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Vertigo is a type of dizziness or sensation of movement when none is actually occurring.

What is going on in the body? 
People with vertigo either feel they are spinning or rotating abnormally or the objects around them are spinning. This condition is not exactly the same as dizziness, which is a more general term. Vertigo is usually caused by problems in the inner ear, which helps control balance, or by the nerves or parts of the brain that receive and send signals to the inner ear.

What are the signs and symptoms of the condition? 
When people describe symptoms of vertigo, the doctor will want to know:
  • when the symptoms started
  • how long the vertigo lasts, whether it is constant or only occurs for a few minutes at a time
  • what makes the symptoms better or worse, such as lying flat or standing up
  • whether the symptoms came on gradually or suddenly
  • what medications a person takes
  • if the person has other medical problems
Other symptoms that may be important include: What are the causes and risks of the condition? 
This condition has several causes, including:
  • infections of the inner ear, such as acute labyrinthitis or occasionally acute otitis media
  • disturbances in the function of the inner-ear balance structures, which occur in a condition called Meniere's disease
  • trauma to the inner-ear structures or head
  • decreased blood supply to the inner-ear structures or the nerves or parts of the brain associated with the inner ear. This disorder can occur with a stroke, for example, or a mini-stroke called a transient ischemic attack or TIA
  • seasickness or motion sickness
  • medications, such as an antibiotic known as gentamicin
  • alcohol dependence
  • tumours or cancer, such as brain tumours that affect the nerve or part of the brain associated with balance
  • benign positional vertigo, which is brought on by certain positions, usually lying flat with the head turned in one direction
  • seizures, or abnormal electrical activity in the brain, such as those that occur in psychomotor seizures
  • psychological conditions, such as severe anxiety
Other causes are also possible. Sometimes, no cause can be found.

What can be done to prevent the condition? 
Most vertigo cannot be prevented. Avoidance of long-term alcohol dependence can prevent cases due to drinking alcohol.

How is the condition diagnosed? 
A history and physical examination may be all the doctor needs to make the diagnosis in some cases. For others, further tests may be needed. The tests that are ordered depend on the suspected cause of the symptoms. For example, a cranial CT scan or cranial MRI may be ordered if a stroke or brain tumour is suspected. Or a special study may be used to measure the function of the inner-ear balance structures.

What are the long-term effects of the condition? 
Vertigo can keep people from engaging in normal activities. They may be more likely to fall and injure themselves. Or simply be unable to get out of bed or drive. Often the most serious long-term effects are related to the cause. For example, benign positional vertigo often goes away on its own and almost never has any long-term effects. A stroke, on the other hand, can cause other serious problems along with vertigo, such as not being able to move or talk. A brain tumour may cause brain damage or even death.

What are the risks to others? 
Vertigo is not contagious and poses no risk to others. If the underlying cause is an infection, the infection is sometimes contagious.

What are the treatments for the condition? 
Bed rest and medications to reduce symptoms are usually suggested when vertigo first starts. Commonly used drugs include antihistamines, such as meclizine, scopolamine, and diazepam. If the vertigo persists, other treatments are usually needed. These may be directed at the underlying cause. For example, a brain tumour may need surgery. A inner-ear infection may need antibiotics. Those with seizures may need medications to control the seizures.

In some cases, the cause is not known but the symptoms continue. In these cases, exercises may be used to try to get the body able to balance again. Diet changes, such as a low sodium diet, are helpful in some cases due to Meniere's disease. Surgery may be needed in rare cases that continue despite other treatments.

One of the most common forms of vertigo, benign positional vertigo, may come and go over a period of weeks or years. For this type, doctors can try a technique to help. It's called the canalith repositioning procedure. While lying on the back, the person extends the head over the end of a table, turns the head to one side, rolls over onto that side, and returns to a sitting position. This is an attempt to move tiny particles around inside the inner ear. Individuals should consult their doctor before using this technique.

What are the side effects of the treatments? 
Side effects depend on the treatments used. All medications have possible side effects. For example, antihistamines commonly cause drowsiness and dry mouth. Other specific side effects depend on the medications used. Surgery carries a risk of bleeding, infection, and hearing loss.

What happens after treatment for the condition? 
If the symptoms go away or the cause is under control, no further treatment may be needed. Benign positional vertigo often goes away on its own within a few months, for example. Other causes may need further treatment, such as a brain tumour or a stroke.

How is the condition monitored? 
People with vertigo can monitor their symptoms at home and report them to a doctor. The cause may need further monitoring. For example, those with seizures may need blood tests to monitor the therapeutic drug level of medications used for seizures.

Author: Adam Brochert, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 26/10/2004
Potential conflict of interest information for reviewers available on request

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