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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

Vertigo is a sensation of spinning or whirling even when you are stationary, often caused by problems in the inner ear or brain. The most common form, benign paroxysmal positional vertigo (BPPV), is triggered by specific changes in head position. While vertigo itself is not usually serious, it can significantly affect daily activities and may sometimes indicate an underlying neurological condition.

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

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