The most common conditions are benign paroxysmal positional vertigo (BPPV), vestibular migraine, Menière's disease and vestibular neuritis/labyrinthitis. Unfortunately, each of these conditions can produce symptoms very similar to those of stroke or TIA, so careful attention to symptom details is required.
If you have been experiencing vertigo for more than a day or two, it's so severe that you can't stand or walk, or you are vomiting frequently and can't keep food down, you should make an appointment with a neurologist.
What test to order? Regardless of suspicion for peripheral or central etiology, for episodic or persistent vertigo, if imaging is indicated the best test is MRI Brain and internal auditory canal with and without IV contrast.
A common misperception is that “vertigo” is equivalent to any type of dizziness, when in fact it is a specific type of dizziness characterized by a sense of spinning or movement of the world around you when there is no actual movement.
Caused by a problem in the brain, central vertigo can be linked to serious conditions such as stroke, brain tumor and multiple sclerosis. Symptoms develop gradually and are typically mild but constant and may include gait instability and loss of coordination.
Key points about labyrinthitis
Labyrinthitis often results from a viral infection of the eighth cranial nerve or the labyrinth. Symptoms include vertigo, hearing loss, and dizziness. Symptoms may start suddenly and go away in a few weeks.
Signs of vertigo
You could feel the nausea or vomiting that sometimes accompanies motion sickness, and you could have vision or hearing symptoms also. Headaches and head sweating are also possible.
In a general sense, vertigo-associated disease is commonly treated using vestibular blocking agents or VBAs. These include medications such as antihistamines (promethazine or betahistine), benzodiazepines (diazepam or lorazepam), or antiemetics (prochlorperazine or metoclopramide).
Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit.
Your doctor has scheduled you for a test called Videonystagmography. The VNG is a test of the inner ear and portions of the brain. The VNG can help your doctor understand the cause of your dizziness or balance problem.
Central Vertigo – This is Serious!
The first and foremost danger of leaving your dizziness untreated is that you could be experiencing dysfunction in your central nervous system. In other words, something could be wrong with your heart or brain – specifically your brainstem and/or cerebellum.
Central vertigo is mostly caused by injury to the brain or brain disease. Central vertigo usually comes without much warning and also lasts for longer periods of time compared to peripheral vertigo. It is also more intense than episodes of peripheral vertigo and patients may need help to walk or even stand up.
Stress, anxiety and depression can all trigger vertigo attacks. Do what you can to avoid these pressures or to manage them when they can't be prevented. Talking to a friend, taking time to relax, or using meditation techniques could help.
Although vertigo usually starts with a condition in the inner ear, stress and anxiety can make it worse. Chronic stress or worry can also lead to more episodes of vertigo in the future. In stress-related vertigo, using strategies for both the body and the mind is the best way to regain your sense of balance.
There's no cure, but you may be able to manage symptoms with medications and vestibular rehabilitation.
“In rare cases, people who experience debilitating vertigo might need surgery, but I find that lying down in the dark, avoiding lights, TVs, and other distractions, and just getting some rest can ease my symptoms,” she said.
Vertigo could also affect your ability to drive. You should avoid driving if you've recently had episodes of vertigo and there's a chance you may have another episode while you're driving.
If you are dizzy right now and have any of the following neurological symptoms along with your dizziness or vertigo, call 911 immediately: New confusion or trouble speaking or understanding speech. New slurred speech or hoarseness of voice. New numbness or weakness of the face, arm, or leg.
Abstract. Benign paroxysmal positional vertigo is a common type of vertigo seen by the otolaryngologist; however, intracranial tumors can mimic benign paroxysmal positional vertigo in their presentation.
In rare cases, vertigo may be associated with a serious medical condition, so you should call 911 or go directly to the nearest emergency room if your sense of imbalance is accompanied by: Shortness of breath. Chest pains. Facial numbness.