What Is Vertigo? Symptoms, Causes, Diagnosis, Treatment, and Prevention

If you have vertigo, you may feel like you’re moving or spinning when you’re not. Or you may feel like your surroundings are in motion when they aren’t.

Many people describe vertigo as feeling dizzy, but it’s different from being light-headed.

Simple movements are unusually intense for people with vertigo, and the condition can impact your everyday life.

Your symptoms will probably depend on what’s causing your episodes and the type of vertigo you have.

Types of Vertigo

The two main types of vertigo are:

Peripheral Vertigo Peripheral vertigo is caused by a problem in areas of the inner ear or the vestibular nerve, which connects the inner ear and the brain. This is the most common type of vertigo.
Central Vertigo Central vertigo happens when there’s a glitch in the brain, particularly in an area of the brain called the cerebellum, or brainstem.

RSV-HSN: A New Type of Vertigo?

Researchers recently discovered a new kind of vertigo. In a 2018 study, scientists called it “recurrent spontaneous vertigo with headshaking nystagmus” (RSV-HSN).

Participants sat in a dark room while an examiner moved their heads forward and then side to side for about 15 seconds. Next, researchers made a video recording of the participants’ eye motions. Results showed those with RSV-HSN had eye movements, known as “nystagmus,” that lasted longer than in others with vertigo.

The scientists say that, compared with other types of vertigo, RSV-HSN involves more severe bouts of motion sickness. In the study, people with RSV-HSN had attacks that included nausea, vomiting, headaches, and intolerance of head motions. They experienced symptoms anywhere from a few times a week to once a year.

At this point, the cause of RSV-HSN isn’t known, but the condition does seem to respond well to medication.

Symptoms of vertigo vary from person to person. Your symptoms might be mild or severe, depending on what’s causing the issue.

Some common signs and symptoms of peripheral vertigo include:

Dizziness
Feeling like you’re moving or spinning
Problems focusing the eyes
Hearing loss in one ear
Balance problems
Ringing in the ears
Sweating
Nausea or vomiting

Central vertigo may cause signs and symptoms such as:

Double vision
Difficulty swallowing
Facial paralysis
Eye movement difficulties
Slurred speech
Weak limbs

What Does It Feel Like to Have Vertigo?

Many people describe vertigo as feeling like the room is spinning. It might cause you to feel like you’re tilted, rocking, unbalanced, or unsteady.

Sometimes these unpleasant sensations are worse if you’re standing up, walking, or moving your head around. Many people describe these feelings as physically exhausting and taxing. Sometimes, the sensations are so severe that you feel nauseated or experience vomiting.

Usually symptoms of vertigo don’t include light-headedness, fainting, or motion sickness.

Vertigo isn’t a disease itself. Instead, it’s a symptom of other conditions. Finding out what’s causing your symptoms is one of the first measures your doctor will take in assessing how to cure vertigo. You’ll need to know what’s triggering your dizziness before you can treat it. Identifying specific risk factors and medical conditions can be helpful.

An array of issues can cause vertigo. Some of the most common are BPPV, Ménière’s disease, and labyrinthitis. Less common causes include migraines, medication, head injuries, and stroke.

Being a woman and being older than 50 can up your risk of having a vertigo episode.

A family member with vertigo, or other factors, such as having a head injury, can also increase your chances of developing symptoms.

Vertigo: Problems With the Inner Ear

Symptoms of vertigo are often the result of an inner ear (vestibular system) problem. Your inner ear plays a big role in helping you feel balanced.

Inside your ear is a tiny organ called the vestibular labyrinth, which includes semicircular canals that contain fluid and hair-like sensors.

Other structures in the ear, called otolith organs, help monitor the movement and position of your head in relation to gravity. Otolith organs contain small crystals that make you responsive to gravity.

Sometimes, these crystals can break free and move into the semicircular canals. This can irritate the hair cells within the canals and make them more sensitive to head position changes. It can allow for false messages about your body’s position to be sent to your brain.

Basically, inner ear disorders cause your brain to obtain signals from the inner ear that don’t match up with what your eyes and sensory nerves (nerves that send messages to your brain) receive.

Learn More About Causes of Vertigo: Common Risk Factors, Genetics, and More

Diagnosing vertigo isn’t always simple. In fact, it can be a tricky and involved process, because people with dizziness often have trouble describing their specific symptoms.

First, your doctor will try to find out if you have “true vertigo” by asking about your specific complaints — be prepared to describe the sensation as precisely as you can to help differentiate vertigo from lightheadedness. Then the focus will be on diagnosing a cause. Your physician might inquire about your family and medical history, perform a physical exam, and conduct various tests. They may perform a maneuver with you, called the Dix Hallpike maneuver, to re-create vertigo symptoms. If positive, this is diagnostic of peripheral vertigo.

Other physical examinations measure your balance, analyze your eye movements, or assess what side of your body is affected by vertigo. Imaging tests, such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI), can be used to let doctors see what’s going on inside your body. In some cases, hearing tests, vision tests, blood work, and even allergy tests are also used.

Each person may require different testing, depending on the suspected cause of vertigo.

Your general practitioner may refer you to a specialist, such as an otolaryngologist or a neurologist — specialists who focus on inner ear or balance problems — to help diagnose or treat your condition.

When choosing a specialist, you should consider his or her education, training, and experience. You might also want to ask if the specialist’s facility has equipment for diagnosing and treating vertigo disorders.

While the diagnostic process may seem tedious at times, it’s important to stay the course so you can find out what’s causing your symptoms.

When Should You Call Your Doctor About Your Symptoms?

You should see a doctor if you have vertigo symptoms that come back periodically for more than one week.

It’s also a good idea to see your healthcare provider if you have any type of dizziness that interferes with your daily activities.

When Should You Seek Out Emergency Care?

Symptoms of vertigo are rarely caused by a serious, life-threatening condition. Still, if the vertigo is acute and this is the first time you’ve experienced something like this, head to the emergency room to rule out something more serious, such as a stroke. But you should visit your doctor immediately or seek emergency medical care if you experience dizziness along with the following:

A new, different, or severe headache
Hearing loss
Double vision or loss of vision
Fever
Slurred speech or trouble speaking
Limb weakness
Loss of consciousness
Numbness or tingling
Difficulty walking
Loss of coordination
Inability to keep food down, or continuous vomiting

Learn More About Diagnosing Vertigo: Tests and Screenings, Early Diagnosis, and Your Doctors

Prognosis of Vertigo

In many cases, symptoms of vertigo will resolve on their own within a few days. But for other people, it’s chronic.

Living with vertigo can be frustrating. Your episodes may be unpredictable and sporadic. Some days, you may not experience any symptoms, while other days, you might have debilitating bouts of dizziness. The good news is there are effective treatment options and most of the time, these treatments can help you control or eliminate your symptoms, so you can enjoy everyday activities.

Symptoms can last a few minutes, or they can persist for hours. In some people the vertigo persists for weeks or months.

Several treatment options are available to help symptoms of vertigo.

The Canalith Repositioning Procedure (also known as the Epley maneuver), a popular therapy that involves exercises to reposition canaliths (calcium crystals) in your inner ear, has a success rate of about 80 percent, in helping people with the most common cause of vertigo.

Other types of physical therapy are used to relieve vertigo caused by inner ear problems. Sometimes medicines, injections, psychotherapy, or surgery are needed. Your doctor can help you decide which options are best for you.

Medication Options

Some medications used to treat vertigo symptoms include:

dimenhydrinate (Dramamine)
meclizine (Antivert)
diazepam (Valium)

Alternative and Complementary Therapies

What if you could cure your vertigo at home? Your doctor may be able to provide you with detailed instructions for doing modified repositioning exercises, like the Epley maneuver, at home.

Many people also report that changing their diet and eliminating foods that are salty, sugary, or high in caffeine can improve their symptoms, particularly when they have been diagnosed with Ménière’s disease. Good hydration is another way to help combat vertigo.
Dietary supplements, such as ginkgo biloba extract, have also been shown to improve symptoms.

Additionally, yoga, tai chi, relaxation techniques, and adequate sleep might help you improve balance and ward off a vertigo episode. Talk to your doctor before performing any at-home remedies.

Learn More About Treatment for Vertigo: Medication, Alternative and Complementary Therapies, Surgery Options, and More

Prevention of Vertigo

Most of the time, vertigo can’t be prevented. But knowing and avoiding certain risk factors may help prevent it. For instance, you can protect yourself from a head injury by wearing a helmet when bicycling or playing sports or taking measures to prevent a fall.

Vertigo can take a toll on your daily life. If your episodes are frequent or severe, you may not be able to work, drive, or perform other tasks.

Typically, people with persistent vertigo are advised not to drive or operate machinery because these activities can pose dangers to themselves and others.

Vertigo can also lead to falls, which may cause injuries. Falling is particularly a concern for older people, who are more prone to bone fractures and other complications. Falling is the primary cause of fatal and nonfatal injuries in older Americans.

Vertigo is considered a common symptom. It’s estimated that nearly 40 percent of all adults in the United States experience vertigo at least once during their lifetime.

Vertigo is typically more prevalent in older people, but it can affect anyone at any age. Women are slightly more likely to experience vertigo symptoms than men.

Other research has shown that about 12.5 million adults over age 65 in the United States have a dizziness or balance issue that significantly interferes with their lives.

There are between five million and eight million doctor’s visits for dizziness in the United States each year, and dizziness is a primary reason for an office visit in people over age 75.

Vertigo can affect people of all colors and ethnicities, but some research has shown minorities may have a higher risk for certain types of dizziness.

One study, published in 2016, found that Black Americans were more likely to have BPPV compared with white Americans. The authors of the study say this may be because diabetes rates are higher in Black Americans.

The data from this study also suggested that BPPV was more prevalent in Asian Americans.

Some medical conditions that are closely related to vertigo include:

Ménière’s disease
BPPV
Labyrinthitis
Stroke
Migraine
Cholesteatoma (a skin growth that occurs in the middle ear behind the eardrum)
Otosclerosis (abnormal bone tissue growth in the middle ear)
Perilymph fistula (an abnormal connection of membranes in the middle and inner ear)
Acoustic neuroma or vestibular schwannoma (a noncancerous tumor on the balance and hearing nerves leading from the brain to the inner ear)
Multiple sclerosis (MS)
Parkinson’s disease
Brain tumors
Diabetes

The Takeaway

If you experience vertigo, it often feels like you're spinning or that your surroundings are moving even though you are still. This sensation can be intense and impact your daily activities, but with proper diagnosis and treatment, your symptoms can often be managed effectively. To help reduce episodes, stay well hydrated and avoid high-salt and high-sugar foods.