Vertigo is an unsettling yet common condition, similar to seasickness but without the sea. With its illusory sense of spinning, vertigo can be frightening and lead to nausea, vomiting, headaches and other symptoms. But a solution is often more simple than you might think.
Vertigo has been linked to anxiety, a drop in blood pressure, migraines, multiple sclerosis and Meniere’s disease, a disorder of the ear that can also cause tinnitus (ringing in the ears) and hearing loss. It can also signal a more serious condition, such as a brain tumor or stroke, although that is less common.
One of the more prevalent types of vertigo, benign paroxysmal positional vertigo, or BPPV, occurs more frequently with age. It is thought to be caused by the formation of canaliths, tiny calcium deposits or crystals within the inner ear that can destabilize equilibrium, causing people to feel as if they’re in a room that’s spinning.
Dizziness from BPPV can be triggered by minor changes in head position, such as looking up, rolling over or leaning forward. Episodes of BPPV are usually brief — measured in minutes instead of the hours or days experienced in other forms of vertigo — but they may occur frequently.
BPPV can usually be treated with simple head movements that can be done in a physician’s office or at home. There are several types of movements. The Epley maneuver and its variations involve moving your head through a series of positions to remove canaliths from the inner-ear canal.
Your primary-care doctor or a vestibular therapist can show you how to perform this simple treatment.
If you experience vertigo, you should see a doctor to rule out more serious causes. And the treatment maneuvers should be done carefully by those who have spinal or vascular conditions in or around the neck.
Terry D. Fife, director of balance disorders and otoneurology at the Barrow Neurological Institute in Phoenix, answers commonly asked questions about dizziness:
What’s the most common cause of dizziness? Transient low blood pressure, the kind that happens when you stand up suddenly from a crouch and feel dizzy for a few seconds. Most people have it occasionally and don’t worry about it.
Is that the same as vertigo? No. In vertigo, people feel the world whirling around them, often with nausea and vomiting. It really gets their attention. The most common recurrent vertigo is benign positional vertigo, in which calcium crystals that are part of the inner-ear structures that detect gravity and movement break off and move into an area of the canal they shouldn’t be. It usually happens when you turn over in bed or when you tilt your head far backward, not from turning your head when you’re sitting up.
Another common vertigo cause is vestibular neuritis, an infection of the inner ear probably caused by ordinary cold viruses. All of a sudden, you feel a little woozy, and within an hour you’re ready for the ER. The nausea and vomiting usually subside within a day or two and your immune system takes care of the virus on the same schedule it takes care of the cold, but you may not move around normally for weeks or months. But you should force yourself to do so, because you’ll recover more quickly.
What about more serious causes? Meniere’s disease is a condition in which the inner ear swells up intermittently. The attacks can cause totally incapacitating vertigo along with a feeling of pressure, ringing in the ear and hearing loss in the affected ear. Each attack does a little more damage to hearing and balance. The initial treatment is a low-sodium diet and a diuretic blood-pressure pill. If that doesn’t work, there are additional treatments, ending with surgery to disconnect the balance nerve of the inner ear.
Sudden vertigo can also be a sign of an impending brainstem stroke, usually accompanied by slurred speech, double vision and clumsiness of the extremities.