You’re dizzy and the room is spinning. Or maybe you feel off-balance, like you’re moving or swaying while you’re standing perfectly still. You’re not sure what triggered it, how long it will last or how to make it stop. These are classic signs of vertigo.
“Vertigo, in general, is the sensation of movement and disorientation in space,” says Hessam Khalili Tabrizi, MD, a family medicine physician at Scripps Coastal Medical Center Solana Beach. “It can be a diagnosis, and it can be a symptom.”
The causes of vertigo fall into two categories: inner ear problems and brain disorders.
The first type of vertigo is related to the balance sensor in the inner ear and a nerve in the same area that can become inflamed.
One of the most common of these forms, benign positional vertigo (BPV), has to do with tiny crystals suspended in our inner ear canal. Sometimes these crystals can become dislodged and interfere with a sensory input area for balance that also calls our inner ear home. In some cases, a head injury can knock the crystals free, but BPV can occur in older patients with no history of accident or injury.
A technique called the Epley maneuver can resolve BPV most of the time. It can be done in a doctor’s office or at home and involves a series of movements, sometimes combined with an electronic device designed to send the crystals back to their original position. But Dr. Tabrizi cautions that only patients experiencing a repeat episode following a doctor’s diagnosis should try this, or over-the-counter medication.
Ménière’s disease can cause bouts of intense vertigo, accompanied by nausea, hearing loss and tinnitus. This inner ear disorder typically affects people in their 30s, 40s and 50s and is often countered by dietary changes — namely lowering sodium intake — which may help reduce inner ear fluid. Diuretics may also help. Surgery to correct the problem is a last resort.
Some people report feeling dizzy when blowing their nose. A bad cold or influenza can trigger vertigo sometimes weeks later by causing an ear infection that affects the vestibulocochlear nerve, which sends balance information to the brain. This is called neuritis, also known as labyrinthitis, and can usually be treated with antiviral medications or steroids.
The second type of vertigo is more sensorial, or related to the brain and nervous system. Although rare, vertigo can be caused by a growth or tumor on the vestibulocochlear nerve, which is usually surgically removed. A circulation problem, stroke, brain stem lesion or multiple sclerosis can also trigger vertigo symptoms.
“It’s super important to determine what type it is before we get to the treatment,” says Dr. Tabrizi.
If you’re experiencing vertigo symptoms, avoid driving and activities that require your full balance, like climbing a ladder, and contact your primary care provider.