Vertigo is a sensation of spinning dizziness that can be very debilitating. While vertigo is a condition in itself, it can sometimes signal an underlying medical issue that needs attention. In this article, we’ll explore whether vertigo can be a symptom of something else.
What is vertigo?
Vertigo is more than just feeling dizzy or lightheaded. It is a specific type of dizziness where you feel like you or your surroundings are spinning or moving. This spinning sensation is often accompanied by nausea, vomiting, trouble walking, and difficulty maintaining balance.
There are two main types of vertigo:
- Peripheral vertigo – This is the most common type of vertigo and is caused by a problem in the inner ear. It can come on suddenly and may be associated with hearing loss or ringing in the ears.
- Central vertigo – This type of vertigo originates in the brain or brainstem. It may come on more gradually and can be caused by migraines, tumors, or stroke.
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of peripheral vertigo. Tiny calcium particles become dislodged in the inner ear canals, causing a sense of spinning with changes in head position.
Can vertigo be a symptom of something else?
Yes, vertigo can sometimes be a symptom of an underlying medical condition. While vertigo is a problem itself, determining the root cause is important for proper treatment and management.
Some conditions that may cause vertigo include:
- Vestibular neuritis – This is an inner ear disorder caused by inflammation of the vestibular nerve. It leads to vertigo, dizziness, and loss of balance.
- Labyrinthitis – An infection or inflammation of the inner ear that affects balance and hearing.
- Meniere’s disease – A chronic inner ear condition caused by fluid buildup that leads to vertigo, ringing ears, hearing loss, and a feeling of fullness in the ear.
- Vestibular migraine – A migraine subtype that causes vertigo and dizziness along with headache.
- Stroke – Vertigo, imbalance, nausea and other neurological symptoms may signal a stroke in the posterior circulation of the brain.
- Multiple sclerosis – Dizziness and vertigo can be an early sign of MS, an autoimmune disease that damages the central nervous system.
- Acoustic neuroma – A non-cancerous brain tumor on the vestibular nerve that causes vertigo, hearing loss, and ringing ears.
Less common causes of vertigo may include head injury, brain hemorrhage, medication side effects, thyroid dysfunction, cervical spondylosis, syphilis, and autoimmune disorders.
When to see a doctor
It’s important to see a doctor if you experience:
- Prolonged or recurring vertigo episodes
- Vertigo along with slurred speech, visual changes, loss of coordination or weakness
- Vertigo with fever, headache, ear pain or loss of hearing
- Difficulty walking or inability to stand due to vertigo
- Vertigo causing significant impact on daily activities
Seeking prompt medical care can help diagnose any underlying condition and start appropriate treatment to relieve symptoms.
Diagnosing the cause of vertigo
To determine if vertigo is due to an underlying problem, the doctor will begin with a medical history and physical exam. They will ask about your symptoms, perform a neurological exam, and test your balance and coordination.
Other tests that may be done include:
- Hearing test – Assesses for hearing loss or ear damage.
- Blood tests – Helps rule out thyroid disorders, autoimmune diseases, syphilis or other infections.
- Imaging – CT or MRI scans of the head may detect strokes, tumors or other brain abnormalities.
- Electronystagmography (ENG) – Records eye movements to assess the vestibular nerves and central nervous system pathways involved in balance.
- Vestibular evoked myogenic potentials (VEMP) – Tests the function of inner ear balance structures.
Once any underlying condition is identified, specific treatment can begin.
Treating vertigo
Treatment will depend on the cause of vertigo. For ongoing management of chronic vertigo, options may include:
- Medications like antihistamines, anticholinergics, and benzodiazepines to reduce inner ear symptoms.
- Vestibular rehabilitation – Exercises to promote central compensation and improve balance.
- Canalith repositioning maneuvers – For BPPV, maneuvers are done to reposition calcium crystals in the inner ear.
- Surgery – If acoustic neuroma, stroke or other structural abnormalities are causing vertigo.
- Treating underlying conditions – This may include antibiotics for infections, controlling diabetes, or adjusting blood pressure medications.
Making certain lifestyle changes can also help minimize episodes of vertigo:
- Avoid positions that trigger vertigo
- Use caution with head movements
- Wear flat shoes for stability
- Use grab bars and railings when needing balance support
- Have adequate lighting in rooms and stairwells
- Don’t drive until vertigo is controlled
When vertigo becomes chronic
For most people, vertigo resolves within a few weeks or months with treatment. But for some, vertigo can become a chronic, long-lasting issue.
Chronic vertigo is generally defined as experiencing vertigo for 3 months or longer.
The main causes of chronic vertigo include:
- Meniere’s disease
- Vestibular migraine
- Vestibular neuritis or labyrinthitis that has not fully resolved
- Malfunction of the vestibular system
- Anxiety disorders
Managing chronic vertigo focuses on symptom relief and learning to function as normally as possible. This may include:
- Balance and gait training
- Head and neck stabilization exercises
- Developing coping strategies for daily activities
- Lowering sodium intake
- Avoiding triggers like alcohol, caffeine, and stress
- Anxiety and depression treatment
- Medications as needed for symptom control
Coping with chronic vertigo
Living with chronic vertigo can be challenging and often requires lifestyle adjustments. Some tips for coping include:
- Take it slow – Make positional changes gradually and sit down if feeling dizzy.
- Use a cane or walker for stability when walking
- Ask for help as needed with tasks like shopping or cleaning
- Arrange home furniture to allow easy movement
- Install grab bars and railings in key areas
- Keep lights on to improve spatial awareness
- Have passengers drive instead of driving yourself
- Join a support group to connect with others experiencing chronic vertigo
Being patient with yourself and acknowledging limitations is important in managing chronic vertigo. With time, many people learn to adapt and regain independence.
When to seek medical advice
Even when vertigo is chronic, it’s important to touch base with your doctor if you experience:
- Increasing severity or frequency of vertigo episodes
- Onset of new vertigo symptoms like hearing changes or ear fullness
- Increase in falls or inability to safely care for yourself
- Significant unsteadiness or new focal neurological symptoms
- Headaches, double vision, slurred speech, or mental confusion
- Loss of consciousness associated with vertigo
Reporting new or worsening symptoms allows your doctor to evaluate whether any medication adjustments, additional testing, or specialty referrals are needed.
When to call emergency services
Seek emergency care if vertigo occurs along with:
- Chest pain, palpitations or difficulty breathing
- Sudden onset of severe vertigo
- Head injury or trauma
- Loss of consciousness
- Seizure
- Rapid progression of neurological symptoms
- Extreme dizziness where you are unable to walk safely or stand
Severe vertigo that comes on suddenly with other concerning symptoms can signal a medical emergency like stroke, heart attack, aneurysm or hemorrhage. Prompt evaluation is needed.
Conclusion
Vertigo can be a symptom of various underlying medical conditions like inner ear disorders, migraines, strokes, MS, and brain tumors. If vertigo arises suddenly or persists longer than one month, see a doctor for an evaluation to determine the cause.
With testing and diagnosis, doctors can identify any treatable reason for vertigo. Managing chronic vertigo involves medication, balance therapy, lifestyle changes and coping strategies. While living with vertigo has challenges, many people are able to regain a good quality of life with proper treatment.
