Vertigo: 7 Things Doctors Want You to Know

Medically Reviewed By William C. Lloyd III, MD, FACS

Written By Karon Warren on March 30, 2020

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  Vertigo: A Misunderstood, but Easily Diagnosed and Treated Condition

  Throughout their lifetime, nearly 40% of all U.S. adults will experience vertigo at least once, according to University of California San Francisco Health, which also states women are slightly more likely to experience vertigo than men. Much more than just dizziness, the cause of vertigo is not always clear. However, it can be easily diagnosed and treated. The key to effective treatment for vertigo is seeking out medical evaluation as soon as possible. This also ensures the vertigo is not indicative of something more serious. Here’s what doctors who treat it want you to know:
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  1. “Vertigo and dizziness are not the same.”

  Although many people may experience dizziness as part of vertigo, it is not the same as vertigo. “The main symptom that distinguishes between the feeling of fainting and dizziness and how you would feel during vertigo is the sensation of the whole world around you spinning,” says Dr. Sashini Seeni of DoctoronCall.com.my. “Some people who experience this are not able to stand upright as they couldn’t perceive which is up or down.”
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  2. There are many different causes of vertigo.

  Determining the cause of vertigo is not always easy; oftentimes, the cause may be unknown. Other times, it takes time to narrow down the cause to one source. “The most common [cause] is known as benign paroxysmal positional vertigo, or BPPV,” says Ilan Danan, MD, MSc, sports neurologist at Kerlan-Jobe Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles. “BPPV is caused by a temporary malfunctioning of the inner ear canals resulting in severe dizziness and rapid involuntary movements of the eyes, known as nystagmus.” Other causes include inner ear disorders, concussion, migraine headaches, stroke, and multiple sclerosis.
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  3. “Vertigo generally is diagnosed during a medical evaluation.”

  In most cases, vertigo can be diagnosed following a full medical evaluation with your doctor that includes a thorough history and clinical examination. “Certain clinical tests and observations, such as head impulse testing or the Dix-Hallpike maneuver can be helpful when assessing for vertigo,” Dr. Danan says. “On certain occasions, additional testing, such as imaging or tests of the auditory (hearing) or vestibular (balance) systems may be indicated.”
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  4. “Some vertigo cases require more advanced testing.”

  Although most cases of vertigo don’t require additional tests beyond a full medical evaluation, there are times when it is necessary. “Some cases of vertigo will require an MRI for diagnosis,” says Kevin Peng, MD, of the House Clinic in Los Angeles. “An MRI scan can be used to detect rarer causes of vertigo, such as vestibular schwannoma, which could require surgical treatment. (Vestibular schwannoma is a noncancerous tumor on the vestibular nerve of the inner ear.) In some cases, videonystagmography, which is a test of the inner ear and portions of the brain, can be considered.”
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  5. “Treatments vary based on the type of vertigo.”

  “Some causes of vertigo are readily treated, like BPPV, which is one of the most common types of vertigo and is caused by a problem with the inner ear,” Dr. Peng says. “BPPV can be treated with a common in-office procedure called the Epley maneuver. Others, like Ménière’s disease or vestibular migraines, may require longer-term treatments.” Also, according to Dr. Danan, vestibular rehabilitation therapy as well as medications, such as meclizine, have been shown to be effective for symptomatic relief.
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  6. “Stress can affect vertigo and vice versa.”

  It’s well known that stress cannot only aggravate but also exacerbate many medical conditions, and vertigo is no different. However, not all vertigo is affected by stress. “In vertigo, there are only a few conditions that are affected by [stress], such as BPPV,” Dr. Seeni says. On the other hand, certain types of vertigo can have the adverse effect. “In other conditions, like Ménière’s disease, instead of [stress] exacerbating it, vertigo itself may induce stress.”
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  7. “Don’t brush off vertigo.”

  “If one were to experience an episode of vertigo, the most important thing to do is see a neurologist for further evaluation,” Dr. Danan says. “This will ensure that the underlying cause has been determined and preventative measures for future events can be addressed.”

Vertigo: 7 Things Doctors Want You to Know

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