Vertigo: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Prognosis
Vertigo is a term used to describe a feeling of rocking, rotation, or spinning, experienced when a person is sitting or standing perfectly still. Approximately 90 million Americans visit healthcare providers each year due to complaints of vertigo, dizziness or balance problems, according to Neuro Kinetics, Inc. So what is vertigo exactly? Some encyclopedias define vertigo as “a sensation of whirling and loss of balance.” This definition of vertigo is often associated with a kind of dizziness associated with looking down from a great height, or caused by a health condition that affects the vestibular nerve or inner ear. Unlike non-specific dizziness or lightheadedness, vertigo has only a few primary causes. Learn more about vertigo and what it could mean for your health.
Types of Vertigo
There are two main types of vertigo: central and positional vertigo. Central vertigo is caused by a problem in the brain, generally the brain stem or the cerebellum (back part of the brain). The cerebellum is the part of the brain that controls the coordination between balance and movements. Central vertigo may be caused by:
- Blood vessel disease
- Certain drugs (e.g. aspirin, anticonvulsants, and alcohol)
- Multiple sclerosis
- Tumors (cancerous or noncancerous)
Peripheral vertigo is caused by a problem within the inner ear, which is responsible for balance. These areas inside the ear are known as the semicircular canals or vestibular labyrinth. Vertigo may also be caused by a problem with the vestibular nerve, which connects the brain stem with the inner ear. Peripheral vertigo may be caused by:
- Benign paroxysmal positional vertigo
- Injury (e.g. head injury)
- Certain medications (e.g. diuretics, antibiotics, aminoglycoside)
- Meniere’s disease
- Inflammation of the vestibular nerve (neuronitis)
- Pressure directly on the vestibular nerve, such as from a tumor
So what causes vertigo? There are numerous causes of vertigo. Some of the disorders that cause vertigo are characterized as central, while others are peripheral. These vertigo causes often require a complex diagnosis and a thorough history and physical examination, as well as imaging studies and balance testing. Some causes include:
- Benign Positional Vertigo (BPV): BPV is characterized as chronic, short spurts of dizziness caused by certain head movements. In most cases, the spinning will only last a minute or less. BPV is generally caused by a buildup of fluid in the inner ear which affects balance.
- Migraine-Related Dizziness: This type of vertigo can be described as a constant sense of dizziness or episodic vertigo. Migraine-related dizziness is generally associated with sound or light sensitivity. Certain foods, such as chocolate, MSG, and processed meats can trigger it, as well as changes in sleep.
- Meniere’s Disease: Meniere’s disease is a type of episodic vertigo that is associated with a ringing or buzzing sound in the ear, pressure in the ear, or fluctuating hearing loss. A high salt diet, alcohol, or caffeine can bring it on.
- Acoustic Neuroma: Acoustic neuroma generally presents with one-sided hearing loss, sudden hearing loss, or ringing in one ear. There is no particular trigger for this type of vertigo and symptoms can appear suddenly or come on gradually.
- Labyrinthitis: Labyrinthitis is a condition that causes severe spinning dizziness and chronic bouts of poor balance. This condition usually lasts two to three weeks and can be accompanied with hearing loss. Labyrinthitis can cause dizziness at any time, when you’re moving or sitting still.
- Vestibular Neuronitis: This condition is characterized by severe imbalance and spinning dizziness. Any type of movement can bring on vestibular neuronitis and it can last for two to three weeks. This condition is usually caused by a virus infection that affects balance.
- Superior Canal Dehiscence: Superior canal dehiscence can cause intermittent dizziness and hearing loss in some cases. Loud noises and various movements can bring on vertigo but the symptoms are brief and temporary. Superior canal dehiscence is caused when the bony part of the ear canal becomes eroded due to pulsations or pressure in the brain.
Signs and Symptoms
If you are experiencing any type of dizziness, you may want to compare your symptoms to common symptoms and signs of vertigo. The primary symptom of vertigo is a feeling or sensation of moving or spinning. This sensation can present when you are sitting, standing, holding still, or moving around.
Vertigo symptoms can be very mild or severely debilitating. Even rolling over in a bed can escalate vertigo. Some symptoms of vertigo include lightheadedness, nausea, vomiting, or a sense of fainting. In some cases, vertigo can be accompanied with other health problems, such as weakness. Other signs and symptoms of vertigo include:
- Involuntary or abnormal eye movement (nystagmus)
- Hearing loss
- Feeling faint
- Difficulty speaking/slurred speech (dysarthria)
- Visual disturbances (oscillopsia)
- Difficulty walking (ataxic gait)
- Numbness or weakness
- Sweating (diaphoresis)
- Blurred vision (diplopia)
Certain factors can increase your risk of developing vertigo. The most common risk factors associated with this condition are head injuries. Getting into an accident or becoming injured can greatly increase your risk of developing vertigo, especially if the accident or injury affected your brain or brain stem.
Taking certain medications can also increase your risk of experiencing vertigo. Some of these medications include blood pressure medications, anti-seizure medications, antidepressants, and aspirin. Factors that increase your risk for stroke, such as heart disease, smoking and diabetes, also increase your risk of developing vertigo.
Diagnosing vertigo can be somewhat tricky, as your general physician (GP) will have to properly distinguish between vertigo and general dizziness. There are several simple tests that can be performed to differentiate the two conditions. First, your GP will want to look at your medical history and get all the details regarding your first and any ongoing symptoms.
You will need to carefully explain all of your signs and symptoms, when they usually occur, how long they last, and what usually triggers them. For example, you may experience dizziness that lasts for several seconds when you get out of the bed in the morning or spinning that occurs when you make sudden head movements.
Your GP will also want to know if your potential vertigo is associated with any other health problems, such as nausea, hearing loss, tinnitus, vomiting, or a feeling of fullness in the ear. He or she may also ask if your symptoms affect your day-to-day activities, such as speaking, walking, or performing work duties.
In addition to what could be potentially triggering your vertigo symptoms, your GP may ask what seems to make your symptoms better. While most episodes of vertigo go away on their own within seconds or minutes, some can last for hours or even on and off for days at a time. Your GP may also ask:
- If you are currently taking any medications
- If you’ve had a recent head injury or ear infection
- If you have a family history of migraines or Meniere’s disease
Need to know how to get rid of vertigo? Treatment for vertigo generally includes medication that can eliminate vertigo symptoms for hours or days at a time. Medications are usually not as effective for people with benign paroxysmal positional vertigo, as these vertigo episodes generally last less than a minute.
A wide variety of medications can be used in a vertigo treatment plan. When considering how to treat vertigo, your GP may consider various combinations of dopamine, acetylcholine, and histamine receptor antagonism. When determining how to cure vertigo symptoms like nausea, anticholinergics or antihistamines may be prescribed.
While there is no one cure for vertigo, many patients find success with vertigo medication in combination with various home remedies. However, like with all medications there are risks associated with vertigo medications, such as gamma-aminobutyric acid (GABA), which is an inhibitory neurotransmitter.
In combination to medicine for vertigo, vertigo exercises can be useful in the treatment of vertigo symptoms. Exercises for vertigo are designed to train the brain to use alternative proprioceptive and visual cues to maintain gait and balance. These vestibular rehabilitation exercises can result in a significant reduction in vertigo.
Home remedies for vertigo include a variety of nutritional and lifestyle changes. For example, a beverage combination of wheat germ, poppy seeds, almonds, and watermelon seeds made into a paste and combined with ghee and cloves and mixed into milk is thought to useful in preventing vertigo. Other vertigo remedies include:
- Beverage made of gooseberry powder, coriander seeds and water
- Get a recommended 8 hours of uninterrupted sleep nightly
- Maintain a healthy diet containing essential vitamins and minerals
- Keep your body hydrated by taking in large quantities of water
- Avoid jerky movements when moving that could result in imbalance
- Consume raw strawberries mixed with yogurt
- Add a piece of raw ginger to your tea or chew on a piece of raw ginger
- Drink a glass of milk containing grinded almonds
Vertigo is a condition that can happen to anyone at any time without warning. While there is no way to prevent the first episode, there are things you can do to prevent future episodes by controlling the symptoms. If you have experienced vertigo in the past, it’s important to avoid situations that could cause you injury.
People who have had vertigo should be cautious when in potentially dangerous situations, such as climbing a ladder or working on a slanted roof. You should also be cautious when exercising or making quick movements that could escalate your condition. Talk to your GP about other ways to prevent episodes of vertigo.
The prognosis of vertigo primarily depends on what condition is causing the dizziness sensation. Vertigo that is caused by problems of the inner ear can be difficult to cope with in daily life and usually require the use of drugs and rehabilitation exercises to properly manage. Symptoms may go away or become more tolerable over time.
Vertigo caused by a brain lesion may or may not get better with time and treatment. This will depend on how much damage was done to the central nervous system from the lesion. Cases of vertigo caused by brain lesions require prompt emergency evaluation by a neurosurgeon or neurologist before the condition worsens.
How long does vertigo last? This will depend on what is causing the condition, what type of vertigo you are experiencing, and how severe your symptoms are. Most cases of dizziness are not serious and either go away quickly on their own or are easily treated. However, if you experience any of the following, call your local emergency number.
- Head injury
- Chest pain
- Fever over 101 °F
- Very stiff neck
- Trouble keeping fluids down
- Inability to move a leg or arm
- Change in speech or vision
- Heart skips beats
- Fainting or losing alertness
So what does vertigo mean? The vertigo definition is a feeling of moving or spinning, or a sensation that the world is spinning around you. If you are experiencing symptoms of vertigo for the very first time, make an appointment with your GP to explain your symptoms and try to find a probable cause.
People with vertigo or people who have experienced multiple episodes of vertigo-like dizziness should not drive or perform any other activity that could endanger themselves or others. With the right treatment plan, vertigo can usually be managed and in many cases eliminated.
Chronic episodes of dizziness can make you feel like you’re not in control of your life and can reduce your quality of life. For more information about how to control vertigo, contact your healthcare provider.