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Vertigo: What Is it and What Causes It?

When you were a kid, did you ever spin around and around as fast as you could? When you stopped spinning, the room seemed to keep spinning. That’s what vertigo often feels like.

Young-girl-spinning-aroundMany people talk about vertigo in a way that makes it sound like a condition or illness. In reality, vertigo is a symptom, one that causes you to feel as though the environment around you is moving, even when it isn’t.

Sometimes, that feeling is as strong as it was when you were a kid spinning around the living room. Other times, it’s barely noticeable. It depends on what causes your vertigo. When the symptoms are severe, they may make daily living a challenge.

In addition to making you feel dizzy, vertigo may cause nausea or affect your balance, making it difficult to walk or even stand.

What Are the Symptoms of Vertigo?

dizzy feeling from vertigoSimply put, when you have vertigo, it feels as though either you or your surroundings are moving. It is similar to feeling dizzy, but that doesn’t quite capture it. In true vertigo, you feel a sense of motion or of being disoriented. You may also feel nauseous or experience other physical symptoms. These include sweating, vomiting, and abnormal eye movements.

Changing position or movement may cause your symptoms, which can be chronic or occasional and last anywhere from a few moments to hours. If symptoms begin after experiencing an injury, particularly whiplash or head trauma, tell your doctor.

The following symptoms are less common and require seeing your doctor immediately:

  • Decreased level of consciousness (i.e. alertness or responsiveness)
  • Difficulty walking
  • Hearing loss or ringing in the ears
  • Muscle weakness
  • Rapid onset of symptoms
  • Speech problems
  • Vision issues

What Causes Vertigo?

Vertigo is a symptom of an enormous variety of conditions, typically those affecting the central nervous system or inner ear. However, the most common cause is benign paroxysmal positional vertigo (BPPV). There is not always a cause for BPPV. However, when doctors do determine a cause, it is typically related to damage in the inner ear.

Balance is closely linked to structures in your inner ear called otolith organs. Within these are crystals that help control your sensitivity to gravity. If these become dislodged due to illness or trauma, the result is often feelings of vertigo or dizziness.

Vertigo symptoms vary according to its cause; BPPV sufferers experience a brief (15 seconds to a few minutes) sensation of motion often described as a “sudden attack” brought on by movements of the head or body. BPPV is rarely serious but can (and should) be treated.

Other common causes of vertigo include:

  • Meniere’s disease: Symptoms include vertigo, hearing loss, and tinnitus (ringing in the ears). Sufferers experience fluctuating hearing loss accompanied by abrupt periods of vertigo alternating with symptom-free periods. Doctors aren’t sure what causes Meniere’s disease, but many believe inner ear infections, head trauma, allergies, and genetics may play a role.
  • Inner ear inflammation: Sometimes called vestibular neuritis or labyrinthitis, the most common cause is a viral or bacterial inner ear infection. The sensation of vertigo may also be accompanied by hearing loss.

Less common causes include:

  • Acoustic neuroma: Related to a tumor that forms on nerve tissue in the inner ear
  • Anxiety or panic attacks: Stress may cause worsening symptoms but not the symptoms themselves
  • Arteriosclerosis: May result due to complications from diabetes, where the arteries harden and restrict blood flow to the brain
  • Decreased blood flow to the brain: May result from a stroke or cerebral hemorrhage
  • Head trauma or injury: In this case, vertigo typically goes away as the injury heals
  • Mal de debarquement: Literally sickness of disembarkation, where the patient experiences vertigo after boat travel
  • Migraine: Severe headache often preceded by vertigo
  • Multiple sclerosis: Features abrupt onset of vertigo, revealed by an inability to move eyes past the midline of the nose

Does Vertigo Require Medical Care?

Although most vertigo cases are harmless, you should still see your primary care physician if your symptoms don’t go away after a few days. It’s important to allow your doctor to rule out one of the more serious causes. And, he or she can usually treat your symptoms with medication or small lifestyle changes. Even if vertigo is not a symptom of a serious illness, it may still cause issues with balance. And, with accidents being the fourth leading cause of death, reducing your chances of falling is vital.

doctor examining inner ear

Vertigo Testing

There are a variety of tests your doctor may perform to determine whether you have vertigo versus dizziness. Physical tests include:

  • Dix-Hallpike test: Sit on an examination table and then quickly lower to a supine position, head tilted slightly to the right or left for the doctor to observe your eye movements
  • Fukuda-Unterberger test: Attempt to march in place with eyes closed while maintaining balance
  • Head thrust test: While you look at the examiner’s nose, they move their head quickly, observing your eye movement
  • Romberg test: Begin standing with feet together and your eyes open before closing your eyes and seeing whether you can maintain your balance

Your doctor may also order an MRI or CT scan to diagnose vertigo.

Vertigo Final Thoughts

Vertigo is a symptom, not a disease. The vast majority of cases aren’t serious, but you should still schedule an examination with your doctor to determine the cause and appropriate treatment.

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