Learn About Vertigo
Vertigo is a sensation of motion or spinning that is often described as dizziness.
Vertigo is not the same as being lightheaded. People with vertigo feel as though they are actually spinning or moving, or that the world is spinning around them.
Peripheral vertigo; Central vertigo; Dizziness; Benign positional vertigo; Benign paroxysmal positional vertigo
There are two types of vertigo, peripheral and central vertigo.
Peripheral vertigo is due to a problem in the part of the inner ear that controls balance. These areas are called the vestibular labyrinth, or semicircular canals. The problem may also involve the vestibular nerve. This is the nerve between the inner ear and the brain stem.
Peripheral vertigo may be caused by:
- Benign positional vertigo (benign paroxysmal positional vertigo, also known as BPPV)
- Certain medicines, such as aminoglycoside antibiotics, cisplatin, diuretics, or salicylates, which are toxic to the inner ear structures
- Injury (such as head injury)
- Inflammation of the vestibular nerve (neuronitis)
- Irritation and swelling of the inner ear (labyrinthitis)
- Meniere disease
- Pressure on the vestibular nerve, usually from a noncancerous tumor such as a meningioma or schwannoma
Central vertigo is due to a problem in the brain, usually in the brain stem or the back part of the brain (cerebellum).
Central vertigo may be caused by:
- Blood vessel disease
- Certain drugs, such as anticonvulsants, aspirin, and alcohol
- Multiple sclerosis
- Seizures (rarely)
- Stroke
- Tumors (cancerous or noncancerous)
- Vestibular migraine, a type of migraine headache
The main symptom is a sensation that you or the room is moving or spinning. The spinning sensation may cause nausea and vomiting.
Depending on the cause, other symptoms can include:
- Problem focusing the eyes
- Dizziness
- Hearing loss in one or both ears
- Loss of balance (may cause falls)
- Ringing in the ears
- Nausea and vomiting, leading to loss of body fluids
If you have vertigo due to problems in the brain (central vertigo), you may have other symptoms, including:
- Difficulty swallowing
- Double vision
- Eye movement problems
- Facial paralysis
- Slurred speech
- Weakness of the limbs
The cause of any brain disorder causing vertigo should be identified and treated when possible.
To help resolve symptoms of benign positional vertigo, the provider may perform the Epley maneuver on you. This involves placing your head in different positions to help reset the balance organ.
You may be prescribed medicines to treat symptoms of peripheral vertigo, such as nausea and vomiting.
Physical therapy may help improve balance problems. You'll be taught exercises to restore your sense of balance. Exercises can also strengthen your muscles to help prevent falls.
To prevent worsening of symptoms during an episode of vertigo, try the following:
- Keep still. Sit or lie down when symptoms occur.
- Gradually resume activity.
- Avoid sudden position changes.
- Do not try to read when symptoms occur.
- Avoid bright lights.
You may need help walking when symptoms occur. Avoid hazardous activities such as driving, operating heavy machinery, and climbing until 1 week after symptoms have disappeared.
Other treatment depends on the cause of the vertigo. Surgery may be suggested in some cases.
University Medical Associates Of The Medical University Of South Carol
Habib Rizk is an Otolaryngologist in Charleston, South Carolina. Dr. Rizk is rated as an Elite provider by MediFind in the treatment of Vertigo. His top areas of expertise are Meniere Disease, Vertigo, Benign Paroxysmal Positional Vertigo, Infant Hearing Loss, and Laryngectomy. Dr. Rizk is currently accepting new patients.
Johns Hopkins Bayview Medical Center
David Newman-Toker, M.D., Ph.D., is an internationally recognized leader in neuro-otology, acute stroke diagnosis, and diagnostic errors research. He completed his undergraduate studies at Yale University, his medical degree at University of Pennsylvania, his residency training and neuro-ophthalmology fellowship at Harvard University, his neuro-otology fellowship at Johns Hopkins University School of Medicine, and his doctoral degree in clinical research methods at the Johns Hopkins Bloomberg School of Public Health. He has served as a full-time faculty member at the Johns Hopkins University School of Medicine since 2002. He is the David Robinson Professor of Vestibular Neurology and also holds appointments in Otolaryngology, Ophthalmology, Emergency Medicine, Acute Care Nursing, Health Sciences Informatics, Epidemiology, and Health Policy & Management at Johns Hopkins. Dr. Newman-Toker is a bedside-to-populations translational researcher, with a focus on eliminating diagnostic errors and achieving diagnostic excellence. He is a leader in the national and international movements to eliminate patient harms from diagnostic error. Dr. Newman-Toker’s clinical focus is on diagnosis of acute disorders affecting the brainstem and cranial nerves, particularly stroke. He is recognized for his research in novel eye-movement-based bedside methods for diagnosing stroke in patients with acute dizziness and vertigo in the emergency department and, in 2024, won the international Bárány Society’s Hallpike-Nylén Prize for clinical research achievement. Dr. Newman-Toker serves as director of the Division of Neuro-Visual & Vestibular Disorders in the Department of Neurology. He also directs the Armstrong Institute Center for Diagnostic Excellence, whose mission is to catalyze efforts to improve diagnostic performance, develop the science of diagnostic safety, and enhance diagnostic research. He has been the principal investigator on numerous National Institutes of Health, Agency for Healthcare Research and Quality (AHRQ), and foundation grants. He has published over 165 journal articles and given more than 300 invited lectures. He has served as an expert consultant on diagnostic safety and quality to AHRQ, the National Quality Forum, and the National Academy of Medicine. He has testified before Congress on the use of artificial intelligence for medical diagnosis. He was president of the Society to Improve Diagnosis in Medicine from 2018-2020. Dr. Newman is rated as an Elite provider by MediFind in the treatment of Vertigo. His top areas of expertise are Vertigo, Benign Paroxysmal Positional Vertigo, Stroke, and Brown Syndrome.
Johns Hopkins Outpatient Center
Neurotologist John Carey specializes in the health and diseases of the inner ear that affect both balance and hearing mechanisms. He is a national expert in superior canal dehiscence syndrome, Menière’s disease, vestibular migraine, acoustic neuromas and other causes of vertigo, and serves as chief of the Division of Otology, Neurotology and Skull Base Surgery in the Department of Otolaryngology–Head and Neck Surgery at the Johns Hopkins University School of Medicine. Dr. Carey earned a medical degree from Washington University School of Medicine and completed two years of training in general surgery at Virginia Mason Medical Center. This was followed by residency training in otolaryngology–head and neck surgery at University of Washington Medical Center and fellowship training in neurotology at the Johns Hopkins University School of Medicine. His research interests include superior canal dehiscence syndrome, Menière’s disease, vestibular implants, and the mechanisms of vestibular migraine. He has a particular interest in superior canal dehiscence syndrome, and, with Lloyd Minor, department director from 2003 to 2009, he helped develop the operation used to repair the superior canal. Dr. Carey has been funded by the National Institute on Deafness and Other Communication Disorders, part of the National Institutes of Health. He has authored or co-authored over 150 peer-reviewed publications, 10 book chapters, and 11 reviews. Dr. Carey is rated as an Elite provider by MediFind in the treatment of Vertigo. His top areas of expertise are Vertigo, Meniere Disease, Acoustic Neuroma, Mastoidectomy, and Endoscopy.
Vertigo can interfere with driving, work, and lifestyle. It can also cause falls, which can lead to many injuries, including hip fractures.
Contact your provider for an appointment if you have vertigo that does not go away or interferes with your daily activities. If you have never had vertigo or if you have vertigo with other symptoms (such as double vision, slurred speech, or loss of coordination), call 911 or the local emergency number.
Summary: This study will assess the sensitivity and specificity of the bedside examination algorithm performed by ED physicians. Finally, it aims to identify predictors of a central cause of the symptoms. This will consequently reduce the rate of misdiagnosis as well as the costs and length of stay due to inappropriate neuroimaging.
Summary: The study will employ a stratified randomization method. Patients presenting to the Afyonkarahisar Health Sciences University Health Application and Research Center, Ear, Nose, and Throat Outpatient Clinic, with a definitive diagnosis of Meniere's disease, unilateral or bilateral involvement, and who consent to participate in the study will be divided into three groups. The control group will rece...
Published Date: December 31, 2023
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017;156(3_suppl):S1-S47. PMID: 28248609 www.pubmed.ncbi.nlm.nih.gov/28248609.
Chang AK. Dizziness and vertigo. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 15.
Crane BT, Minor LB. Peripheral vestibular disorders. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 167.
Kerber KA, Baloh RW. Neuro-otology: diagnosis and management of neuro-otoligical disorders. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 22.