Vertigo (Medical Condition)

Overview

Vertigo is a medical condition characterized by a sensation of feeling off balance. It is often associated with a feeling of spinning or tilting, which can lead to difficulty in standing or walking. Vertigo is not a disease in itself, but rather a symptom of various conditions, most commonly those affecting the inner ear or brain.

Close-up view of a healthy human inner ear.

Causes

Vertigo is typically caused by issues within the inner ear or brain. These issues can be due to diseases, injuries, or conditions that affect the balance centers of the human body.

Inner Ear Conditions

Conditions of the inner ear are the most common causes of vertigo. These include:

Benign paroxysmal positional vertigo (BPPV): This condition occurs when tiny calcium particles clump up in the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity, and disruptions in these signals can lead to vertigo.

Meniere's disease: This is an inner ear disorder caused by a buildup of fluid and changing pressure in the ear that can cause episodes of vertigo along with tinnitus (ringing in the ear) and hearing loss.

Vestibular neuritis or labyrinthitis: These are inflammation of the inner ear usually caused by a viral infection, resulting in dizziness and loss of balance.

Brain Conditions

Less commonly, vertigo can be caused by problems in the brain, such as:

Stroke or transient ischemic attack (TIA): Interruption in the blood supply to the brain can cause symptoms of vertigo.

Multiple sclerosis: This disease of the nervous system can lead to vertigo.

Migraines: Some people may experience vertigo and other types of dizziness before or during migraines.

Acoustic neuroma: This is a benign growth on the nerve that connects the inner ear to the brain.

Symptoms

The primary symptom of vertigo is a sensation of spinning, tilting, swaying, unbalance, or being pulled in one direction. Other symptoms that may accompany vertigo include:

Nausea or vomiting
Nystagmus (abnormal eye movements)
Headache
Sweating
Ringing in the ears or hearing loss
Difficulty standing or walking

Symptoms can last a few minutes to a few hours, and may come and go.

Diagnosis

Diagnosis of vertigo begins with a medical history and physical examination. Your doctor may ask about your symptoms, including what they are, when they happen, and how long they last. The doctor may also perform tests to check your balance and movement.

In some cases, further tests may be required to identify the cause of vertigo. These can include:

Electronystagmography (ENG) or videonystagmography (VNG): These tests measure abnormal eye movement.
Magnetic resonance imaging (MRI): This can provide detailed images of the inner ear and brain.
Computerized tomography (CT) scan: This can identify any problems in the brain that may be causing vertigo.

Treatment

Treatment for vertigo depends on the cause and severity of the symptoms. In many cases, vertigo goes away without treatment. This is because the brain is able to adapt, at least in part, to the inner ear changes, relying on other mechanisms to maintain balance.

For some, treatment is needed and may include:

Vestibular rehabilitation: This is a type of physical therapy aimed at helping strengthen the vestibular system.
Canalith repositioning maneuvers: Procedures such as the Epley maneuver, can help relieve vertigo caused by BPPV.
Medication: In some cases, medication may be given to relieve symptoms such as nausea or motion sickness associated with vertigo.

Prevention

While not all causes of vertigo can be prevented, some tips can help you manage or reduce your symptoms:

Avoid sudden changes in position, especially sudden head movement.
Reduce your intake of salt, which can help manage the symptoms of Meniere's disease.
Stay hydrated, especially during episodes of vertigo.
Limit alcohol and caffeine, which can affect your balance and could trigger vertigo.