Vertigo

Feeling dizzy or like the room is spinning is a common problem for many people. Issues with the inner ear or the brain, such as infections, migraines, injuries, or conditions like benign paroxysmal positional vertigo (BPPV), Ménière’s disease, and vestibular migraines, most often cause vertigo. For others, problems with the central nervous system or even certain medications can also cause vertigo.

Understanding what leads to vertigo helps people manage symptoms and get the right treatment. This article will explore the main triggers of vertigo and what makes someone more likely to experience these dizzy spells.

Definition of Symptom

Vertigo is the feeling that a person or their surroundings are moving or spinning when there is no real movement. It is not the same as simple dizziness, which can feel more like lightheadedness or feeling faint.

Key Features of Vertigo

• A sensation of spinning, tilting, or swaying
• Feeling off-balance or unsteady
• Environment seeming to move around

Problems often start in the inner ear, especially in the semicircular canals. These tiny tubes help control balance and sense motion. When they do not work right, they send mixed messages to the brain. Sometimes, vertigo comes with other symptoms, such as:

• Nausea or vomiting
• Ear fullness (a feeling the ear is clogged or under pressure)
• Ringing in the ears (tinnitus)
• Difficulty walking or standing

Doctors ask about these symptoms to tell vertigo apart from other types of dizziness. Vertigo is a symptom itself, not a disease, and it often points to a problem in the inner ear or brain.

Symptom	Description
Spinning	Room feels like it’s moving
Dizziness	Loss of balance or lightheadedness
Ear fullness	Pressure or clogged feeling in ear

Possible Causes/Diseases Condition

A range of medical conditions, many involving the inner ear or the brain, can cause vertigo. Here are some common and important causes:

Benign Paroxysmal Positional Vertigo (BPPV)

• This is the most common cause of vertigo.
• Tiny crystals in the inner ear move out of place, causing short bursts of dizziness, especially with head movement.

Labyrinthitis and Vestibular Neuronitis

• Viral infections usually cause these conditions.
• Labyrinthitis is inflammation of the inner ear, while vestibular neuronitis involves the nerve connecting the ear to the brain.
• They can bring sudden, intense vertigo along with balance problems.

Meniere’s Disease

• This rare condition causes episodes of vertigo, ringing in the ears, hearing loss, and a feeling of fullness in the ear.
• Fluid buildup in the inner ear is believed to play a role.

Migraines

• Some migraines produce vertigo even without a headache.
• Migraine-related vertigo may cause dizziness, visual disturbances, and sound sensitivity.

Head Injury

• A blow to the head can damage the inner ear or brain and lead to vertigo.
• Symptoms may develop soon after the injury.

Brain Tumors

• Vertigo can sometimes be a sign of a tumor affecting parts of the brain responsible for balance.

Condition	Primary Problem	Key Symptoms
BPPV	Inner ear crystals	Brief dizziness
Labyrinthitis	Ear inflammation	Severe vertigo, nausea
Neuronitis	Nerve inflammation	Intense dizziness
Meniere’s Disease	Fluid buildup (ear)	Vertigo, hearing loss
Migraines	Nerve changes	Dizziness, aura
Head Injury	Trauma	Dizziness, confusion
Brain Tumors	Growth in brain	Vertigo, balance loss

Other causes can include certain medications or ongoing medical problems.

Other Non-Disease Causes

Daily life factors, not linked to illness or infection, can also cause vertigo or make someone feel off balance.

Sudden Position Changes

Standing up too quickly or shifting position in bed can lead to brief vertigo. Blood pressure drops, causing reduced blood flow to the brain for a short time.

Sleep Habits and Pillows

Poor sleep posture or using a pillow that does not support the neck well can affect the inner ear and spinal alignment. This may trigger vertigo episodes when waking up.

Motion Sickness

Traveling by car, boat, or plane can sometimes lead to vertigo. The brain receives conflicting signals from the eyes, inner ear, and body, resulting in dizziness.

Head Movements and Gaze Stabilization

Quick or repetitive head movements, such as spinning or looking quickly from side to side, may bring on vertigo.

Environmental Triggers

Bright lights, loud noises, or crowded spaces can also set off vertigo in sensitive individuals.

Non-Disease Cause	Example
Sudden position change	Standing up fast
Poor sleep posture	Incorrect pillow height
Motion sickness	Car or boat travel
Rapid head movement	Turning or nodding quickly
Environmental trigger	Bright lights, loud spaces

How It Causes the Symptom

Problems in the inner ear or the parts of the brain that control balance usually start vertigo. The inner ear helps the body sense movement and position. When something affects this system, it can send the wrong signals to the brain. These mixed signals make a person feel like they are spinning or the room is moving, even when everything is still. Common causes include:

• Benign Paroxysmal Positional Vertigo (BPPV): Small crystals in the inner ear become loose and confuse balance signals.
• Meniere’s Disease: Extra fluid in the inner ear can also cause hearing loss and ringing in the ears.
• Vestibular Neuritis: A viral infection of the inner ear can inflame the nerves that help with balance.

These causes can lead to symptoms like dizziness, spinning, and trouble walking. Sometimes, people also notice hearing loss and ringing in the ears, especially with inner ear problems. Medications, head injuries, and migraines can also affect the inner ear or brain, leading to vertigo. When nerves or structures responsible for balance don’t work right, these symptoms often appear.

Cause	Can cause Hearing Loss	Can cause Tinnitus
BPPV	No	No
Meniere’s disease	Yes	Yes
Vestibular neuritis	Rarely	Rarely
Migraines	Sometimes	Sometimes

Possible Complications

People with vertigo sometimes face a higher risk of falling. Falls can lead to broken bones or other injuries, especially in older adults. Vertigo often makes it hard to balance or walk straight. This lack of stability can limit a person’s ability to work, drive, or do daily activities safely. Possible complications of vertigo:

• Falls and injuries
• Trouble working or going to school
• Difficulties driving or using machinery
• Anxiety or fear due to repeated dizziness

Some may develop anxiety or depression if vertigo episodes are frequent or severe, causing stress or worry about when the next attack will happen. Certain underlying causes of vertigo, like inner ear disorders, may affect hearing or lead to a feeling of fullness in the ear. If the cause is a brain condition, other problems such as headaches or vision changes may also develop.

Complication	Possible Outcome
Falls	Bone fractures or head injuries
Work Limitations	Missed days or decreased function
Difficulty Driving	Car accidents or loss of license
Anxiety or Depression	Lower quality of life
Hearing Effects (if present)	Hearing loss or ringing in ears

When to Seek Medical Attention

Vertigo can sometimes be harmless, but certain situations require medical help. If vertigo keeps coming back, starts suddenly, or is severe, see a doctor. Get medical attention right away if vertigo starts suddenly and comes with:

• Confusion
• Trouble speaking or understanding
• Weakness or numbness in the arms, legs, or face
• Sudden, strong headache
• Trouble walking or keeping balance
• Vision changes

These signs may point to a serious issue, such as a stroke or another problem in the brain. Even without these warning signs, talk to a healthcare provider if vertigo:

• Lasts a long time
• Gets worse over time
• Makes it hard to do daily activities
• Happens with hearing loss, ringing in the ears, or fainting

A quick look at when to seek help:

Situation	Action Needed
Sudden, severe vertigo with other symptoms	Seek emergency care
Unclear cause or recurrence	Schedule doctor visit
Makes daily life difficult	Schedule doctor visit