Peripheral Vertigo — Causes of Dizziness

Meniere's Disease, BPPV, and Other Causes

dizzy Asian woman holding head
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Vertigo is the sensation of motion in the absence of movement. This can cause you to experience symptoms similar to motion sickness and may commonly be referred to as: vertigo, presyncope (nearly passing out), disequilibrium (unstable or unbalanced), or lightheaded. Vertigo is commonly caused by abnormalities with structures of your inner ear, referred to as peripheral vertigo, but can also be caused by your brain (central vertigo).

Peripheral vertigo is most commonly caused by a malfunction of one or more of the structures in the inner ear. These structures make up the vestibular system, which is responsible for your balance. The following are the most common causes of peripheral vertigo.

Symptoms of Vertigo

Feelings of vertigo can seriously disrupt your ability to participate in normal everyday activities. Symptoms that commonly accompany vertigo include:

  • nausea
  • vomiting
  • nystagmus (quick, jerking eye movements, usually from side to side).
  • dizziness
  • balance problems or a feeling that you are standing still while the world is spinning around you
  • feeling pulled in different directions
  • problems with hearing and vision
  • headaches

You may find that you have a difficult time describing the exact feeling or symptom to your healthcare provider; this is normal.

Your physician will be able to use their assessment skills to help differentiate what is causing your symptoms. When visiting with your physician, be prepared to discuss:

  • timing of episodes
  • triggers of your symptoms

Causes, Prevention, and Treatment

There isn't a one-size-fits-all treatment for vertigo.

In general, however, because vertigo is directly related to the fluid balance in your inner ear, dietary changes that affect body fluids may help. Your doctor will likely recommend changes in the amount of salt, sugar, and caffeine you consume.

Proper diagnosis of the vertigo's cause is important for selecting treatment that's most likely to be effective. Common causes include the following.

Motion Sickness — If you get motion sickness, chances are you know the situations that bring it on -- such as boating or reading in a moving car -- and avoid them as much as possible. If you can't avoid such a situation, try staring at a stationary object while you're moving; this may help you maintain a sense of balance and prevent other symptoms. If you're planning to be in a situation where you can expect to experience vertigo, such as a cruise, ask your doctor if you can wear a scopolamine patch to help prevent nausea and vomiting.

Benign Paroxysmal Positional Vertigo — BPPV is a disorder that causes calcium deposits to float in the semicircular canals of the inner ear, causing vertigo when you move. Treatment of this disorder involves canalith repositioning like the Epley maneuver. Canalith repositioning involves a series of rotating head positions that aid in moving the debris out of the semicircular canals and into other areas of your ear, where symptoms don't occur and the deposits will be broken up.

This procedure must be performed by a specialist.

Meniere's Disease — This is a more difficult cause of vertigo to treat, simply because the cause is still unknown. What is known is that, in Meniere's disease, the fluid in your inner ear is not in balance, which leads to the symptoms of vertigo.

There's no cure for Meniere's disease. However, appropriate treatment to help restore fluid balance, such as changing to a low-salt diet and using a diuretic (water pill), may help control the symptoms. Medications that may help to either prevent or relieve symptoms of vertigo include:

  • Meclizine
  • Benzodiazepines
  • The scopolamine patch
  • Antibiotics

Surgical procedures to treat Meniere's disease include:

  • Injection of the antibiotic gentamicin or steroids
  • Removal of parts of the inner ear, based on symptoms
  • Cutting the vestibular nerve so that information from the inner ear about the body's balance is no longer available to the brain (this procedure doesn't damage hearing)

Depending on the severity of your vertigo and the treatment you receive, your doctor may recommend vestibular rehabilitation (an exercise-based program to reduce dizziness and improve balance) for you. This program teaches you to work with a different sense of balance as a way of compensating for the problems caused by Meniere's disease.

A Word From VeryWell

  • See a doctor if you have recurring or unexplained vertigo.
  • The most common types of peripheral vertigo, such as motion sickness and benign paroxysmal positional vertigo (BPPV), are not life threatening.
  • Most instances of vertigo are temporary, but it can become chronic.
  • Support groups are available to help you cope with vertigo and exchange coping techniques with others in your situation.

Yes, living with vertigo can be difficult. But there are things you can do to minimize its adverse effects. Understanding your personal vertigo situation and working with a doctor who treats vertigo can help you keep your life "in balance".

Sources:

Canalith Repositioning Procedure - for Treatment of BPPV. Vestibular Disorders Association website. http://vestibular.org/understanding-vestibular-disorders/treatment/canalith-repositioning-procedure-bppv. Accessed July 23, 2017

Meniere's Disease. Merck website. http://www.merckmanuals.com/home/ear-nose-and-throat-disorders/symptoms-of-ear-disorders/dizziness-and-vertigo. Accessed July 23, 2017

Muncie, HL, Sirmans, SM & James, E. (2017). Dizziness: Approach to Evaluation and Management. Am Fam Physician. 95(3):154-162.

Possible Symptoms of Vestibular Disorders. Vestibular Disorders Association. https://vestibular.org/understanding-vestibular-disorder/symptoms. Accessed July 23, 2017

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