What Is Vertigo?
Vertigo is a type of dizziness in which the person perceives themselves or their surroundings as spinning or moving. Dizziness, on the other hand, is a broader concept; light-headedness, unsteadiness, feeling about to faint, or a feeling of walking on air can also be described by patients as “dizziness.”
Common Causes of Dizziness
The source of dizziness can be the inner ear and balance system, the brain-nervous system, the cardiovascular system, medications used or metabolic conditions. For this reason, not every case of dizziness is assessed in the same way.
Benign Paroxysmal Positional Vertigo (BPPV)
BPPV runs its course with usually short-lasting attacks of spinning triggered by certain positions of the head. Turning over in bed, getting up from bed or moving the head up and down can start the complaint. Position tests are used in the diagnosis; in appropriate patients, canalith repositioning maneuvers can be effective in treatment.
Vestibular Neuritis
In vestibular neuritis, marked vertigo, nausea and unsteadiness that can last hours or days may be seen. New hearing loss is generally not expected. Treatment can include symptom control and vestibular rehabilitation according to the patient’s clinical condition.
Meniere’s Disease
In Meniere’s disease, recurrent vertigo attacks may be accompanied by fluctuating hearing loss, fullness in the ear or ringing. The presence of hearing complaints is important for the differential diagnosis, and an otolaryngology assessment may be needed.
Neurological Causes
Stroke, multiple sclerosis, migraine and certain other central nervous system diseases can cause dizziness or unsteadiness. Vertigo accompanied particularly by new neurological symptoms should be carefully assessed in terms of central causes.
Which Cases of Dizziness Require Emergency Assessment?
If new-onset severe dizziness is accompanied by one of the following findings, emergency health service assessment is needed:
- Weakness or numbness in an arm or leg
- Speech disorder or facial asymmetry
- Double vision or new loss of vision
- Unsteadiness marked enough to be unable to stand
- New and very severe headache
- Change in consciousness
How Is Vertigo Diagnosed?
The diagnosis begins with a detailed history and examination. The duration of the dizziness, its relationship with position, hearing symptoms and accompanying neurological findings are assessed. Eye movements, a balance-gait examination and, when necessary, position tests can be done.
A brain MRI or CT is not needed in every case of vertigo. If the clinical findings suggest a central cause, imaging and other neurological investigations can be planned. If there is hearing loss or ear complaints, an audiological and otolaryngology assessment may be needed.
Vertigo Treatment
Treatment varies according to the underlying cause. Appropriate maneuvers in BPPV, symptomatic treatment and rehabilitation in vestibular neuritis, and a hearing- and balance-system-focused approach in Meniere’s disease may be needed. In central causes, treatment is planned according to the relevant neurological disease.
Since long-term and uncontrolled use of certain medications that suppress dizziness can delay vestibular compensation, the duration and choice of medication should be determined by the physician.
Information about neurological examination
Practice and contact information
This content has been prepared for general informational purposes; it does not replace personal diagnosis or treatment advice.
