Do you feel dizzy and out of sorts while doing your daily chores? If so then this feeling could be related to a phenomenon called vertigo. Vertigo creates a false sensation of either you or your surroundings moving or spinning. This condition might feel similar to motion sickness or lightheadedness but vertigo is not the same thing.

Vertigo makes you feel off-balance and creates a hallucination of movement. Vertigo is not a condition in itself but is more like a symptom of something deeper. Vertigo causes are most often related to some problems in the inner ear like benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniere's disease, etc. Though they are all different diseases they similarly affect the ear which topples the brain’s sense of balance.

This sensation can present itself in many forms. At times it could be barely noticeable and other times it may be so severe that you are unable to find balance and it may disrupt your daily activities.

A vertigo attack can come over all of a sudden and may last for a few seconds (or much longer at times). Severe vertigo may persist for several days and make life difficult for the patient. Apart from the loss of balance certain other symptoms associated with vertigo are:

Dizziness
Unable to stand or walk
General malaise or feeling of sickness.
Being pulled in one direction
Swaying
Tilting
Nausea
Headache
Sweating
Hearing loss or ringing in the ear.
Nystagmus (Jerking or abnormal eye movement).

We will look into a few different vertigo reasons, vertigo treatment, and a few other factors associated with this condition.

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Types of Vertigo

Vertigo is a symptom of many underlying conditions. The symptoms of a vertigo episode depend on the type of vertigo you have. Some of the major types of vertigo are mentioned below:

1. Peripheral Vertigo

This is the most common type of vertigo which is caused by problems in the vestibular nerve or areas of the inner ear and the balance mechanism of the brain. The most common causes of this type of vertigo are BPPV, labyrinthitis, being on a certain type of medication, head injury, Meniere's disease, etc.

2. Central Vertigo

There is an area in the brain called the cerebellum which is also referred to as “little brain” (located at the bottom part of the brain) and is responsible for many functions including motor control. The cerebellum has a role in coordination, timing of movements, and precision. When there is an issue in this part of the brain one might experience central vertigo. Central vertigo is also related to the brain stem which is the lower part of the brain that connects to the spine. Vertigo reasons for central type include migraines, multiple sclerosis, acoustic neuroma, brain tumour in the cerebellum, and being on certain types of medications.

3. Cervical Vertigo

This is also called cervicogenic dizziness and it is a neck-related sensation. This type of vertigo is caused due to poor neck position, trauma or injury to the cervical spine, neck disorders, etc. Cervical vertigo could also be caused by injury to the head which results in a whiplash or disruption of head and neck alignment.

Vertigo Causes

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As we know by now that the inner ear is the most common cause of vertigo, let us look at some of the diseases that are associated with vertigo:

Benign Paroxysmal Positional Vertigo - Positional vertigo occurs when tiny calcium particles or canaliths get dislodged from their normal position (i.e. the utricle) and get collected in the inner ear (or semicircular canal). There is no specific reason for BPPV and it is assumed to be associated with age. Positional vertigo can cause mild to severe sensations of dizziness.

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Meniere's Disease - This condition is caused due to fluid buildup in the inner ear and a change of pressure in the ear. This can lead to vertigo, hearing loss, or ringing in the ear (also called tinnitus).
Labyrinthitis or Vestibular Neuritis - This condition is again related to inner ear issues which are caused by infection (mostly viral). There are nerves in the inner ear which are responsible for balance in the body. When an infection occurs it causes inflammation around these nerves.

Few other vertigo causes which are not so common are:

Neck or head injury
Migraine headaches
Problems in the brain like tumours or stroke.

Vertigo Treatment

Some vertigo cases do not need treatment and they improve with time. This happens because our brains can adapt to inner ear changes (at least in parts) and are able to rely on other mechanisms for maintaining balance. Whereas some cases of vertigo might need treatment if the patient has repeated episodes for several months (it could even be years). Some of the vertigo treatments are:

Vestibular Rehabilitation - This dizziness treatment is a kind of physiotherapy which aims at strengthening the vestibular system. Our vestibular system functions in a way that sends signals to our brains about our body and head movements in relation to gravity. A person with recurrent bouts of vertigo would be recommended for vestibular rehabilitation. With the help of this therapy, other senses in our system are trained to compensate for vertigo.
Canalith Repositioning Maneuvers - This is also called the Epley maneuver and is one of the most common exercises recommended to treat vertigo especially benign paroxysmal positional vertigo. In this vertigo cure, a series of simple body movements are taught as outlined in the guide given by the American Academy of Neurology. With the help of these movements, calcium deposits are moved out of the canal into a chamber within the inner ear, enabling the body to absorb it. During the procedure, one might experience vertigo due to the movement of canaliths. These movements are usually guided by a therapist or a doctor. These are very safe and effective movements.
Medicine - In some cases, antihistamine medicines or prochlorperazine can help in the early stages of most vertigo cases. Symptoms such as nausea or motion sickness can be reduced by such medicines. In case the vertigo reason is inflammation or infection then steroids or antibiotics can help in reducing the swelling and getting rid of the infection.
Surgery - If the underlying vertigo causes are more severe such as an injury to the brain, tumour, or injury to the neck then surgery might be needed.

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FAQs on Vertigo: Understanding Its Causes, Symptoms, and Solutions

1. What is vertigo, and how is it different from general dizziness?

Vertigo is a specific type of dizziness characterised by the sensation that you or your surroundings are spinning or moving. This is different from general dizziness, which is a broader term that can include feelings of lightheadedness, faintness, or unsteadiness. The key distinction is the rotational or spinning component, which points towards an issue with the body's vestibular system.

2. What are the most common causes of vertigo?

Vertigo is a symptom, not a disease, and it can be caused by several conditions, most of which affect the inner ear. The primary causes include:

Benign Paroxysmal Positional Vertigo (BPPV): This is the most common cause, triggered by the displacement of tiny calcium carbonate crystals (otoconia) in the inner ear.
Meniere's Disease: A disorder of the inner ear that causes vertigo spells along with hearing loss, tinnitus (ringing in the ear), and a feeling of fullness.
Vestibular Neuritis or Labyrinthitis: This is an inflammation of the inner ear or the vestibular nerve, usually caused by a viral infection, leading to intense vertigo.
Head or neck injury: Trauma can damage the inner ear structures, leading to vertigo.

3. How does the vestibular system in the inner ear cause the sensation of vertigo?

The vestibular system, located in the inner ear, is our body's balance centre. It consists of the semicircular canals and the otolith organs (utricle and saccule). These structures detect rotational and linear movements of the head. Vertigo occurs when the brain receives conflicting information from this system. For instance, in BPPV, displaced crystals stimulate nerve endings inside the semicircular canals, sending false signals to the brain that the head is spinning, even when it is still. This mismatch between what the eyes see and what the inner ear reports causes the intense spinning sensation.

4. What are some common triggers for a vertigo attack?

A vertigo attack can be initiated by specific movements or conditions, depending on the underlying cause. Common triggers include:

Sudden changes in head position, such as looking up, bending down, or rolling over in bed.
High levels of stress and anxiety, which can worsen symptoms.
Certain illnesses like a cold or flu that cause inflammation.
Changes in atmospheric pressure.
Dehydration or dietary factors like high salt intake, particularly for those with Meniere's disease.

5. What are the typical symptoms of vertigo and how is it diagnosed?

The main symptom is a spinning sensation. However, it is often accompanied by other signs such as loss of balance, nausea, vomiting, sweating, and abnormal eye movements (nystagmus). To diagnose the cause, a doctor will typically perform a physical examination, ask about your symptoms, and may use specific tests like the Dix-Hallpike maneuver to check for BPPV. Hearing tests and, in some cases, an MRI or CT scan may be used to rule out more serious causes like a stroke or tumour.

6. Can vertigo be cured, or is it a permanent condition?

Whether vertigo can be cured depends entirely on its cause. For instance, BPPV can often be effectively treated and resolved with a series of simple head movements called Canalith Repositioning Procedures (like the Epley maneuver). For conditions like vestibular neuritis, symptoms usually improve as the inflammation subsides. However, for chronic conditions like Meniere's disease, there is no permanent cure, but the symptoms can be managed through diet, medication, and therapy to reduce the frequency and severity of attacks.

7. Is vertigo considered a dangerous condition?

While the underlying causes of vertigo are often not dangerous, the symptom itself can pose significant risks. The primary danger comes from the increased risk of falls and injuries, especially when an attack occurs unexpectedly during activities like walking, driving, or climbing stairs. In rare cases, vertigo can be a symptom of a serious neurological problem like a stroke or brain tumour, which is why it is essential to seek a medical diagnosis to identify the cause and ensure it is not life-threatening.