Vertigo can stem from infections, migraines, injuries, and various medical conditions. Identifying and treating the underlying cause is essential for alleviating symptoms and achieving long-term relief.
Vertigo presents as a false sensation of spinning or movement, creating the illusion that either the person or their environment is moving when they’re actually stationary.
While it shares some characteristics with motion sickness, vertigo differs significantly from general lightheadedness.
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Types of vertigo – Causes of vertigo – Symptoms of vertigo – Vertigo Treatment – Vertigo diagnosis – How long does vertigo last? – Vertigo vs. dizziness – Vertigo in pregnancy – Is vertigo hereditary? – Takeaway
Types of vertigo
Vertigo manifests in different forms, each with distinct characteristics and causes. Recognizing these variations is crucial for proper diagnosis and treatment. The main types include:
- Peripheral Vertigo:
This type originates in the inner ear or vestibular nerve, which transmits balance signals to the brain. The most common form is benign paroxysmal positional vertigo (BPPV), caused by displaced calcium crystals in the inner ear. Other causes include vestibular neuritis, labyrinthitis, and Meniere’s disease. Symptoms typically involve sudden spinning sensations, nausea, vomiting, and balance difficulties. - Central Vertigo:
This form stems from central nervous system issues, particularly in the brainstem or cerebellum. Unlike peripheral vertigo, it’s often persistent and may accompany neurological symptoms. Potential causes include migraines, multiple sclerosis, tumors, or strokes affecting these brain regions. Symptoms may include prolonged dizziness, difficulty walking, double vision, and slurred speech. - Positional Vertigo:
Triggered by head position changes, this type includes BPPV, where specific movements induce brief vertigo episodes. Diagnosis often involves specialized tests like the Dix-Hallpike maneuver to identify displaced inner ear crystals. - Migraine-Associated Vertigo:
Also called vestibular migraine, this occurs alongside migraine headaches. The exact mechanism isn’t fully understood but may involve abnormal brain processing of sensory information. Treatment focuses on managing migraine symptoms through lifestyle changes, medications, and sometimes vestibular rehabilitation. - Non-Vertiginous Dizziness:
This broader category includes lightheadedness, faintness, or unsteadiness without the spinning sensation. Causes range from dehydration and low blood pressure to anxiety or medication side effects.
Accurate differentiation between these types is vital for effective treatment. Persistent or severe vertigo warrants professional medical evaluation.
Causes of vertigo
Common vertigo triggers include:
- BPPV: The leading cause, featuring brief but intense spinning episodes triggered by head movements, often following head trauma.
- Viral infections: Vestibular neuritis or labyrinthitis can cause persistent vertigo from inner ear nerve inflammation.
- Meniere’s disease: Inner ear fluid buildup leads to prolonged vertigo attacks lasting hours.
- Migraines: Vertigo may accompany migraines, lasting minutes to hours.
- Head/neck injuries: Trauma affecting the vestibular system often causes vertigo.
- Medications: Certain drugs may induce vertigo along with dizziness, hearing changes, or tinnitus.
While BPPV isn’t typically serious, it increases fall risk. Common symptoms include dizziness, spinning sensations, imbalance, nausea, and vomiting.
Stress doesn’t directly cause vertigo but can worsen it. Research also links severe stress to increased stroke risk, which could potentially lead to vertigo.
Symptoms of vertigo
Vertigo presents with various disruptive symptoms:
- Spinning sensation: The hallmark symptom, ranging from mild to severe, often worsening with head movements.
- Nausea/vomiting: Common during severe episodes, adding to discomfort.
- Balance problems: Increased unsteadiness raises fall risk.
- General dizziness: Persistent lightheadedness between spinning episodes.
- Sweating/paleness: Physical stress responses during attacks.
- Vision changes: Blurring, double vision, or involuntary eye movements.
- Headaches: May accompany vertigo episodes.
- Tinnitus: Ringing in ears, especially with Meniere’s disease.
- Anxiety: Distress during attacks may trigger panic.
- Concentration difficulties: Cognitive impairment during and after episodes.
Prompt medical evaluation is crucial for proper diagnosis and management of these symptoms.
Vertigo Treatment
Treatment approaches vary based on the underlying cause. Effective options include:
Repositioning maneuvers:
The Epley maneuver helps relocate inner ear crystals causing BPPV. Performed by healthcare professionals, it involves specific head positions held for 30-60 seconds each.
Medication:
Antihistamines like meclizine can relieve motion sickness-related vertigo but may cause confusion in older adults.
Exercises:
Vestibular rehabilitation therapy (VRT) customizes exercises to improve dizziness, eye movement control, and balance. Severe cases should seek professional guidance.
Surgery:
Required for structural causes like tumors or severe injuries.
Natural remedies:
Supplements like ginkgo biloba and melatonin may help. Home exercises (Brandt-Daroff, Semont, Foster maneuvers) can also provide relief.
Essential oils:
Lavender may ease dizziness and nausea, though scientific evidence is limited.
Vertigo diagnosis
Diagnosis involves comprehensive evaluation:
- Medical history and exam: Assessing symptoms, triggers, and medical background.
- Vestibular tests:
- Dix-Hallpike maneuver for BPPV
- Caloric testing evaluating ear response to temperature changes
- Videonystagmography (VNG) recording eye movements
- Rotary chair testing
- Imaging: MRI to rule out structural abnormalities.
- Blood tests: Checking for infections or metabolic issues.
- Specialist consultations: With neurologists or ENT specialists as needed.
Early diagnosis enables targeted treatment for better outcomes.
How long does vertigo last?
Duration varies by cause:
- BPPV: Brief episodes (under a minute) but may recur frequently.
- Vestibular neuritis/labyrinthitis: Days to weeks initially, with possible residual dizziness.
- Meniere’s disease: Attacks last 20 minutes to several hours.
- Migraine-associated: Hours to days, depending on migraine duration.
- Other causes: May persist weeks to years if untreated.
Proper treatment can reduce episode frequency and duration.
Vertigo vs. dizziness
Key differences:
Vertigo:
- Specific spinning sensation
- Worsens with head movement
- Often accompanied by nausea/vomiting
- Typically inner ear-related
Dizziness:
- General lightheadedness/unsteadiness
- No spinning sensation
- Multiple potential causes
Accurate distinction guides proper treatment approaches.
Vertigo in pregnancy
Affecting 20-30% of pregnancies, vertigo stems from:
- Hormonal changes affecting inner ear fluid
- Increased blood volume impacting blood pressure
- Postural shifts from growing uterus
- Anemia or gestational diabetes
- Orthostatic hypotension
- Pre-existing inner ear conditions
Management includes:
- Gradual position changes
- Proper hydration/nutrition
- Balance exercises
- Stress reduction
Severe cases require medical consultation.
Is vertigo hereditary?
While not directly inherited, some associated conditions have genetic links:
- Meniere’s disease: Family history increases risk
- BPPV: Possible anatomical predispositions
- Migraine-associated vertigo: Genetic migraine tendencies
- Rare inner ear disorders: Some familial patterns
Environmental factors also play significant roles in vertigo development.
Takeaway
Vertigo has diverse causes requiring targeted treatment. Home remedies and medications can supplement professional care. Consultation is advised for proper diagnosis and effective treatment plans.
Jump to Section
Types of vertigo – Causes of vertigo – Symptoms of vertigo – Vertigo Treatment – Vertigo diagnosis – How long does vertigo last? – Vertigo vs. dizziness – Vertigo in pregnancy – Is vertigo hereditary? –