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Vertigo

Vertigo Quick Overview

  • The definition of vertigo is the feeling of a sense that your environment is spinning. It is a form of dizziness.
  • Vertigo is caused by problems in the brain or inner ear, including sudden head movements, inflammation within the inner ear due to a viral or bacterial inner ear infection, Meniere's disease, tumors, decreased blood flow to the base of the brain, multiple sclerosis, head trauma and neck injury, migraine headaches, or complications from diabetes.
  • Symptoms of vertigo include a sensation of disorientation or motion, which may be accompanied by nausea or vomiting, sweating, or abnormal eye movements. Other symptoms of vertigo may include hearing loss and a ringing sensation in the ears, visual disturbances, weakness, difficulty speaking, a decreased level of consciousness, and difficulty walking.
  • Vertigo is diagnosed by a medical history and physical exam. CT scans, blood tests, magnetic resonance imaging (MRI), and electrocardiogram (ECG) may also be performed depending on the suspected cause.
  • Treatments for vertigo include self-care home remedies, medications, and physical therapy maneuvers.
  • The prognosis for vertigo depends on the cause. Some cases of vertigo are self-limiting and can be cured with drugs and self-care plus physical therapy.

What Is Vertigo?

Vertigo is the feeling that you or your environment is moving or spinning. It differs from dizziness in that vertigo describes an illusion of movement. When you feel as if you yourself are moving, it's called subjective vertigo, and the perception that your surroundings are moving is called objective vertigo.

Unlike nonspecific lightheadedness or dizziness, vertigo has relatively few causes.

What Causes Vertigo?

Vertigo can be caused by problems in the brain or central nervous system (central vertigo) or the inner ear (peripheral vertigo). Vertigo is a symptom of other conditions and is not in itself contagious.

  • Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo and is characterized by the brief sensation of motion lasting 15 seconds to a few minutes. This may be described as a sudden attack of vertigo. It may be initiated by sudden head movements or moving the head in a certain direction, such as rolling over in bed. This type of vertigo is rarely serious and can be treated.
  • Vertigo may also be caused by inflammation within the inner ear (labyrinthitis or vestibular neuritis), which is characterized by the sudden onset of vertigo and may be associated with hearing loss. The most common cause of labyrinthitis is a viral or bacterial inner ear infection. The duration of symptoms can last for days until the inflammation subsides. Viruses that may cause labyrinthitis or vestibular neuritis include herpes viruses, influenza, measles, rubella, mumps, polio, hepatitis, and Epstein-Barr virus (EBV).
  • Meniere's disease is composed of a triad of symptoms including episodes of vertigo, ringing in the ears (tinnitus), and hearing loss. People with this condition have the abrupt onset of severe vertigo and fluctuating hearing loss as well as periods in which they are symptom-free. The cause of Meniere's disease is not fully understood but is thought to be due to viral infections of the inner ear, head injury, a hereditary factors, or allergies.
  • Acoustic neuroma is an uncommon cause of vertigo related to a type of tumor of the nerve tissue of the inner ear that can cause vertigo. Symptoms may include vertigo with one-sided ringing in the ear and hearing loss.
  • Vertigo can be caused by decreased blood flow to the base of the brain. A blood clot or blockage in a blood vessel in the back of the brain can cause a stroke (cerebral vascular accident or CVA). Another type of stroke consisting of bleeding into the back of the brain (cerebellar hemorrhage) is characterized by vertigo, headache, difficulty walking, and inability to look toward the side of the bleed. The result is that the person's eyes gaze away from the side with the problem. Walking is also extremely impaired.
  • Vertigo is often the presenting symptom in multiple sclerosis. The onset is usually abrupt, and examination of the eyes may reveal the inability of the eyes to move past the midline toward the nose.
  • Head trauma and neck injury may also result in vertigo, which usually goes away on its own. Cervical vertigo can be caused by neck problems such as impingement of blood vessels or nerves from neck injuries.
  • Migraine, a severe form of headache, may also cause vertigo. The vertigo is usually followed by a headache, although not always. There is often a prior history of similar episodes but no lasting problems.
  • Complications from diabetes can cause arteriosclerosis (hardening of the arteries) which can lead to lowered blood flow to the brain, causing vertigo symptoms.
  • Changes in hormones during pregnancy along with low blood sugar levels can cause pregnant women to feel dizziness or vertigo, especially during the first trimester. In the second trimester, dizziness or vertigo may be due to pressure on blood vessels from the expanding uterus. Later in pregnancy dizziness and vertigo may be caused by lying on the back, which allows the weight of the baby to press on a large vein (vena cava) that carries blood to the heart.
  • Anxiety or panic attacks may also cause people to feel the sensation of vertigo. Stress may worsen symptoms, though it usually does not cause them.
  • Mal de Debarquement, which means "sickness of disembarkation," is the medical term for the dizziness and vertigo felt after travel by ship or boat. This is commonly felt after a cruise. In some cases people experience this sensation after getting out of a plane, car, or train.
Picture of the ear and internal ear structures.
Picture of the ear and internal ear structures.
Medically Reviewed by a Doctor on 1/12/2016
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Benign Paroxysmal Positional Vertigo (BPPV) Treatment

Self-Care at Home

Prevention begins by maintaining good hydration and avoiding rapid movements of the head. Should symptoms of vertigo begin, the following suggestions may be helpful:

  • Lie down with the head elevated slightly. Take precautions to prevent falls.
  • Drink plenty of fluids.
  • In the midst of a vertigo attack, do not drive, work at heights, or operate dangerous machinery since loss of balance may cause significant injury.



Read What Your Physician is Reading on Medscape

Dizziness, Vertigo, and Imbalance »

Dizziness and vertigo are among the most common symptoms causing patients to visit a physician (as common as back pain and headaches).

Read More on Medscape Reference »


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