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Dazed and Dizzy: What’s Causing My Vertigo?

Commonly characterized by a feeling of spinning, vertigo can be a scary and confusing symptom of a larger problem.

More than 15% of American adults experience dizziness, including vertigo, each year. But there’s one major misconception when it comes to vertigo: It’s not a diagnosis, but a symptom.

Vertigo is defined as an illusion of motion—it may feel like you or your environment is moving or spinning. “The disorder that often gets called vertigo is actually known as benign paroxysmal positional vertigo, or BPPV. It’s the most common cause of vertigo,” says otolaryngologist Dennis Fitzgerald, MD.

Benign Paroxysmal Positional Vertigo

BPPV results when small calcium particles in the inner ear either break loose on their own or get knocked loose due to a head injury. “These small particles will float into a part of the inner ear where they don’t belong,” Dr. Fitzgerald explains. “And vertigo can happen when you lay down flat in bed, roll over from one side to the other, get out of bed, look up at a high shelf or bend over to get something off the floor.”

For many years, BPPV had no known cause and no treatment options. Today, there are a few physical maneuvers that can be used to allow the loose particles to float back into place and alleviate feelings of vertigo. The Epley maneuver is a series of head movements to relieve symptoms of vertigo. Dr. Fitzgerald says it is the most popular way to treat vertigo. “It’s successful in over 95% of patients being treated for BPPV in just one or two sessions.”

Migraine Disorders

The second most common cause of vertigo is a migraine disorder. “When occurring due to migraine, vertigo is considered an aura,” says Dr. Fitzgerald. “Auras can also be visual, in which case the person would experience flashing lights or structures appearing in their vision.”

While some will experience vertigo alongside symptoms of a headache, other people may experience a vestibular migraine—which may or may not involve a headache in combination with vertigo, balance issues, nausea and vomiting. Migraine-related vertigo can be treated with daily medications, such as calcium channel blockers.

Meniere’s Disease

Although less common than BPPV and migraine disorders, another cause of vertigo is Meniere’s disease. This is a disorder of the inner ear that leads to four telltale symptoms: vertigo occurring in brief, intermittent intervals; fluctuating, low-frequency hearing loss; feelings of fullness or pressure in the ear; and roaring tinnitus—hearing a sound that isn’t really there. “Meniere’s disease is episodic but, over time, can result in permanent hearing loss in the affected ear,” says Dr. Fitzgerald.

Treatment for Meniere’s disease in its early stages involves lifestyle changes, like adopting a low-sodium diet, and prescription medication, such as a mild diuretic. In later stages, it can be treated with injections into the ear or surgery on the ear.

Visit Your Doctor

Vertigo can be a frightening experience that warrants a trip to the emergency department. If you’re experiencing recurrent vertigo, it’s important to talk to your healthcare provider, who can refer you to an otolaryngologist, commonly known as an ENT. “You don’t have to suffer. An ENT can conduct the proper tests to determine the cause of your vertigo and prescribe a treatment plan,” says Dr. Fitzgerald.

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