Vertigo is a sensation of spinning. If you have these dizzy spells, you might feel like you are
spinning or that the world around you is spinning.
Causes of Vertigo
Vertigo is often caused by an inner ear problem. Some of the most common causes include:
BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny
calcium particles (canaliths) 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. This is an inner ear disorder thought to be caused by a buildup of fluid and
changing pressure in the ear. It can cause episodes of vertigo along with ringing in the ears
(tinnitus) and hearing loss.
Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection
(usually viral). 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:
Migraine headaches
Symptoms of Vertigo
Vertigo is often triggered by a change in the position of your head.
People with vertigo typically describe it as feeling like they are:
Spinning
Tilting
Swaying
Unbalanced
Feeling nauseated
Headache
Sweating
Symptoms can last a few minutes to a few hours or more and may come and go.
Vestibular rehabilitation. This is a type of physical therapy aimed at helping strengthen the
vestibular system. The function of the vestibular system is to send signals to the brain about head
and body movements relative to gravity.
Vestibular rehab may be recommended if you have recurrent bouts of vertigo. It helps train your
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 for BPPV. The movements are done to
move the calcium deposits out of the canal into an inner ear chamber so they can be absorbed by
the body. You will likely have vertigo symptoms during the procedure as the canaliths move.
A doctor or physical therapist can guide you through the movements. The movements are safe
and often effective.
Medicine. In some cases, medication may be given to 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 be prescribed to reduce pressure from fluid
buildup.
Surgery. In a few cases, surgery may be needed for vertigo.
If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain
or neck, treatment for those problems may help to alleviate the vertigo.
Cholesteatoma
An abnormal skin growth in the middle ear behind the eardrum is called cholesteatoma.
Repeated infections and/or a tear or pulling inward of the eardrum can allow skin into the middle
ear. Cholesteatomas often develop as cysts or pouches that shed layers of old skin, which build
up inside the middle ear. Over time, the cholesteatoma can increase in size and destroy the
surrounding delicate bones of the middle ear leading to hearing loss that surgery can often
improve. Permanent hearing loss, dizziness, and facial muscle paralysis are rare, but can result
from continued cholesteatoma growth.
What causes a cholesteatoma?
A cholesteatoma usually occurs because of poor eustachian tube function as well as infection in
the middle ear. The eustachian tube conveys air from the back of the nose into the middle ear to
equalize ear pressure (clear the ears). When the eustachian tubes work poorly, perhaps due to
allergy, a cold, or sinusitis, the air in the middle ear is absorbed by the body, creating a partial
vacuum in the ear. The vacuum pressure sucks in a pouch or sac by stretching the eardrum,
especially areas weakened by previous infections. This can develop into a sac and become a
cholesteatoma. A rare congenital form of cholesteatoma (one present at birth) can occur in the
middle ear and elsewhere, such as in the nearby skull bones. However, the type of cholesteatoma
associated with ear infections is most common.
How is cholesteatoma treated?
Initially, the ear may drain fluid with a foul odor. As the cholesteatoma pouch or sac enlarges, it
can cause a feeling of fullness or pressure in the ear, along with hearing loss. An ache behind or
in the ear, especially at night, may cause significant discomfort.
Dizziness, or muscle weakness on one side of the face (the side of the infected ear) can also
occur. Any or all of these symptoms are good reasons to seek medical evaluation.
Cholesteatoma is a serious but treatable ear condition, which can be diagnosed only by medical
examination. Bone erosion can cause the infection to spread into the surrounding areas, including
the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and, rarely, death can
occur.
lying down
turning over
getting up
BPV can be annoying, but its rarely serious except when a person falls due to dizziness.
vomiting
blurred vision
nausea
dizziness
lightheadedness
loss of balance
unsteadiness
Symptoms of BPV can come and go. They commonly last less than one minute.
A variety of activities can bring on BPV. However, most symptoms occur when theres a change
in your heads positioning. Abnormal eye movements, also called nystagmus, usually accompany
BPV symptoms. Although its extremely rare, you can have BPV in both ears.
In some extreme cases of BPV, people can develop dehydration due to vomiting.
caloric stimulation, which is a warming and cooling the inner ear with water or air to
observe eye movements
hearing evaluation
Medication
Your doctor may prescribe medications to relieve spinning sensations. These drugs may include:
sedative-hypnotics
anticholinergics
antihistamines
Home Treatment
There are steps you can take to manage the dizziness associated with BPV.
Losing your balance is always a possibility. Be aware of your surroundings and avoid placing
yourself at risk. Falls can cause serious injuries.
Whenever you feel dizzy, take a seat. Sitting down during a dizzy spell can help you avoid
falling. You should also take precautions such as using good lighting around the home and using
a cane for stability.
Also, learn what triggers your episodes. Preventing symptoms of vertigo from becoming worse
during episodes of BPV can be as simple as avoiding the positions that trigger it.
Mayo Clinic Staff. (2015, May 28). Benign paroxysmal positional vertigo (BPPV).
Retrieved from http://www.mayoclinic.org/diseasesconditions/vertigo/basics/definition/con-20028216
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recommendations.
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Walking is a simple but powerful exercise for vertigo that can help your balance. Walking with
greater balance will allow you to function better on your own, which in turn may lead to
improved self-confidence. As you walk, you will also be working your muscles, which helps you
keep muscle tone and may increase your strength.
Because you are moving, there is an increased risk of falling. If possible, do your walking next to
a wall with a handrail or in a hall, or be sure to have someone with you.
If you are concerned about falling, always have someone with you.
Walking exercise 1
Walk 5 steps and stop abruptly. Wait 10 seconds or until any dizziness goes away. Repeat this
until you have walked about 50 ft (15 m).
Do this exercise twice. To chart your progress, gradually work up to walking 100 ft (30 m).
Walking exercise 2
Walk 5 steps, and then turn around and walk back. Wait 10 seconds or until any dizziness goes
away. Repeat 5 times.
Do this exercise twice. To chart your progress, gradually work up to repeating the exercise 10
times.
Walking exercise 3
1. Walk and turn your head to the left and then to the right, every other step. Try to walk
about 50 ft (15 m).
2. Walk about 50 ft (15 m) while moving your head up and down.
3. Walk about 50 ft (15 m) while tipping your head side to side (tip your ear toward your
shoulder).
When first starting this exercise, you will probably weave considerably. Weaving less while
doing the exercise is a sign of progress. This is a more difficult walking exercise, so consider
having someone with you.
Do this exercise twice each day. To chart your progress, gradually work up to walking 100 ft (30
m).