Vertigo is a form of dizziness that causes a feeling of movement when standing still. At times, it might feel like the affected person or the room is rapidly spinning or swaying. This sensation can temporarily make a person lose his or her balance, and some people feel nauseous and vomit during or after an episode. Vertigo is usually divided into two different types, peripheral and central, depending on the origin of the sensation.
Peripheral Vertigo
Peripheral vertigo occurs when there is a problem with the vestibular system. This is the organs and structures that help a person know his position in space, detect movements of the head, and allow the person to keep his balance. The vestibular nerve sends signals from the vestibular system to the brain.
Within the vestibular labyrinth, an organ in the inner ear, there are structures called the otolith organs and fluid-filled semicircular canals that detect movement and allow the brain to determine the head’s location in relation to the ground. The otolith organs contain calcium crystals that make people sensitive to gravity and motion. Problems with the inner ear, such as inflammation from illnesses like the flu or a cold, can disrupt this system and cause vertigo.
Benign Paroxysmal Positional Vertigo
Benign paroxysmal positional vertigo (BPPV) is one of the most common forms. It is characterized by brief periods of dizziness, typically when there are sudden changes in the position of the head, such as when a person tips his or her head up or down or sits up in bed. A person with BPPV may have difficulty with balance when standing up or walking, with feelings of dizziness that range from mild to severe. BPPV, although distressing, is not a serious condition and is usually treated with exercises to move the head and dislodge the crystals causing the problem. In some cases, surgery may be necessary.
Often, there isn’t a specific cause of BPPV, though the vestibular labyrinth plays an important role. If the crystals move from the otolith organs into the semicircular canals, they can become very sensitive to changes in the position of the head. This movement is can be caused by a blow to the head, but often has no clear reason. Some people who suffer from migraines are also diagnosed with BPPV, though it is not clear if there is a connection between the two.
Meniere’s Disease
This disease, the cause of which is not entirely clear, can make the fluid pressure in the inner ear fluctuate, which results in dizziness, as well as hearing loss and a sense of fullness in the ear. To treat Meniere’s disease, a patient may be placed on a low-sodium diet and prescribed a diuretic to manage the fluid in the inner ear, which can help decrease or diminish the symptoms. Treatment often also includes medications to alleviate the nausea that accompanies episodes. In some cases, medications may be injected directly into the middle ear, or surgery to remove the structures causing the symptoms may be performed.
Other Causes
An ear infection, cold, or influenza can cause swelling in the inner ear, which may trigger cases of vertigo. The vestibular nerve may also get infected or compressed, so that it can no longer transmit signals between the ear and the brain correctly. There are some medications that may disrupt the function of the vestibular system as well. In some cases, once the illness has passed or the medication is discontinued, the dizziness may go away, but it can be permanent.
Central Vertigo
Central vertigo is caused by an injury to or problem with the central nervous system, which includes the brain and the spinal cord. Often, this disorder results from lesions in the brainstem, the lower part of the brain that connects to the spinal cord. Problems with the cerebellum, the area at the lower back of the brain that plays a critical role in coordinating movement, can also cause vertigo.
Tumors or strokes may also cause brain damage that leads to balance problems. Degenerative diseases, such as Parkinson’s disease or multiple sclerosis, can also cause vertigo, along with other symptoms. Treatments tend to focus on treating the cause of the damage. The brain is a very complex and sensitive organ, so this type of vertigo tends to respond slowly to treatment and is not always fully treatable.