Vertigo: Causes, Diagnosis, and Treatments

Vertigo can be a major disruptor to your daily life, throwing off your sense of balance, stopping you from doing simple daily tasks, and causing many other challenges.

Vertigo is different from person to person. It can be a single acute episode, chronic episodes, or a sign of a more serious underlying condition.

Lynn Wood, PT, a physical therapist certified in vestibular rehabilitation at our Ridgeway Medical Campus, wants you to know that, regardless of the source of their vertigo, you don’t need to continuously suffer through the symptoms.

“You can get treatment for vertigo,” Wood said. “A lot of people think they have to live with it and that is not the case. They may also feel that medication is the answer, which does not always help. There are exercises and treatments that cure and prevent future episode.”

Our neurology and physical therapy experts share the causes of vertigo, how it is diagnosed, and how different treatments and therapies can bring relief for you.

Symptoms of vertigo

Vertigo is a sensation of dizziness and spinning caused by issues with your body’s vestibular function, which helps control your sense of balance. While it affects both men and women, studies suggest women are 2-3 times more likely to experience vertigo.

Each person who has vertigo experiences it differently. Some of the symptoms may include but are not limited to:

• feeling like the room is spinning
• feeling like you are spinning
• feeling lightheaded
• loss of balance/unsteady feeling
• sensation of everything “being off”
• distorted vision
• nausea/vomiting
• falling over due to imbalance
• vestibular migraines
• headaches
• full sensation in your inner ear
• ringing in your ears (tinnitus)

Depending on the underlying cause, these symptoms can last anywhere from a few minutes to hours or even bouts of vertigo that come and go over a period of days.

Causes of vertigo

Vertigo can stem from two main areas: peripheral or central causes. Peripheral causes of vertigo are linked to disruptions within the inner ear system; central causes are related to the body’s neurologic system, including the brain.

Peripheral causes include:

• Benign Paroxysmal Positional Vertigo (BPPV)
• Ménière disease
• Labyrinthitis
• Vestibular neuritis

BPPV is the most common source of peripheral vertigo, stemming from tiny calcium carbonate crystals being dislodged in your inner ear. This requires specific physical therapy treatments to resolve the BPPV.

“For patients with labyrinthitis or vestibular neuritis, their symptoms are usually due to inflammation within the ear caused by a post-viral infection,” said John Cullen, MD, a neurologist with Rochester Regional Health’s Ridgeway Medical Campus.

Central causes include:

• stroke
• seizure
• vestibular migraine/headache
• tumor
  • brainstem glioma
  • medulloblastoma
  • vestibular schwannoma
• Head trauma/concussion

In some cases, taking a new medication may also lead to symptoms of vertigo.

To help rule out a serious medical event such as a stroke or seizure, and to get you the quickest relief possible, patients experiencing symptoms of vertigo should immediately go to an urgent care or emergency room.

“Experts can help to rule out different sources of irregular vestibular function that could be the sign of something more serious,” Dr. Cullen said.

Treatments and therapies for vertigo

Experts suggest the majority of patients experience acute vertigo episodes compared to vertigo that becomes chronic. Each person’s specific treatment depends on the source of their vertigo.

For patients who ask, ‘How long will my vertigo last?’, the length of time for vertigo episodes also varies from person to person. Physical therapy treatments and education will help to identify the source of the dizziness.

For example, most patients recovering from a virus tend to improve within 1-2 weeks; BPPV patients tend to start improving within 1-2 days. The progression of vertigo symptoms resolving is gradual; recovery doesn’t happen all at once.

Providers may prescribe medication in the short term to help treat symptoms associated with vertigo. These may include:

• antiemetics (lessens nausea/vomiting)
• antihistamines (relieves nausea/vomiting, dizziness)
• benzodiazepine (reduces anxiety, dizziness)

Diagnosing the unique reason behind your personal sensation of dizziness and spinning is your best method for preventing future episodes of vertigo.