Vertigo vs Dizziness

December 29, 2023

3 min read

The terms ‘vertigo’ and ‘dizziness’ are often used interchangeably to describe two different sensations.

Vertigo

Vertigo is a spinning sensation you feel from an imbalance in the vestibular system located in your inner ear. With vertigo, you can find your environment spinning in circles, making you dizzy and off-balance.

Types of Vertigo

Vertigo can be of two types.

Peripheral vertigo

It is a common type of vertigo that can affect your sense of balance. Peripheral vertigo occurs when there is a problem with the vestibular nerve or inner ear.

Central vertigo

A less common type of vertigo that occurs from brain conditions like stroke, infection, or traumatic brain injury. Central vertigo can cause severe instability or difficulty in walking.

Dizziness

Dizziness is a term that is commonly used to describe certain sensations like:

Lightheadedness
A spaced-out or swimmy-headed feeling
A feeling of faintness
A sense of getting off-balanced or unsteady (Dysequilibrium)
Vertigo ( A sense of movement when there is no actual movement)

Causes of Vertigo and/or Dizziness

The causes of vertigo and dizziness vary even though they are hardly life-threatening.

Labyrinthitis: An inflammation of the labyrinth that causes hearing loss, vertigo, and other symptoms.
Vestibular neuritis: An inner ear disorder with symptoms like severe vertigo, nausea, vomiting, dizziness, and balance issues.
Benign paroxysmal positional vertigo(BPPV): An inner ear disorder caused when the calcium crystals in the inner ear get dislodged from their original position. A person with BPPV experiences a sudden spinning sensation when they move their head.
Menieres disease: A rare inner ear disorder that affects balance and sense of hearing.
Migraine: Vertigo can trigger symptoms of a migraine headache. Episodes of migraine headaches can happen without a headache and can occur with light and noise sensitivity.
Other causes of dizziness: Dizziness can occur from factors other than a chronic condition or underlying infection like:
Low iron and blood sugar levels
Dehydration
Medicinal side effects
Overheating
Anxiety disorders
A sudden drop in blood pressure with abrupt sitting or standing up

Even though dizziness and vertigo usually result from common causes, some vertigoes can occur without the feeling of dizziness. This can happen in non-neurological disorders, like severe anemia and heart and lung disorders.

Other less common causes of dizziness include

Vestibular schwannoma or a tumor of the vestibular cochlear nerve;
Multiple sclerosis
A stroke, tumor, or a TIA (transient ischemic attack) in the brain
An injury to the inner ear, eardrum, or base of the skull
Pregnancy

Evaluation of Vertigo and/or Dizziness

People experiencing the following symptoms may need a doctor’s evaluation for vertigo and dizziness.

Neurological symptoms like difficulty in hearing, speaking, seeing, swallowing, or moving legs or arms
Episodes of fainting or losing consciousness
Difficulty in walking
Headaches
Neck pain

Diagnosis of Vertigo and/or Dizziness

If you are experiencing vertigo or dizziness, your medical provider will ask you about the symptoms and perform a physical exam where your sense of balance and other functions will be checked.

Your doctor may examine your ears to check for abnormalities in the ear canal or eardrum.

Eyes are checked for abnormal eye movements or nystagmus. A complete neurological examination may be conducted with particular attention to walking, coordination, and balance.

Based on your symptoms and medical history, your medical provider may recommend specific tests like:

Blood tests
Romberg Test that evaluates balance and gait
Electrocardiography, echocardiography, and Holter monitoring that detect heart abnormalities
Comprehensive vestibular testing that includes rotary chair testing that looks for abnormal eye movements while sitting on a rotating chair, electronystagmography that analyzes abnormal eye movements, and vestibular invoked myogenic testing

Treatment of Vertigo and/or Dizziness

The treatment of vertigo and dizziness will depend on their causes.

Where inner ear disorders cause vertigo, antihistamine drugs, like meclizine are recommended
Nausea and vomiting can be treated with drugs, like Promethazine
Where vertigo occurs with migraine, the migraine is treated
Repositioning maneuvers, like the Epley maneuver, are used in people with benign paroxysmal positional vertigo

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