Vertigo

Feeling dizzy can make every day a challenge. At Atrium Health Floyd and Harbin Clinic, our ear, nose and throat specialists and audiologists (doctors who specialize in hearing and balance disorders) can help you find the cause of vertigo and connect you to the right treatment.

What is vertigo?

Vertigo is the feeling that you or your surroundings are spinning. As a symptom of many health conditions, vertigo can be debilitating and increase your risk of falls.

Vertigo types

In vertigo, a problem in your inner ear or brain interferes with your sense of balance. There are two types of vertigo:

• Peripheral vertigo, the most common type, occurs due to an issue with your inner ear or vestibular nerve. Structures in your inner ear detect head motion and your position in relation to your environment. The vestibular nerve carries this information to your brain.
• Central vertigo happens when a problem affects the balance centers of your brain. These areas process information from your inner ear and the rest of your body to help you maintain balance.

Causes of vertigo

Causes of peripheral vertigo include:

• Displacement of motion-sensing crystals in your inner ear (benign paroxysmal positional vertigo)
• Head injury
• High pressure of the fluid inside the inner ear (Meniere’s disease)
• Inflammation of the inner ear (labyrinthitis)
• Inflammation of the vestibular nerve (vestibular neuritis)
• Medications that damage the inner ear, such as certain antibiotics and chemotherapy drugs
• Pressure on the vestibular nerve, such as from a noncancerous tumor

Causes of central vertigo include:

• Blood vessel disease
• Brain tumors
• Migraine headaches
• Multiple sclerosis
• Stroke

Vertigo symptoms

Feeling like you or the room is spinning is the main symptom of vertigo. Often, this symptom causes nausea and vomiting. Rapid, involuntary eye movements (nystagmus) are also common during vertigo episodes. Identifying specific eye movement patterns can help distinguish between the types of vertigo.

Other symptoms of peripheral vertigo may include:

• Hearing loss in one ear
• Loss of balance
• Ringing in your ears (tinnitus)

Other symptoms of central vertigo may include:

• Difficulty speaking
• Difficulty swallowing
• Double vision
• Facial paralysis
• Headache
• Weakness

Vertigo diagnosis

Diagnosis typically involves a review of your symptoms and medical history and a physical exam. Your doctor will assess your balance, coordination and hearing and may perform other tests, such as:

• Blood tests
• Brain stem auditory evoked potential studies: Tests your response to an auditory stimulus
• CT and MRI imaging: Checks for brain conditions that could be causing vertigo
• Electroencephalogram (EEG): Tests electrical activity in the brain
• Electronystagmography (ENG): Records involuntary eye movements to help identify disorders

Vertigo treatment

Treatment depends on the type of vertigo and underlying cause.

• Dietary changes can help when certain foods or drinks trigger symptoms.
• Balance therapy, a type of physical therapy, may improve balance.
• Medications can help ease dizziness, nausea and vomiting.
• Surgery may be required to treat some causes of vertigo.

In general, the conditions that cause central vertigo are more challenging to treat. Peripheral vertigo usually has a better prognosis. For example, a simple in-office maneuver can completely resolve benign paroxysmal positional vertigo.

When symptoms occur, try the following to prevent a worsening of symptoms:

• Avoid bright lights
• Don’t try to read
• Sit or lie down and keep still
• Restart activity gradually

Talk to your doctor about when you can resume activities after an episode of vertigo. Driving, climbing or operating heavy equipment can be especially dangerous if you have any symptoms.