Vertigo

Most experts agree that dizziness and vertigo can be broadly defined as the sensation of spinning or whirling while stationary. It is commonly associated with nausea, vomiting, unsteadiness (postural instability), falls,  and difficulties in walking. Several different things can cause you to have vertigo.

Ménière’s disease is a disorder of the inner ear that is characterized by episodes of vertigo, ringing in the ears (tinnitus), hearing loss and a fullness in the ear. Episodes generally last from 20 minutes to a few hours. The length of time between episodes varies and typically, only one ear is affected initially.

Labyrinthitis is inflammation of the inner ear. This is usually caused by a virus. This results in the sensation of the world spinning. Some people will have possible hearing loss and ringing in the ears. It occurs as a single attack that diminishes over three to six weeks. It may be associated with nausea, vomiting and eye nystagmus (a vision condition in which the eyes make repetitive, uncontrolled movements).

Benign Paroxysmal Positional Vertigo (BPPV) is a disorder stemming from the inner ear. It is characterized by brief periods of vertigo with head movement. This can occur with turning in bed or changing position. Each episode of vertigo typically lasts less than one minute. Nausea and disequilibrium is commonly associated. It can be diagnosed using the dix-hallpike maneuver and treated by a series of simple movements you can do at home, such as the Epley maneuver.

Migraine headaches can be a potential cause of dizziness or vertigo. Some experts refer to this as vestibular migraines. In most cases, treating the headache or migraine can resolve the dizziness.

Orthostatic hypotension is a persistent drop in blood pressure that occurs upon moving from sitting to standing or from lying down to sitting up position. This can be treated with hydration (drinking 6-8 glasses of water a day), compression stockings, and sometimes by medications (such as Florinef, Midodrine, Droxidopa, or Mestinon).

Transient ischemic attack or stroke can cause sudden onset of dizziness, usually in the presence of other neurological signs and symptoms such as the inability to move or feel on one side of the body, problems understanding or speaking, dizziness, or loss of vision on one side. If a stroke is suspected, you should seek medical attention immediately and undergo appropriate imaging and potentially stroke-related therapies.

Medication-induced dizziness or vertigo.  Common drugs associated with dizziness include anticonvulsants, antihypertensives, antibiotics, antidepressants, antipsychotics, pain medications, and anti-inflammatory drugs.