Patient education: Vertigo (a type of dizziness) (The Basics)

What are dizziness and vertigo? — Dizziness is a feeling that is sometimes hard to describe. It often makes you feel like you are about to fall or pass out. Dizziness can also cause you to feel lightheaded or make it hard for you to walk straight.

Vertigo is a type of dizziness. It makes you feel like you are spinning, swaying, or tilting, or like the room is moving around you. Depending on the cause, these feelings can come and go, and might last seconds, hours, or days. You might feel worse when you move your head, change positions, cough, or sneeze.

Some people with vertigo have trouble walking. Others have nausea and might vomit.

What causes vertigo? — The most common causes of vertigo include:

●Inner ear problems – Deep inside the ear, there is a small network of tubes that are filled with fluid (figure 1). Floating inside that fluid are special calcium deposits. These tubes and deposits are part of the "vestibular system." This system tells the brain what position the body is in and how, and if it is moving or still. It also helps keep you balanced.

Problems that affect the inner ear and can lead to vertigo include:

•Benign paroxysmal positional vertigo ("BPPV") – In this condition, calcium deposits become dislodged from their location in the inner ear. This can lead to short episodes of vertigo that happen when you move your head in certain ways.

•Meniere disease – This is a condition in which fluid builds up inside the inner ear. This causes vertigo, as well as hearing loss and ringing in 1 or both ears.

•Vestibular neuritis – This is believed to be caused by a virus that can cause inflammation of the nerve in the inner ear. It is sometimes called "labyrinthitis." People with this condition have vertigo that starts quickly and can last several days. They also often feel very sick and off balance.

•Head injury – Even a minor head injury can cause inner ear damage and vertigo. This is usually temporary.

●Other problems – Other things that can cause vertigo include:

•Vestibular migraine – People who get migraine headaches can sometimes have episodes of vertigo. This can happen with or without a headache.

•Certain medicines

•Problems that affect the brain, such as stroke or multiple sclerosis

Should I see a doctor or nurse? — See your doctor or nurse right away if you have vertigo and:

●Have a new or severe headache

●Have a fever higher than 100.4°F (38°C)

●Start to see double, or have trouble seeing clearly

●Have trouble speaking or hearing

●Have weakness in an arm or leg, or your face droops to 1 side

●Cannot walk on your own

●Pass out

●Have numbness or tingling

●Have chest pain

●Cannot stop vomiting

You should also see your doctor or nurse if you have vertigo that lasts for several minutes or more and you:

●Are older than 60

●Had a stroke in the past

●Are at risk for having a stroke, for example, because you have diabetes or you smoke

If you have dizziness or vertigo that comes and goes but you do not have any of the problems listed above, you should still make an appointment with your doctor or nurse.

Will I need tests? — Maybe. Your doctor will start by learning about your symptoms and doing an exam. During the exam, they will check:

●Your hearing

●How you walk and keep your balance

●How your eyes work when you watch a moving object, and when your head is turned from side to side

Depending on what your doctor finds during the exam, they might order more tests to better understand your hearing or balance problems. In some cases, the doctor will order an MRI of your brain. An MRI is an imaging test that creates pictures of the inside of your body.

How is vertigo treated? — If your doctor knows what is causing your vertigo, they will probably try to treat that problem directly. For instance, if you have BPPV, the doctor might try moving your head in a specific way. This can move the calcium deposits that are causing your vertigo.

Your doctor can also give you medicines that might help your vertigo and relieve nausea and vomiting.

If your vertigo does not get better, your doctor might also suggest a treatment called "balance rehabilitation." This treatment teaches you exercises that can help you cope with your vertigo.

Is there anything I can do on my own? — Yes. You can:

●Prevent falls – If you have trouble standing or walking because of vertigo, you are at risk of falling. To lower this risk, make your home as safe as possible. Get rid of loose electrical cords, clutter, and slippery rugs. Also, wear sturdy, non-slip shoes, and make sure that your walkways are clear and well lit.

●Sit or lie down if you start to feel dizzy. If you start to feel dizzy while driving, pull over right away.

●Use a cane or walker to help you balance if needed.

●Try to avoid changing positions quickly. When you wake up, sit up first, then get out of bed slowly.

More on this topic

Patient education: Vertigo (Beyond the Basics)