Vertigo

About Vertigo

Vertigo is the sensation of spinning or movement when the body is stationary. It is a symptom, not a diagnosis, and affects approximately 20 to 30 percent of people at some point. The most common cause is benign paroxysmal positional vertigo BPPV, accounting for approximately 20 percent of vertigo cases. BPPV occurs when otoconia calcium crystals dislodge from the utricle and enter the semicircular canals, causing brief episodes of intense spinning lasting under 1 minute, triggered by head position changes. The Epley maneuver repositions the crystals and is highly effective. Vestibular neuritis and labyrinthitis cause sudden severe vertigo lasting days, often following a viral infection. Meniere disease involves recurrent vertigo episodes lasting 20 minutes to 12 hours, with fluctuating hearing loss, tinnitus, and ear fullness. Vestibular migraine is an underdiagnosed cause. Clinicians consider central causes including stroke, multiple sclerosis, and tumors, particularly with accompanying neurological symptoms. Sudden vertigo with double vision, slurred speech, facial drooping, limb weakness, or inability to walk may indicate a stroke and is a medical emergency; call your local emergency number. Diagnosis involves the Dix Hallpike maneuver for BPPV, head impulse test for vestibular neuritis, and imaging when central causes are suspected. Treatment depends on the cause. Vestibular rehabilitation therapy helps compensate for vestibular dysfunction.