What Is Vertigo?
If you've been on your share of amusement park rides, you probably know what vertigo is like — the feeling that the world is spinning around you. But if you feel dizzy and didn't just step off a roller coaster, check with your doctor to see if you've got one of the two most common forms of vertigo: central and peripheral.
There are drugs and other treatments for both types. Finding out which one you've got — and what's causing it — can help you and your doctor decide how to manage it.
Peripheral Vertigo
If your doctor tells you you have peripheral vertigo, you have plenty of company. It's the most common type of vertigo. A problem in the inner ear, which controls your balance, causes most cases.
Peripheral vertigo causes
The most common causes of the inner ear trouble that leads to peripheral vertigo are:
- Benign paroxysmal positional vertigo (BPPV)
- Vestibular neuronitis
- Meniere's disease
BPPV is a condition that causes small crystals to get loose and float in the fluid of your inner ear. The movement of the crystals and the fluid leads you to feel dizzy. Sometimes, an ear injury can lead to BPPV.
Vestibular neuronitis causes severe, sudden dizziness that lasts two to three weeks. Doctors think an infection with a virus may be the cause.
Meniere's disease is a condition that combines symptoms of dizziness with occasional hearing loss. Doctors aren't sure what causes it, though stress can be a trigger, along with eating salt or drinking caffeine and alcohol.
Some other conditions of the inner ear also lead to peripheral vertigo, including:
- Labyrinthitis
- Perilymph fistula
- Superior semicircular canal dehiscence syndrome (SSCDS)
A viral infection of your inner ear may cause labyrinthitis. Perilymph fistula may be due to a head injury or sudden pressure change, such as scuba diving. SSCDS may be due to a breakdown of part of a bony part of a canal that carries fluids in your inner ear.
Peripheral vertigo symptoms
Nausea and vomiting, sweating, and ear problems are all common symptoms that you may have, along with vertigo.
If your peripheral vertigo is caused by an inner ear infection or a disease, you may have some pain or a feeling of fullness in your ear.
In labyrinthitis and Meniere's disease, you may have hearing loss and tinnitus (ringing of the ears) in one or both ears, along with the vertigo.
There are some common features of peripheral vertigo that can help your doctor make a diagnosis. Vertigo that starts without warning and stops just as quickly is more likely to be peripheral vertigo.
Your eyes may also move without your control. This movement may go away when you try to focus your vision on a fixed point. It also tends to only happen during the first few days of vertigo symptoms and then disappears.
Peripheral vertigo treatment
You can treat peripheral vertigo by managing the condition that's causing it.
BPPV, the most common cause of peripheral vertigo, can be treated with a 15-minute exercise known as the Epley maneuver. This series of movements, done in your doctor's office, helps return the crystals that control balance to the correct place in your inner ear.
Anti-inflammatory drugs can sometimes help ease symptoms of peripheral vertigo caused by vestibular neuronitis, Meniere's disease, or labyrinthitis. You can also control Meniere's disease by cutting down on salt, caffeine, and alcohol and lowering your stress.
For some conditions, such as perilymph fistula or SSCDS, your doctor may suggest surgery to correct problems in your inner ear.
Some conditions causing peripheral vertigo may be chronic, meaning they are ongoing. In these situations, you'll need a combination of balance exercises, lifestyle changes, and medication to manage the vertigo. Motion sickness medicine may also help ease nausea. Your doctor may also prescribe medicines that help reduce balance problems.
Central Vertigo
An issue in the brain, typically the brain stem or cerebellum (back part of the brain), triggers central vertigo.
Central vertigo causes
Central vertigo is caused by a disease or injury to the brain, such as:
- Head injuries
- Illness or infection
- Multiple sclerosis
- Migraines
- Brain tumors
- Strokes
Transient ischemic attacks ("mini" strokes that last a short time and don't cause permanent damage)
Central vertigo symptoms
While episodes of peripheral vertigo tend to pass quickly, central vertigo often comes without warning and may last long periods. The episodes are generally much more intense than peripheral, and you may be unable to stand or walk without help.
Eye movement that you can't control happens in both types of vertigo. But in central vertigo, this eye movement lasts longer (weeks to months during vertigo episodes) and does not go away when you're asked to focus on a fixed point.
Hearing problems, which are common in peripheral vertigo, are rare in central vertigo. But other symptoms, such as headaches, weakness, or trouble swallowing, are common in central vertigo.
Central vertigo treatment
The only way to manage central vertigo is to find and treat its root cause. If migraines are the cause, for instance, medication and reducing stress may help.
For some ongoing conditions, such as multiple sclerosis, stroke, and some tumors, treatment may consist of managing the symptoms. This may include medicines for nausea and drugs that help lessen the sensation of movement.
A stroke in the brain can trigger vertigo, dysarthria (slurred speech), ataxia (problems moving), weakness, and numbness/tingling. You should get emergency help right away.
Takeaways
Vertigo is the sensation that the world is spinning. It can be caused by two main types: peripheral and central. Peripheral vertigo is the more common type and is usually caused by problems in the inner ear, such as BPPV, vestibular neuronitis, or Meniere's disease. Symptoms can include dizziness, nausea, ear pain, hearing loss, and a feeling of fullness in the ear. Treatment may involve exercises like the Epley maneuver, medications, and lifestyle changes.
Central vertigo, which is caused by issues in the brain, such as head injuries, strokes, or multiple sclerosis, tends to be more severe and lasts longer. It often comes with headaches, weakness, and trouble swallowing and requires treatment based on the underlying cause.
If you have vertigo, it's important to talk a doctor to figure its cause and get the right treatment.
