Vertigo is a sensation of motion or spinning that is often described as dizziness.
Vertigo is not the same as being lightheaded. Lightheadedness is a feeling that you might faint. Vertigo is a feeling that you are spinning or moving, or that the world is spinning around you.
There are 2 types of vertigo, peripheral and central vertigo.
Peripheral vertigo is due to a problem in the part of the inner ear that controls balance. Peripheral vertigo may be caused by:
- Benign paroxysmal positional vertigo (BPPV)
- Certain medicines
- Injury (such as head injury)
- Inflammation of the vestibular nerve
- Meniere’s disease
Central vertigo (sometimes called central dizziness) is due to a problem in the brain, usually in the brain stem or the back part of the brain.
Central vertigo is most common in patients with atherosclerosis (hardening of the arteries), coronary or peripheral artery disease, hypertension or a history of smoking. It may result from vascular problems such as arterial blockages that cause decreased blood flow to the brain, increasing the risk of stroke.
The main symptom of vertigo is a sensation that you or the room is moving or spinning. The spinning sensation may cause nausea and vomiting. Depending on the cause, other symptoms may include:
- Problem focusing the eyes
- Hearing loss in one ear
- Loss of balance
- Ringing in the ears
If you have vertigo due to problems in the brain (central vertigo), you may have other symptoms including:
- Difficulty swallowing (dysphagia)
- Double vision
- Slurred speech
- Facial paralysis
- Weakness of the limbs
Your health care provider will conduct a physical exam. They may observe:
- Problems walking due to loss of balance
- Eye movement problems
- Hearing loss
- Lack of coordination or balance
Additional tests may be done and can include:
- Blood tests
- Brain stem auditory evoked potential studies
- Electroencephalogram (EEG)
- Head CT
The cause of any brain disorder causing vertigo should be identified and treated when possible.
You may be prescribed medications to treat symptoms of peripheral vertigo, such as nausea and vomiting.
Physical therapy and balance therapy can help improve balance problems. Balance therapy is designed to train the brain to use balance-related information more effectively. While balance therapy may help with central vertigo, the benefits are less predictable than with peripheral vertigo.
If you have central vertigo, your doctor may also recommend medications, procedures, lifestyle changes to reduce the risk of stroke, or modifications to your living environment to reduce the risk of falling.