Vertigo: Causes, symptoms, and treatments

Vertigo refers to a sense of spinning dizziness. It is a symptom of a range of conditions. It can happen when there is a problem with the inner ear, brain, or sensory nerve pathway.

Dizziness, or vertigo, can happen at any age, but it is common in people aged 65 years and over.

Vertigo can be temporary or long-term. Persistent vertigo has been linked to mental health issues. A psychiatric problem may cause the dizziness, or vertigo may affect a person’s ability to function in daily life, potentially leading to depression or anxiety.

What is vertigo?

Vertigo is a sensation of spinning dizziness. It is not, as many people maintain, a fear of heights.

It is often associated with looking down from a great height but can refer to any temporary or ongoing spells of dizziness caused by problems in the inner ear or brain.

Many conditions can cause vertigo.


[ear problems can lead to vertigo]
Ear problems can lead to vertigo.

A person with vertigo will have a sense that their head, or their surrounding environment, is moving or spinning.

Vertigo can be a symptom of other conditions, and it can also have its own set of related symptoms.

These include:

balance problems and lightheadedness

a sense of motion sickness

nausea and vomiting


a feeling of fullness in the ear


Vertigo is not just a general feeling of faintness. It is a rotational dizziness.


Some types of vertigo resolve without treatment, but any underlying problem may need medical attention, for example, a bacterial infection that would likely need antibiotic therapy.

Drugs can relieve some symptoms, for example, and may include antihistamines or anti-emetics to reduce motion sickness and nausea. If you want to buy antihistamines, then there is an excellent selection available online.

Patients with an acute vestibular disorder associated with a middle ear infection may be prescribed steroids, antiviral drugs, or antibiotics.

Nystagmus is an uncontrolled eye movement, usually from side to side. It can happen when a person has vertigo, due to dysfunction of the brain or inner ear.

Sometimes, inner surgery is carried out to treat patients with intractable benign paroxysmal positional vertigo (BPPV). The surgeon inserts a bone plug into the inner ear to block the area where vertigo is being triggered.

The plug prevents this part of the ear from responding to particle movements inside the semicircular canal of the inner ear or head movements that could lead to vertigo.

Treatment of Ménière’s disease

Prescription drugs, such as meclizine, glycopyrrolate, or lorazepam, can be used to relieve the dizziness experienced with Ménière’s disease.

Other options include:

restricting salt and taking diuretic therapy to reduce the volume of fluid retained in the body that could build up in the inner ear

avoiding caffeine, chocolate, alcohol, and smoking tobacco

pressure pulse treatment, in which a device fitted to the outer ear delivers air pressure pulses to the middle ear, reducing vertigo

surgery to decompress the endolymphatic sac or cutting the vestibular nerve, if nothing else works

Some people have tried acupuncture, acupressure, and herbal supplements such as gingko biloba. However, there is no scientific evidence showing that these are effective.

Patients should discuss any alternative treatments with their doctor before using them.


Anyone who experiences vertigo or other types of dizziness should not drive or use a ladder. It may be a good idea to make adaptations in the home to prevent falls. Getting up slowly may alleviate the problem. People should also take care when looking upward and not make sudden changes in head position.

[vertigo - looking up]
Looking up can make symptoms worse.

There is a range of different diseases and conditions that can lead to vertigo.

Vertigo often occurs as the result of an imbalance in the inner ear. Less commonly, problems in parts of the brain can cause vertigo.

Conditions that can cause the different types of vertigo include:

Labyrinthitis: This is an inflammation of the inner ear labyrinth, and the nerve within that is responsible for encoding the body’s head motion and position as well as sound, known as the vestibulocochlear nerve. It is usually caused by a viral infection.

Vestibular neuronitis: This is also thought to occur as a result of inflammation of the vestibular nerve, usually due to a viral infection.

Cholesteatoma: This is a skin growth that occurs in the middle ear, usually as a result of repeated infection. If the growth becomes larger, it can damage the ear, leading to hearing loss and dizziness.

Ménière’s disease: A buildup of fluid in the inner ear can lead to attacks of vertigo with ringing in the ears and hearing loss. It tends to affect people between the ages of 40 and 60 years.

The National Institute on Deafness and Other Communication Disorders (NIDCD) estimates that the prevalence of people in the United States currently diagnosed with Ménière’s Disease 615,000. It may stem from blood vessel constriction, a viral infection, or an autoimmune reaction, but this is not confirmed.

BPPV: This is thought to stem from a disturbance in the otolith particles. These are the crystals of calcium carbonate within inner ear fluid that touch the sensory hair cells inside the semicircular canals during movement. They stimulate the vestibular nerve to send information to the brain about a person’s position.

In people with BPPV, movement of the endolymph fluid continues after head movement has stopped because of the presence of otolith crystals in the semicircular canals.

BPPV normally affects older adults, and the cause is usually unknown. It has been linked to dementia and twice as common in women as in men.

Vertigo can also be caused by or related to:

migraine headaches

head injuries or trauma

taking certain medication

ear surgery

prolonged bed rest

perilymphatic fistula, a tear in one or both of the membranes separating the middle and inner ear causing leakage of inner ear fluid into the middle ear

herpes zoster oticus, acute viral infection of shingles close to the ear affecting the facial nerve, also known as Ramsay Hunt syndrome

otosclerosis, a middle ear bone problem that causes hearing loss

side effects of medication or drug toxicity



transient ischemic attack

cerebellar or brainstem disease, such as a tumor or stroke

acoustic neuroma, a benign growth on the vestibular nerve that traverses between the inner ear to the brain

multiple sclerosis


There are different types of vertigo, depending on the cause.

Peripheral vertigo usually occurs when there is a disturbance in the balance organs of the inner ear.

Central vertigo occurs as the result of a disturbance in one or more parts of the brain, known as sensory nerve pathways.

Peripheral vertigo

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