Vertigo Explained: Causes, Symptoms, Triggers and When to Seek Help

If you have ever experienced vertigo, you know that it is no fun at all. Here is a closer look at this condition, its causes, and what to do if you suspect you are being affected.

Symptoms and Causes of Vertigo

Sufferers of vertigo know all too well the uncomfortable and scary feeling that can seemingly come out of nowhere. Vertigo is often described as feeling as if the room is spinning and a loss of balance. Other symptoms include nausea, vomiting, and a ringing sensation in the ear.

The latest research indicates that 20% of people have experienced some degree of vertigo. According to the American Medical Association (AMA), peripheral vertigo is the most common type of vertigo, accounting for roughly 80% to 90% of the cases.

There are several subtypes within the peripheral vertigo type. These include benign paroxysmal positional vertigo (BPPV), labyrinthitis, vestibular neuritis, and Ménière’s disease.

Vertigo is defined as a specific type of dizziness that is marked by the feeling of movement even when the body is at rest. According to Rebecca Andrews, PT, DPT, who specializes in vertigo and vestibular issues at Gaylord Specialty Healthcare in Connecticut, "People may describe this as spinning, rotating, tilting, or feeling as though the room is moving. In contrast, dizziness is a broad, nonspecific symptom descriptor that can include sensations of lightheadedness, imbalance, disorientation, floating, or feeling 'off.'"

There are many things that trigger vertigo, making it sometimes difficult to determine what is causing the sensation. One of the most common causes of vertigo comes from issues with the vestibular system. These causes are typically referred to as peripheral or central issues. Peripheral vestibular disorders involve the inner ear, encompassing the vestibular organs and labyrinth.

Conversely, central vestibular disorders have a root cause in the brain and its vestibular pathways. This includes problems with the pathways that connect the inner ear to the central nervous system.

There are also several systemic or metabolic conditions that can cause dizziness and symptoms that resemble classic vertigo. These conditions include thyroid or adrenal disorders, certain vitamin deficiencies, dehydration, hypoglycemia, or hyperglycemia.

It is also not unusual for patients with dysautonomia to develop what is known as orthostatic dizziness. For example, individuals with postural orthostatic tachycardia syndrome (POTS) often describe the associated dizziness as vertigo. Andrews explained that "In the clinic, I see patients with a variety of vestibular and balance-related conditions. Some of the most common include vestibular neuritis, labyrinthitis, vestibular migraine, Ménière’s disease, BPPV (benign paroxysmal positional vertigo) and PPPD (persistent postural-perceptual dizziness)." She went on to detail that "The key distinction is that vertigo describes a specific sensation of movement, while dizziness is a broader term that describes a range of abnormal sensations related to balance, orientation, or spatial perception."

Forms of Vertigo

Looking specifically at BPPV, sufferers of this type of vertigo present with small calcium crystals that are pushed out of their normal spot within the inner ear. From there, the crystals travel into one of the semicircular canals and trigger brief bouts of positional vertigo. This type of vertigo happens as a result of sudden movements, such as rolling over in bed or looking up quickly.

Other forms of dizziness are triggered by vestibular migraine. This is one of the most common types of spontaneous vertigo.

Andrews notes that vestibular migraine can be brought on by anxiety. According to Andrews, "Anxiety can both worsen existing dizziness and increase the risk of developing persistent dizziness, particularly PPPD. PPPD is a functional vestibular disorder characterized by persistent dizziness, unsteadiness, or non-spinning vertigo that is often aggravated by upright posture, movement, and visually complex environments."

Although anxiety does not specifically cause dizziness, a person is more likely to be more attuned to bodily sensations when they are feeling anxious. This hyperawareness can interfere with balance and general spatial information. Or as Andrews explains, "This can create a cycle in which dizziness increases anxiety, and anxiety subsequently makes the dizziness more noticeable or persistent."

Allergies can be another trigger for BPPV. This is particularly true for allergies that impact eustachian tube dysfunction and increase middle ear pressure.

The various root causes of vertigo not only make it difficult to diagnose, but it can also be challenging to determine what course of treatment will be the most effective. For example, a patient dealing with eustachian tube dysfunction may need to see an allergist, while another vertigo sufferer will find more success with a neurologist or an ear, nose, and throat specialist.

While vertigo itself is not typically dangerous, it is important to seek immediate medical attention if your vertigo episodes come with double vision, severe headache, chest pain, trouble walking, body weakness, or slurred speech. This could be a sign of something more serious and potentially life-threatening.

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