Vertigo

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KEY POINTS

• Vertigo is a balance problem. Vertigo is the feeling that you are swaying, floating, or spinning or that the room is moving around you. It can cause nausea, vomiting, and falls.
• The treatment depends on the cause of the vertigo and may include medicines, physical therapy, and a low-salt diet.
• If your vertigo does not allow you to continue your usual routine, rest at home. Do not try to drive or operate tools or machinery. Avoid other tasks such as cooking or going up and down stairs that could endanger yourself or others if you suddenly feel unsteady.

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What is vertigo?

Vertigo is a balance problem. Vertigo is the feeling that you are swaying, floating, or spinning or that the room is moving around you. You cannot tell which way is up, and you may lose your balance. Often, even as you lie in bed, the room seems to be moving or spinning around you. This can go on for a few moments or for days or weeks. The feelings can come and go depending on the cause.

Vertigo is different from dizziness. Dizziness means that you feel lightheaded, faint, weak, or woozy. Vertigo is a feeling of motion outside of you or around you, while dizziness is a feeling inside of your head.

What is the cause?

Sometimes vertigo goes away on its own, and at other times it can be a sign of a problem that needs treatment. Vertigo can be caused by:

• An inner ear problem caused by infection, extra fluid, swelling, or calcium deposits
  • Ménière’s disease, which along with vertigo can cause hearing loss and ringing in the ear
  • Benign paroxysmal positional vertigo, which is caused by changes in the position of your head
  • Vestibular neuritis, which is irritation (swelling) of the nerve in the inner ear usually caused by a virus
• Vestibular migraine, which is a migraine headache that may include an aura, pain, feelings of spinning or rocking, nausea, vomiting, and sensitivity to light and sound
• Acoustic neuroma, which is a growth on a nerve between the brain and the ear
• Diseases such as multiple sclerosis
• Head injury or stroke
• Certain medicines
• Alcohol

What are the symptoms?

The most common symptom is feeling like the room is spinning. Vertigo is almost always made worse with certain head movements. Other signs and symptoms include:

• Nausea and vomiting
• Sweating
• Unsteady gait
• Feeling like you are tilting or falling
• Vision changes as if an object is jiggling in front of you
• Constant rapid eye movements that you cannot control (nystagmus)
• Ringing in one or both ears
• Hearing loss or a feeling of fullness in one ear

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have tests to check for possible causes of your symptoms.

How is it treated?

The treatment depends on the cause of the vertigo. Treatment may include:

• Antihistamine medicine for motion sickness
• Medicine to prevent or control vomiting
• Steroid medicine to decrease swelling and inflammation
• Antibiotic or other medicines to treat infections
• Medicine to prevent or control migraine headache symptoms
• A low-salt diet to decrease swelling in your inner ear
• Physical therapy and occupational therapy that may include special exercises to improve your balance and decrease your symptoms. This type of therapy may help decrease your risk of falls.

If you have severe vertigo that has not gone away after a few weeks, or if it comes back after treatment, sometimes surgery may help.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Try to avoid sitting or standing in one position for a long time if that causes vertigo for you. When you stand up, do it slowly. If you have been lying down, sit for a while before standing.
• Tell your healthcare provider if you think a medicine you are taking may be making your symptoms worse. Check with your provider or pharmacist about nonprescription medicines and supplements before you start taking them.
• If you smoke, stop. If someone else in your household smokes, ask them to smoke outside. Smoking can increase vertigo.
• If your vertigo does not allow you to continue your usual routine, rest at home. Do not try to drive or operate tools or machinery. Avoid other tasks such as cooking or going up and down stairs that could endanger yourself or others if you suddenly become unsteady.

Call 911 or your local emergency services right away if you have symptoms of a stroke or heart attack.

Work closely with your healthcare provider to find the medicines and therapies that are most helpful for you. Ask your provider:

• How and when you will hear your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Join a support group. Support groups can help by sharing common concerns and solutions to problems with others in the same situation. You can find these services through your healthcare provider, therapy programs, and local and national support organizations.

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.