There are only a few times it’s fun to feel like everything around you is spinning, such as on your favorite ride at an amusement park. But for people with vertigo, this is a terrifying and dizzying reality.
People who have vertigo might describe it as the room is spinning, or that they’re dizzy. Recent research has found that one in five people experience vertigo, with the most common type being peripheral vertigo. According to the American Medical Association, that's around 80% to 90% of cases. Subtypes within that type include:
- Benign paroxysmal positional vertigo (BPPV)
- Labyrinthitis
- Vestibular neuritis
- Ménière’s disease
Experts know how to determine what is true vertigo, along with the causes and treatments.
What is vertigo?
"Vertigo is a specific type of dizziness characterized by the sensation of movement when no actual movement is occurring," says
Rebecca Andrews, PT, DPT who specializes in vertigo and vestibular issues at Gaylord Specialty Healthcare in Connecticut. "People may describe this as spinning, rotating, tilting or feeling as though the room is moving. In contrast, dizziness is a broad, nonspecific symptom descriptor that can include sensations of lightheadedness, imbalance, disorientation, floating or feeling 'off.'"
There are several causes, she says, including:
- Vertigo can originate from problems involving the vestibular system. These causes are generally classified as peripheral or central.
- Peripheral vestibular disorders involve structures of the inner ear, including the vestibular organs and labyrinth.
- Central vestibular disorders involve the brain and its vestibular pathways, including the connections between the inner ear and the central nervous system.
- Metabolic or systemic conditions can produce dizziness and, in some cases, vertigo-like sensations. Examples include vitamin deficiencies, thyroid or adrenal disorders, dehydration and hypo- or hyperglycemia.
- Conditions involving dysautonomia, such as POTS, can produce orthostatic dizziness and, in some individuals, sensations described as vertigo.
"In the clinic, I see patients with a variety of vestibular and balance-related conditions. Some of the most common include vestibular neuritis, labyrinthitis, vestibular migraine, Ménière’s disease, BPPV (benign paroxysmal positional vertigo) and PPPD (persistent postural-perceptual dizziness)," Andrews says. "The key distinction is that vertigo describes a specific sensation of movement, while dizziness is a broader term that describes a range of abnormal sensations related to balance, orientation or spatial perception."
What’s happening in the head that causes vertigo
For those with BPPV, "small calcium carbonate crystals, called otoconia, become displaced from their normal location within the inner ear and enter one of the semicircular canals. This can cause brief episodes of positional vertigo, typically triggered by movements such as rolling in bed, lying down or looking up," Andrews says.
Some types of dizziness can actually be caused by vestibular migraine, one of the more common causes of spontaneous episodic vertigo, or even anxiety.
"Anxiety can both worsen existing dizziness and increase the risk of developing persistent dizziness, particularly PPPD. PPPD is a functional vestibular disorder characterized by persistent dizziness, unsteadiness or non-spinning vertigo that is often aggravated by upright posture, movement and visually complex environments," Andrews says. While anxiety doesn’t necessarily cause dizziness, she says heightened attention to bodily sensations can influence how we process balance and spatial information. "This can create a cycle in which dizziness increases anxiety, and anxiety subsequently makes the dizziness more noticeable or persistent."
Dr. Jason Bellak, principal investigator for clinical research at the Allergy and Asthma Center in Las Vegas, adds that allergies impacting eustachian tube dysfunction, which increases middle ear pressure, can worsen BPPV. So sometimes, treating vertigo involves different specialists, from allergists like him, to vestibular therapists, neurologists and others.
This article originally appeared on USA TODAY: Do I have vertigo? Here's what might be causing it
