NeurologicalICD-10: H81BPPV affects about 2.4% of the general population; vertigo accounts for about 5% of ER visits

Vertigo

Also known as: Dizziness, Benign paroxysmal positional vertigo, BPPV, Spinning sensation, Vertigo attacks

Vertigo is the false sensation that you or your surroundings are spinning, tilting, or moving when you are actually still. It is a symptom rather than a disease in itself, and it most often arises from problems in the inner ear (peripheral vertigo) or, less commonly, the brain (central vertigo). The single most common cause is benign paroxysmal positional vertigo (BPPV), in which tiny calcium crystals become dislodged in the inner ear and trigger brief, intense spinning with specific head movements — such as rolling over in bed or looking up. Other causes include vestibular neuritis, Meniere's disease, and vestibular migraine. Although most vertigo is not dangerous and is highly treatable, sudden vertigo with neurological symptoms can occasionally signal a stroke and needs urgent attention.

Symptoms

Sensation of spinning or tilting
Loss of balance or unsteadiness
Nausea or vomiting
Sweating
Abnormal eye movements (nystagmus)
Headache
Ringing in the ears (tinnitus)
Hearing loss in some cases

Causes

  • BPPV caused by displaced calcium crystals in the inner ear
  • Vestibular neuritis or labyrinthitis from viral inner ear infections
  • Meniere's disease causing fluid buildup in the inner ear
  • Migraine-associated vertigo
  • Acoustic neuroma or other brain tumors (rare)

Risk Factors

  • Age over 50
  • History of head injury
  • Inner ear infections
  • Female sex for BPPV
  • Migraine history

Diagnosis

  • Dix-Hallpike maneuver to diagnose BPPV
  • Head impulse test and other vestibular function tests
  • Audiometry if hearing loss is suspected
  • MRI to rule out central causes such as stroke or tumor
  • Electronystagmography to analyze eye movements

Treatment

  • Epley maneuver and other canalith repositioning procedures for BPPV
  • Vestibular rehabilitation exercises
  • Medications such as meclizine or diazepam for acute symptom relief
  • Treatment of underlying conditions like Meniere's disease
  • Lifestyle modifications to reduce triggers

Prevention

  • Moving slowly when changing positions, especially getting out of bed
  • Vestibular exercises to improve balance
  • Avoiding rapid head movements
  • Managing migraine triggers if applicable

When to See a Doctor

  • Severe or recurrent episodes of vertigo
  • Vertigo with hearing loss, severe headache, or difficulty speaking
  • Loss of balance causing falls or injuries
  • Vertigo that does not resolve within a few days

Frequently Asked Questions

Related Conditions

Meniere's Disease

Eye & Ear

Tinnitus

Eye & Ear

Hearing Loss

Eye & Ear

Migraine

Neurological

Vitamin B12 Deficiency

Metabolic

Stroke

Cardiovascular

Related from the Supplement Library

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Herb · Supports cognitive function and memory

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Vitamin D

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Ginger

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Herb · Anti-nausea (motion, pregnancy, chemotherapy)

Magnesium Glycinate

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Mineral · Improves sleep quality and onset

These supplements have been studied in relation to Vertigo. Always consult your healthcare provider before starting any supplement, especially if you take medications.

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