Symptoms of Vertigo

Vertigo is a sensation of movement. Many believe vertigo means a spinning sensation, but vertigo can mean any type of movement that you know to be false such as swaying, rocking, floating or tilting.

Vertigo may worsen when you change positions (lie down or stand up) or move your head. The duration, intensity, and timing of vertigo can vary widely. It can be:

• Brief or long-term
• Mild or severe
• Occasional or frequent

Depending on the cause, symptoms that can occur with vertigo include:

• Balance problems, including trouble walking
• Dizziness (a feeling of disorientation or lightheadedness)
• Ear pressure or fullness
• Headache
• Involuntary eye movements (nystagmus)
• Nausea and vomiting
• Ringing in the ears (tinnitus)
• Sensitivity to light, sound, smell, or motion
• Sensorineural hearing loss

Vertigo Causes

The most common causes of vertigo are benign paroxysmal positional vertigo (BPPV) and vestibular migraine. Other causes include:

• Persistent postural perceptual dizziness (PPPD)
• Inner ear infections, including acute vestibular syndrome and viral labyrinthitis
• Hemorrhagic or ischemic stroke
• Meniere’s disease
• Brain tumors, such as acoustic neuroma (vestibular schwannomas), medulloblastomas, and brainstem gliomas
• Multiple sclerosis
• Otosclerosis
• Cholesteatomas
• Injury to the inner ear or brain
• Medications

Diagnostic Tests for Vertigo

Your clinician will evaluate you to diagnose vertigo and identify the underlying cause. This assessment typically includes questions about your medical history and symptoms, such as when they began and how long they have lasted. It may also include vestibular diagnostics, such as:

• Audiogram to assess how well you hear loud and soft sounds at different frequencies
• Electronystagmography (ENG) and videonystagmography (VNG) to detect abnormal eye movements and check your ability to focus
• Rotary chair test to assess whether your brain or inner ear is causing vertigo
• Vestibular evoked myogenic potential (VEMP) to measure your vestibular system’s responses to stimulation
• Video head impulse testing (vHIT) to assess how well your eyes and ears work together

Additional tests that your clinician may recommend to confirm a diagnosis, or to rule out other conditions, include:

• Dix-Hallpike maneuver to test for BPPV by having you do a series of movements
• Gait testing to assess your ability to stand and walk
• Hearing tests to check for hearing loss
• Imaging tests, such as MRI and CT scans, to detect brain conditions
• Neurological tests to check for changes in brain and nervous system function