head, body and eye exercises that decrease dizziness and nausea. Surgery on the vestibular organs may be recommended for patients whose symptoms cannot be controlled by more conservative methods.
Benign Paroxysmal Positional Vertigo
Benign Paroxysmal Positional Vertigo, also known as BPPV, is a common form of vertigo, a balance disorder caused by inner ear issues. Patients who suffer from BPPV may have brief periods of vertigo that come and go. Although BPPV is not a life-threatening condition, it should be evaluated by a doctor to ensure proper treatment.
Causes of BPPV
BPPV is caused by a problem with the inner ear. The inner ear contains tiny particles of calcium that stimulate nerve cells and help to maintain balance. When these particles shift or are disrupted, vertigo may occur. BPPV may be caused by an infection or inflammation of the ear that causes the calcium particles to shift, resulting in balance problems and vertigo.
Symptoms of BPPV
Patients with BPPV experience a sensation of tilting or spinning, although neither is actually occurring. In some cases, the vertigo may be brought on by a tilt or turn of the head. These symptoms may last for a few minutes at a time, and are usually mild. Additional symptoms may include:
- Difficulty standing or walking
Diagnosis of BPPV
To diagnose BPPV, a physical exam is performed, as well as a test of the nervous system to detect communication issues between the nerves and the brain. Additional tests may include an electronystagmography or an MRI scan.
Treatment of BPPV
Most cases of BPPV go away on their own, with no treatment needed. A doctor may prescribe certain medications, such as antihistamines and corticosteroids, to relieve the vertigo symptoms of BPPV. Antibiotics may also be prescribed when a bacterial infection is the underlying cause.
Although BPPV often goes away on its own, recurrence is possible. To prevent recurrence, certain exercises that train the brain to resist vertigo-inducing signals can be performed. Although severe symptoms can be managed with medication, they may cause BPPV to last longer.
- Benign Paroxysmal Positional Vertigo (BPPV)
- Dizziness and Motion Sickness
- Fall Prevention
- Ménière’s Disease