Vertigo: A Common Symptom With Many Different Causes

The first step in treating vertigo is understanding its cause. Many conditions can trigger vertigo an expert says.

Middle ear fluid, dislodged crystals in the inner ear, Meniere’s disease, vestibular neuritis and vestibular migraine all can cause vertigo, according to Dr. Mina Le. She is an otolaryngologist-head and neck surgeon with Mountainside Medical Group in New Jersey.

“If your vertigo is from middle ear fluid, you likely have trouble hearing and it may sound like you’re underwater,” Le said in a news release from Hackensack Meridian Health.

“You may have pain or pressure in the affected ear,” she continued. “The problem commonly begins after a head cold. A physician can look at your eardrum to confirm this diagnosis. You will get antibiotics if it’s an acute infection, and decongestants and nasal balloon therapy if it’s chronic.”

Short bouts of dizziness may be due to benign paroxysmal positional vertigo (BPPV).

“If your vertigo only lasts for a few seconds at a time, and if it is brought on by turning your head or rolling over in bed, you most likely have BPPV, in which the crystals in your inner ear are dislodged,” Le said. “A physician can confirm this diagnosis with a Dix-Hallpike test.”

If you have BPPV, you will be treated with a method called the Epley maneuver, in which the head is turned from side to side to reset your inner ear crystals.

“Working with a physical therapist can help,” Le said.

Debilitating episodes of vertigo that interfere with daily tasks may indicate Meniere’s disease.

“Meniere’s disease is characterized by distinct episodes of spinning vertigo, usually with nausea and vomiting, that are accompanied by a roaring sound, a fullness in your ears and hearing loss,” Le said.

Episodes, which are disabling, tend to last for hours.

“Treatment begins with a low-salt diet, reduction of caffeine and diuretic pills to decompress the inner ear,” Le said. “Migraines are a common concurrent diagnosis that Meniere’s patients need to address in managing the disease.”

Vestibular neuritis — inflammation of a nerve in the inner ear — is another condition that can cause vertigo.

“Vestibular neuritis is a self-limited illness in which you are essentially confined to bed with severe vertigo that causes nausea and vomiting, but it improves in a few days and is gone in a few weeks,” Le said.

“This is most likely the result of a viral infection, so the treatment is rest and time,” she added. “Over-the-counter medications, like meclizine, can help with the symptoms.”

If your vertigo isn’t due to any of the previous conditions and it lasts for minutes to days but happens over and over, it’s most likely caused by vestibular migraine.

“The first step is to identify and remove common migraine triggers such as stress, poor sleep, sensory overload and food elements such as MSG, preservatives, alcohol and caffeine. If that’s not enough, you may be started on a preventative medication,” Le said.

More information

There’s more on vertigo at the U.S. National Library of Medicine.

SOURCE: Hackensack Meridian Health, news release, April 20, 2021