What is Vertigo?

Q: A friend of mine has been diagnosed with vertigo. What is it and how to you treat it?

A: Vertigo is known to cause dizzy spells, like the feeling you are spinning or the world is spinning around you. Vertigo is often caused by an inner ear problem. Some of the most common causes include:

BPPV, or benign paroxysmal positional vertigo, which occurs when tiny calcium particles clump up in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps you keep your balance. BPPV can occur for no known reason and may be associated with age.

  • Meniere's disease, an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It causes episodes of vertigo along with ringing in the ears and hearing loss.

  • Vestibular neuritis or labyrinthitis, an inner ear problem usually related to infection (typically due to a virus). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance.

Less often vertigo may be associated with head or neck injury, brain problems such as stroke or tumor, certain medications that cause ear damage, and migraine headaches

Treatment for vertigo depends on what's causing it. In many cases, vertigo goes away without any treatment because the brain is able to adapt, at least in part, to the inner ear changes, relying on other mechanisms to maintain balance. For some, treatment is needed and may include:

  • Vestibular rehabilitation: A type of physical therapy aimed at helping strengthen the vestibular system, which sends signals to the brain about head and body movements relative to gravity. Vestibular rehab may be recommended for recurrent bouts of vertigo. It helps train the other senses to compensate for vertigo.

  • Canalith repositioning maneuvers: Guidelines from the American Academy of Neurology recommend a series of specific head and body movements. The movements move the calcium deposits out of the canal into an inner ear chamber so they can be absorbed by the body. Vertigo symptoms may occur during the procedure as the canaliths move. A doctor or physical therapist can guide you through the movements, which are safe and effective. They relieve BPPV in 8 out of 10 cases.

  • Medicine: In some cases, medication may relieve symptoms such as nausea or motion sickness associated with vertigo.

  • If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling and cure infection. 

  • For Meniere’s disease, diuretics (water pills) may to reduce pressure from fluid buildup.

In a few cases, surgery may be needed. If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain or neck, treatment of those problems often helps to alleviate the vertigo.

By Ellen Wenberg, MD, assistant medical director and family physician, ThedaCare Physicians-Waupaca.