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.

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.

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.

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