Vertigo

Individuals with vertigo feel as if they’re moving when they’re not, or they may feel like things are moving around them when they aren’t. Vertigo may also cause the person to feel dizzy.

The two types of vertigo are peripheral vertigo and central vertigo. Peripheral vertigo is caused by a problem in the vestibular nerve or the inner ear. Central vertigo is caused by a problem in the cerebellum, which is the part of the hindbrain responsible for coordinating movement and balance.

About 93 percent of vertigo causes are peripheral vertigo.

Signs of VAD include nausea, headache, vomiting, and stumbling while walking.

Signs of serious vertigo include:

• Sudden vertigo that is not affected by changes in position
• Vertigo that has no history of Meniere’s disease
• Vertigo associated with deafness
• Vertigo associated with new weakness or a severe lack of muscle coordination

Peripheral vertigo may be caused by:

• Benign paroxysmal positional vertigo (BPPV) is caused by calcium crystals floating in the semicircular canals of the ear.
• Acute peripheral vestibulopathy (APV) is inflammation of the inner ear.
• Meniere’s disease affects balance and hearing.
• Other uncommon causes:
  • Otosclerosis is abnormal growth in the middle ear.
  • Cholesteatoma erosion is erosion caused by a cyst in the inner ear.
  • Perilympathic fistula is abnormal communication between the inner ear and the middle ear.

Central vertigo may be caused by stroke, migraine, multiple sclerosis, or a tumor in the cerebellum.

Individuals may be at increased risk of VAD if they:

• Have been diagnosed with a cardiovascular disease
• Have a history of head trauma
• Have had a recent ear infection
• Take medications such as antipsychotics or antidepressants

During an initial visit, the physician will ask the patient if they feel as if the world is spinning or if they feel lightheaded. This will help the physician distinguish between vertigo and dizziness.

If the patient feels as if their world is spinning, then they have true vertigo. To determine the type of vertigo, the physician may conduct the following tests:

• Head-thrust test. The patient will look at the physician’s nose. Then, the physician will make a quick head movement to the side and check to see if the patient’s eyes moved correctly in response.
• Fukuda-Unterberger test. The patient is asked to march in place with their eyes closed and maintain straight posture.
• Romberg test. The patient stands with their feet together and keeps their eyes open. They then close their eyes and try to maintain balance.
• Dix-Hallpike test. The patient lies down from a seated position with their head pointed in the left or right direction. The physician will observe the patient’s eye movements.

The physician may also request a CT and MRI scan.

If vertigo symptoms are not severe, they may be treated with at-home remedies such as the Epley maneuver. However, for consistent vertigo that interferes with daily life, talk to your doctor about long-term solutions.