Causes and Treatments of Dizziness and Vertigo

Dizziness and vertigo symptoms can range from the merely uncomfortable to the incapacitating. Severe vertigo can limit life activities and cause nausea, headaches, abnormal eye movements, and imbalance. The condition is most common among adults but can occur in younger patients as well.

Symptoms of Vertigo

Vertigo is typically described as a feeling of spinning, tilting, being off balance, or being pulled in one direction. The symptoms can be triggered when the head changes position or can occur spontaneously. The symptoms occur because the vestibular system, which controls our sense of balance and position, sends conflicting messages to the brain.

Causes of Dizziness and Vertigo

Many cases of vertigo are the result of an inner ear problem. The most common ear problems associated with vertigo include:

• Benign positional vertigo – A condition that causes vertigo lasting less than a minute when the head is placed in particular positions. It is caused by microscopic crystals of the inner ear getting displaced into the balance canals
• Ménière's disease - A condition of fluid imbalance in the inner ear that can lead to vertigo, tinnitus, hearing loss and other issues. This condition has been found to primarily be caused by a migraine related problem in most patients.
• Vestibular migraine – A condition of the brain that affects the function of the balance and the control of eye movement leading to vertigo, imbalance, blurry vision, sometimes ear pressure, ear pain, headaches, pulsatile sound, feeling of being on a boat among others
• Labyrinthitis - An inner ear infection caused by a virus that can cause extreme dizziness and balance problems with hearing loss lasting several weeks
• Vestibular neuronitis - A viral infection of the vestibular nerve in the inner ear with no hearing loss. The vertigo lasts 2-3 weeks.

Treatments for Vertigo

The best treatment for vertigo depends on the exact cause. Some of the most common therapies include:

• Canalith repositioning (Epley) maneuver, which are a specific set of head and body movements designed to force the calcium deposits which are abnormally displaced in the inner ear canals and into the inner ear chamber where they can be reabsorbed by the body.
• Medications may be used to relieve the motion sickness and nausea associated with vertigo. If the vertigo is due to labyrinthitis, steroids, and intratympanic injections (behind the ear drum) are performed to reduce the hearing loss.
• Migraine preventative medications are used to treat vestibular migraine and Meniere’s disease. In one of our studies, 92% of patients had significant improvement of their symptoms with this treatment. Sometimes, injections in the ear are needed to control the symptoms of Meniere’s disease and vestibular migraine.
• Balance rehabilitation, which is a specialized exercise-based program designed to teach patients how to compensate for their faulty vestibular system in order to reduce gaze instability, imbalance, and falls.
• Rarely, surgery is used to treat patients with incapacitating vertigo.

Anyone experiencing vertigo accompanied by a sudden change in speech or vision should seek immediate medical help. This could indicate a more serious problem, such as a transient ischemic attack or stroke.