Vertigo

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Overview

Vertigo is a common presenting complaint in primary care offices and emergency departments. It is a symptom of vestibular dysfunction and has been described as a sensation of motion, most commonly rotational motion. It is important to differentiate vertiginous symptoms from other forms of dizziness, such as lightheadedness, which is most often associated with presyncope. Vertigo affects all ages. In younger patients, middle ear pathology is most often the cause. In the elderly, specific assessment is needed due to the risk of falls and their complications.

Symptoms

Vertigo distorts your sense of direction and the spatial perception of your body. The episodes can last anywhere from a few minutes or less to several hours. They may be barely noticeable or completely disruptive (for example, a complete loss of balance to the point that you can't stand without falling).1

Common symptoms of vertigo include:

A dizzy feeling like you or your surroundings are spinning

A feeling of swaying, tilting, or being pulled in a direction

Loss of balance

Difficulty standing or unsteady walking

Other symptoms may accompany vertigo and will depend on the underlying cause. These symptoms can include:

Nausea

Vomiting

Headache

Sensitivity to light and sound

Sweating

Abnormal eye movements

Hearing loss

Ringing in the ears

One-sided tinnitus (ringing in the ear)

Ear fullness

Ear pain

Causes

Migraine headaches.

Certain medications.

Stroke.

Arrhythmia.

Diabetes.

Head injuries.

Prolonged bed rest.

Shingles in or near the ear.

Risk factors

Benign paroxysmal positional vertigo occurs most often in people age 50 and older, but can occur at any age. BPPV is also more common in women than in men. A head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

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Complications

Vertigo can interfere with driving, work, and lifestyle. It can also cause falls, which can lead to many injuries, including hip fractures.

Prevention

There are a few steps you can take to reduce your risk for vertigo. These include:


Taking extra time to stand up, turn your head or perform other triggering movements.

Sleeping with your head elevated on two pillows.

Sitting down as soon as you feel dizzy.

Squatting instead of bending over when picking something up.