Vertigo

General

Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall.

Vertigo occurs when there is conflict between the signals sent to the brain by various balance- and position-sensing systems of the body. Your brain uses input from four sensory systems to maintain your sense of balance and orientation to your surroundings.

  • Vision gives you information about your position and motion in relationship to the rest of the world. This is an important part of the balance mechanism and often overrides information from the other balance-sensing systems.
  • Sensory nerves in your joints allow your brain to keep track of the position of your legs, arms, and torso. Your body is then automatically able to make tiny changes in posture that help you maintain your balance (proprioception).
  • Skin pressure sensation gives you information about your body's position and motion in relationship to gravity.
  • A portion of the inner ear, called the labyrinth, which includes the semicircular canals, contains specialized cells that detect motion and changes in position. Injury to or diseases of the inner ear can send false signals to the brain indicating that the balance mechanism of the inner ear (labyrinth) detects motion. If these false signals conflict with signals from the other balance and positioning centers of the body, vertigo may occur.

Common causes of vertigo include:

  • Inner ear disorders, such as benign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, or labyrinthitis.
  • Injury to the ear or head.
  • Migraine headaches, which are painful, debilitating headaches that often occur with vertigo, nausea, vomiting, and sensitivity to light, noise, and smell.
  • Decreased blood flow through the arteries that supply blood to the base of the brain (vertebrobasilar insufficiency).

Less common causes of vertigo include:

  • A noncancerous growth in the space behind the eardrum (cholesteatoma).
  • Brain tumors and cancer that has traveled from another part of the body (metastatic).

Immediate medical attention is needed if vertigo occurs suddenly with loss of function. Vertigo that occurs with loss of function in one area of the body can mean a problem in the brain, such as a stroke or transient ischemic attack (TIA).

Alcohol and many prescription and nonprescription medicines can cause lightheadedness or vertigo. These problems may develop from:

  • Taking too much of a medicine (overmedicating).
  • Alcohol and medicine interactions. This is a problem, especially for older adults, who may take many medicines at the same time.
  • Misusing or abusing a medicine or alcohol.
  • Drug intoxication or the effects of withdrawal.