Dizziness and/or loss of balance is the second most common complaint doctors hear, and it is the most common complaint in patients over the age of 75. Your bout of dizziness may simply be a fleeting experience, or it may be a symptom of a reoccurring balance condition called vertigo.
According to the National Institutes of Health, 70 percent of Americans will experience dizziness at some point in their lives, and about 40 percent of the population will report having vertigo at least once in their life. The prevalence of vertigo is greater in women and increases with age, but it can occur in people of all ages, including children. Vertigo as a condition isn’t going to hurt you, but the accompanying symptoms can affect your overall well-being. In mild cases, it might lead to fatigue, struggles at work, and depressed feelings. In more severe cases, it can result in difficulty walking and standing, and it can lead to sudden falls and injury.
Identifying the symptoms you experience might help you identify which type of vertigo you have, and it will help your hearing and balance care provider identify the specific causes of your vertigo. Certain types of vertigo have certain causes, and most equilibrium disorders typically fall into two categories:
- Acute attacks of dizziness or a general loss of balance that may last a few seconds or a few hours
- A persistent sense of imbalance, unsteadiness, or what some people refer to as a loss of sure-footedness
So What Causes Vertigo?
Generally, vertigo occurs as a result of a disturbance in equilibrium due to a disorder in the vestibular system, an area in the inner ear responsible for keeping objects in focus as the body moves. Specific vestibular disorders that may cause vertigo include benign paroxysmal positional vertigo (BPPV), Ménière’s disease, vestibular neuritis, and ototoxicity (ingestion of a chemical that is toxic to your inner ear). Each of these disorders has their own unique causes, effects, and treatments.
- BPPV is the most common type of vertigo and makes up approximately 50 percent of vertigo complaints, particularly in older individuals. With BPPV, tiny particles made up of calcium and protein form and break off into the inner ear canals. Head movements cause these particles to shift the inner ear’s nerve hairs, which send signals to the brain that initiate the sensation of vertigo.
- BPPV is characterized by bouts of vertigo that can be accompanied by weak facial muscles, reduced cognitive function, and hearing loss. Common causes of this type of vertigo include head injuries, infection, and inner-ear degeneration due to aging.
- Ménière’s disease is an inner-ear disorder believed to result from excess fluid and changing pressure in the inner ear. Ménière’s typically affects only one ear and is characterized by sudden vertigo attacks that sometimes occur after a brief period of muffled hearing or tinnitus. You may also have a feeling of fullness in the ear, as well as prolonged hearing loss that may be temporary or permanent.
Ménière’s is considered a chronic condition that usually affects people between the ages of 40 and 60, but it can occur in people of all ages. Causes of Ménière’s include constricted blood vessels, viral infections, allergies, autoimmune reactions, and genetic predispositions. There is no cure, but medications to treat vertigo, and other treatments to balance the fluids in the body, are usually effective at alleviating symptoms.
- Vestibular neuritis is an inner-ear disorder usually related to infections that cause inflammation in the ear. Most of the inflammation happens around nerves that are crucial to the body’s sense of balance, and once inflamed, these nerves are unable to send the correct sensory information to the brain. This causes vertigo, as well as other vision and hearing disturbances. The infection takes hold suddenly and can occur at any time.
Treatment for this type of vertigo usually includes relieving nausea and dizziness while healing the infected area with antibiotics, steroids, or antiviral drugs. Rarely, vertigo symptoms will become chronic and persist for several months.
- Ototoxicity is a poisoning of the inner ear due to exposure to or ingestion of medications or chemicals that damage the vestibular nerves. High doses or long-term use of certain antibiotics, antidepressants, loop diuretics, pain relievers, and prescription or over-the-counter medications can cause ototoxicity. Symptoms of an ototoxic infection include vertigo, blurred or bouncing vision, headaches, fatigue, and nausea.
There’s no standard treatment for ototoxicity because there are more than 750 potentially ototoxic chemicals, and discovering the exact toxic chemical can be difficult. Treating vertigo caused by ototoxicity usually focuses on therapies to help restore balance until you are able to process the chemicals and pass them out of your body.
Most types of vertigo are treatable when accurately diagnosed by a hearing and balance specialist. Relief may come in the form of medication or physical maneuvers to help resolve your spinning, nausea, and headaches — but you won’t know until you get a diagnosis.