Vertigo is a sensation of spinning dizziness, as though the room or surrounding environment is spinning in circles around the person. Many people use the term to describe a fear of heights, but this is not correct.
Vertigo can happen when a person looks down from a great height, but it usually refers to any temporary or ongoing spells of dizziness that occur due to problems in the inner ear or brain.
It is not an illness but a symptom. Many different conditions can cause vertigo.
A person with vertigo will feel as though their head or the space around them is moving or spinning.
Vertigo is a symptom, but it can lead to or occur alongside other symptoms, too.
These may include:
- balance problems
- a sense of motion sickness
- nausea and vomiting
- ringing in the ear, called tinnitus
- a feeling of fullness in the ear
- nystagmus, in which the eyes move uncontrollably, usually from side to side
Various conditions can lead to vertigo, which usually involves either an imbalance in the inner ear or a problem with the central nervous system (CNS).
Conditions that can lead to vertigo include the following.
This disorder can happen when an infection causes inflammation of the inner ear labyrinth. Within this area is the vestibulocochlear nerve.
This nerve sends information to the brain about head motion, position, and sound.
Apart from dizziness with vertigo, a person with labyrinthitis may experience hearing loss, tinnitus, headaches, ear pain, and vision changes.
An infection causes vestibular neuritis, which is inflammation of the vestibular nerve. It is similar to labyrinthitis, but it does not affect a person’s hearing. Vestibular neuritis causes vertigo that may accompany blurred vision, severe nausea, or a feeling of being off balance.
This noncancerous skin growth develops in the middle ear, usually due to repeated infection. As it grows behind the eardrum, it can damage the middle ear’s bony structures, leading to hearing loss and dizziness.
Vertigo can also occur with:
- migraine headaches
- a head injury
- ear surgery
- perilymphatic fistula, when inner ear fluid leaks into the middle ear due to a tear in either of the two membranes between the middle ear and inner ear
- shingles in or around the ear (herpes zoster oticus)
- otosclerosis, when a middle ear bone growth problem leads to hearing loss
- ataxia, which leads to muscle weakness
- A stroke or a transient ischemic attack, which people sometimes refer to as a mini stroke
- cerebellar or brainstem disease
- acoustic neuroma, which is a benign growth that develops on the vestibulocochlear nerve near the inner ear
- multiple sclerosis
Prolonged bed rest and the use of some medications can also lead to vertigo.
Some types of vertigo resolve without treatment, but a person may need treatment for an underlying problem.
A doctor may, for example, prescribe antibiotics for a bacterial infection or antiviral drugs for shingles.
Medications are available that can relieve some symptoms. These drugs include antihistamines and anti-emetics to reduce motion sickness and nausea.
Rehabilitation /vestibular exercises help in most of cases .
There are different type of vertigo, which vary in their cause.
About 80% of cases are of this type. Peripheral vertigo usually results from problems in the inner ear.
Tiny organs in the inner ear respond to gravity and the person’s position by sending messages via nerve signals to the brain. This process enables people to keep their balance when they stand up.
Changes to this system can produce vertigo. BPPV and inflammation are common causes. Other causes include Ménière’s disease and acoustic neuroma, among others.
Central vertigo relates to problems with the CNS. It usually stems from a problem in a part of the brainstem or cerebellum. Approximately 20% of cases are of this type.
Possible causes include vestibular migraine, demyelination, and tumors involving the affected CNS region or regions.
The doctor will try to find out what is causing the dizziness. They will carry out a physical examination, ask the person how their dizziness makes them feel, and take their medical history.
The doctor may also carry out some simple tests.
Romberg’s test: The doctor will ask the person to stand with their arms by their sides and their feet together and ask them to close their eyes. If the person becomes unsteady on closing their eyes, this could be a sign of a CNS problem.
Fukuda-Unterberger’s test: The doctor will ask the person to march on the spot for 30 seconds with their eyes closed. If they rotate to one side, this may indicate a lesion in the inner ear labyrinth, which could cause peripheral vertigo.
Depending on the results of these and other tests, the doctor may recommend a head CT or MRI scan to obtain more details.