Vertigo (Dizziness)

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Signs and Symptoms

Vertigo, or dizziness, refers to the sensation of spinning (subjective vertigo) or the perception that surrounding objects are moving or spinning (objective vertigo). Some patients describe a feeling of being pulled toward the floor or toward one side of the room. Moving the head, changing position, and turning while lying down often worsen vertigo.

The sudden onset of vertigo usually indicates a peripheral vestibular disorder (inner ear disturbance; e.g., BPPV, Ménière disease, vestibular neuritis).

Symptoms of benign paroxysmal positional vertigo (BPPV) usually last a few seconds to a few minutes and are intermittent (i.e., come and go). They also may include lightheadedness, imbalance, and nausea, usually as a result of a change in position (e.g., rolling over in bed, getting out of bed).

Symptoms of Ménière disease and vestibular neuritis include vertigo, hearing loss, ringing in the ears (tinnitus), and ear pressure that often lasts hours to days.

Peripheral vestibular disorders also may cause the following symptoms:

• Blurred vision
• Fatigue and reduced stamina
• Headache
• Heart palpitations (rapid fluttering of the heart)
• Imbalance
• Inability to concentrate
• Increased risk for motion sickness
• Muscle ache (especially of the neck and back)
• Nausea and vomiting
• Reduced cognitive function (i.e., thinking and memory)
• Sensitivity to bright lights and noise
• Sweating

Vertigo caused by a central vestibular disorder usually develops gradually. In addition to vertigo, central vestibular disorders (e.g., stroke [brain attack], migraine) may cause the following symptoms:

• Double vision (diplopia)
• Headache (may be severe)
• Impaired consciousness
• Inability to speak due to muscle impairment (dysarthria)
• Lack of coordination
• Nausea and vomiting
• Weakness

Complications

Severe vertigo can be disabling and may result in complications such as irritability, loss of self-esteem, depression, and injuries from falls. Falls are the leading cause of serious injury in people over the age of 65.

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