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Vertigo, or dizziness, is a symptom, not a disease. It refers to the sensation of spinning that occurs as a result of a disturbance in balance (equilibrium). It also may be used to describe feelings of dizziness, lightheadedness, faintness, and unsteadiness.
Vertigo usually occurs as a result of a disorder in the vestibular system (i.e., structures of the inner ear, the vestibular nerve, brainstem, and cerebellum). The vestibular system is responsible for integrating sensory stimuli and movement and for keeping objects in visual focus as the body moves.
The sudden onset of vertigo usually indicates a peripheral vestibular disorder (e.g., benign paroxysmal positional vertigo (BPPV), Ménière disease, vestibular neuritis).
Symptoms of Meniere disease and vestibular neuritis include vertigo, hearing loss, ringing in the ears (tinnitus), and ear pressure that often lasts hours to days. Symptoms of BPPV usually last a few seconds.
It is important to diagnose the cause of vertigo, or dizziness, as quickly as possible to rule out serious conditions such as stroke, hemorrhage, or tumor. Diagnosis includes clinical history, physical and neurological examination, blood tests, and imaging tests (e.g., CT scan, MRI scan).
Treatment includes antibiotics, antiemetics and antivertiginous drugs. Ménière disease may be treated by reducing sodium (salt) intake and with diuretic medications. A short, tapered course of corticosteroids may be prescribed early in the disease to reduce inflammation and stabilize hearing. Antibiotics (e.g., gentamicin) may be administered into the middle ear to treat severe vertigo caused by Ménière disease.
Vestibular rehabilitation therapy is an option in some patients to treat vertigo.
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