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Vertigo—that feeling of the room spinning around you when you’re stationary—is a relatively common occurrence, but it can certainly feel alarming. About 40% of U.S. adults experience vertigo at some point in their lives. It can have many different causes, from migraines to ear infections.

What exactly is happening in your body when you experience vertigo? “Usually, there is a stimulation of the inner ear balance organ that leads to it,” explains Hamid Djalilian, M.D., an otolaryngologist and neurotologist with UCI Health. “It can also occur due to changes affecting the nerve centers for balance in the back part of the brain,” he says.

Meet the Experts: Hamid Djalilian, M.D., an otolaryngologist and neurotologist with UCI Health; Jared Braunstein, D.O., board-certified internist with Medical Offices of Manhattan and contributor to LabFinder.com and Daniel Flaherty, P.T., D.P.T., a physical therapist with Kindred Health Care.

Vertigo is often a symptom of something else that’s happening in your body. Below, doctors explain more about what vertigo is, other symptoms that may accompany it, and signs that mean you should speak to a doctor about your vertigo.

What is vertigo?

Vertigo happens when you experience “the sensation of movement or of surrounding objects moving when they are not,” explains Jared Braunstein, D.O., board-certified internist with Medical Offices of Manhattan and contributor to LabFinder.com. “Patients often feel as if the room is spinning.”

Vertigo symptoms

Rather than a condition, vertigo is usually a symptom of a wider diagnosis, Neil Bhattacharyya, M.D., a professor of otolaryngology at Massachusetts Eye and Ear and Harvard Medical School previously told Prevention. That said, there are other symptoms people report experiencing alongside vertigo, which include nausea, vomiting, hearing loss, ringing in ears, and trouble walking, Braunstein says. Others include blurry vision, balance impairments, ear fullness, headaches, and light headedness, adds Daniel Flaherty P.T., D.P.T., a physical therapist with Kindred Health Care.

Vertigo causes

The sensation of vertigo is often caused by signals between your ear, brain, and eyes. “The inner ear is connected through the brain stem with nerves that direct eye motion,” says Dr. Djalilian. “When the inner ear is stimulated abnormally, it sends a signal to the brain, and the brain interprets that as motion. The brain subsequently sends a signal, moving the eyes to adjust for that head motion. However, the brain realizes that motion has not occurred and then corrects that eye motion back. This can repeat a few times or many times. That movement of the eyes is what creates the sensation of motion to the patient.”

The most common causes, according to Flaherty and Braunstein, are:

Benign paroxysmal positional vertigo (BPPV)

“The most benign cause of vertigo is benign paroxysmal positional vertigo (BPPV),” says Braunstein. “This occurs when calcium carbonite crystals in the inner ear [which help maintain balance] are displaced by certain head movements.” BPPV most often occurs in people ages 50 and older and is most common in women, Flaherty adds.

Vestibulopathy

Vestibulopathy is essentially a malfunction of the vestibular system in one ear, causing the brain to perceive head motion when it’s not moving. Vertigo most often strikes during standing or movement, rather than when sitting or laying down, research shows.

Migraines

“Vestibular migraine is a form of migraine that affects the inner ear and can cause symptoms of short or long episodes of vertigo,” says Dr. Djalilian. He says some patients with this type of migraine can have vertigo for weeks or months at a time.

Inner ear infection

An inner ear infection, or the inflammation of parts of the inner ear, can very easily affect balance and therefore cause vertigo, per Cleveland Clinic.

Vertigo treatments

Treatment for vertigo is dependent on its cause. A common solution for BPPV is known as the Epley maneuver, Flaherty explains, or the professional and strategic repositioning of the head to return inner-ear crystals to their rightful place for restored balance. “In some cases, people can learn to safely do these movements at home,” Flaherty adds.

A vestibulopathy, on the other hand, is treated with vestibular rehab that helps the brain to recognize that it is receiving a faulty signal, Flaherty says. In general, medications like antihistamines are used to help with dizziness and nausea, and antibiotics can be prescribed for bacterial inner ear infections, Braunstein says.

For vertigo caused by vestibular migraines, treatment can involve “using a combination of medications, supplements, and lifestyle changes to optimize sleep, diet, and reduce stress,” says Dr. Djalilian. “This condition occurs more frequently around menopause time, so sometimes patients may need hormone replacement to help improve their symptoms.”

When to see a doctor about vertigo

“Vertigo can be a sign of something more serious like tumors or acoustic neuroma, multiple sclerosis, head trauma, or Meniere’s disease (fluid build-up in the inner ear),” says Braunstein. These should be evaluated by a neurologist or ear, nose, and throat specialist, he advises.

Flaherty recommends seeing a doctor if you experience any of the below symptoms along with vertigo:

  • Hearing loss
  • Vision loss
  • Facial drooping
  • Speech dysfunction
  • A loss of consciousness
  • Shortness of breath
  • Chest pains
  • Head injury
  • Seizures

“Vertigo can lead to falls, accidents, and a decreased quality of life,” Flaherty warns. “You should talk with your health care provider if you experience symptoms consistent with vertigo.”

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