Vertigo is a type of dizziness that creates the false sense that you or your surroundings are spinning or moving.
There are many possible causes of vertigo, but in our experience, the three most common causes of vertigo are:
- Cold viruses
- Head trauma
- Meniere’s disease
The most common causes of vertigo are all conditions that affect the patient’s inner ear. The inner ear is responsible for our sense of balance and also our sense of positioning in space. If the inner ear dysfunctions, we then can lose our sense of balance and will frequently suffer from symptoms such as vertigo, nausea, dizziness, and loss of balance.
Most of the common causes of vertigo are readily treatable with physical therapy, medication, surgery, or time. Because of the many different causes of vertigo, the critical issue in choosing a neurologist who is experienced in working with patients with vertigo.
After asking about your symptoms and documenting your health history, your neurologist may suggest one or several different tests which may include:
Dix-Hallpike Maneuver
The Dix-Hallpike maneuver is commonly used if your doctor suspects you have benign paroxysmal positional vertigo (BPPV) — the most common cause of vertigo. This method can also help your physician figure out if your vertigo is due to an inner ear problem or something else.
You will be asked to turn your head 45 degrees to one side. Then, you’ll quickly lie on your back, with your head off the side of the table, and maintain the 45-degree head rotation for a period of at least 30 seconds. Your doctor will then inspect your eyes and ask if you feel any dizziness. The procedure is then repeated on the other side.
Head Impulse Test
The head impulse test evaluates how well your eyes and inner ears work together. It’s often used if a condition called vestibular neuritis is suspected. Your doctor will quickly rotate your head to look for certain rapid eye movements and reflex functions that could imply a problem in the semicircular canals of the inner ear.
Romberg Test
For the Romberg test, you’ll most likely be asked to stand with your feet close together. Then, you will close your eyes. Your doctor will assess how much you sway or fall to determine what may be causing your vertigo.
Fukuda-Unterberger Test
The Fukuda-Unterberger test requires you to walk in a line with your eyes closed. Your physician will look at how your body strays from the midline to identify which side of your body is affected by vertigo.
Electronystagmography (ENG) or Videonystagmography (VNG)
ENG and VNG are used to detect abnormal eye movements and determine if vertigo symptoms are caused by an inner ear problem.
ENG uses electrodes and VNG uses small cameras to measure eye movements while your head is placed in different positions or as you’re asked to track certain visual targets. Air or water may also be used to control your ear canal temperature. These tests are usually performed in a dark room and may elicit jerking eye movements.
Rotation Tests
Rotation tests are used to see how well the eyes and inner ear work together. They involve moving the head slowly from side to side while analyzing eye movements. There are different types of rotation tests. You may be asked to sit in a chair that moves from side to side, or to look at a fixed target and move your head back and forth or up and down.
It is extremely rare, but not impossible, for young children to have vertigo. It becomes more common in the early 20s and affects all ages commonly after that. Its consequences however become more substantial as you get older because loss of balance in the elderly commonly leads to major fractures.
Yes, this is a fairly common occurrence. Usually they are mistaken because of use of the word dizziness. Dizziness can refer to lightheadedness, which is not vertigo and is commonly produced by vascular problems. Dizziness also can mean vertigo, and there are very few causes of vertigo that do not come from the inner ear. Occasionally, rare types of strokes can cause vertigo, but these are usually associated with other neurological symptoms as well.
There are some surgical procedures that are commonly used to treat certain types of vertigo. If the vertigo is caused by a disease such as Meniere’s disease, where the function of the ear changes over time, and these changes are not responding to ongoing medical therapy, then a surgical intervention may help to eliminate the vertigo.