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

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 that makes you feel like you are spinning, swaying, or tilting, or like the room is moving around you. These feelings 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. Some people with vertigo 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. Floating inside that fluid are special calcium deposits. Together, these tubes and deposits make up the "vestibular system." This system tells the brain what position the body is in. It also helps keep you balanced (figure 1).

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

Benign paroxysmal positional vertigo – In this condition, extra calcium deposits form 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 sometimes caused by a virus which can affect the inner ear or the nerve in the inner ear. It is sometimes called "labyrinthitis." People with this condition have vertigo that comes on 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.

Vestibular migraine – People who get migraines, which are a type of headache, can sometimes have episodes of vertigo. This can happen with or without a headache.

Other problems – Other things that can cause vertigo include:

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 one 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 calcium deposits in your inner ear, the doctor might try to get them out by moving your head in a specific way.

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

If your vertigo is really bad, your doctor might also suggest a treatment called "balance rehabilitation." This treatment teaches you exercises that can help you cope with your vertigo.

What can I do on my own to deal with my vertigo? — If you have trouble standing or walking because of vertigo, you are at risk of falling. To reduce the risk of falls, make your home as safe as possible. Get rid of loose electrical cords, clutter, and slippery rugs. Also, make sure that you wear sturdy, non-slip shoes, and that your walkways are clear and well lit.

More on this topic

Patient education: Vertigo (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 01, 2023.
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