Is it dizziness or vertigo?

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The spinning feeling of coming off an amusement ride can be thrilling for some and sickening for others. Not being able to stop the twirling sensation in your body on a daily basis is what it’s like to live with vertigo. But how do you know if you have vertigo or are just dizzy?

What is vertigo?

Vertigo is the illusion of a spinning, whirling or turning sensation when none is present. A person affected by vertigo can have the sensation that the world is spinning or moving around them, commonly resulting in nausea, vomiting and an overall sense of feeling poorly. Overall, this feeling can be disruptive to a person’s quality of life. Vertigo can last for varying amounts of time. Both the time period and precipitating factors are critical in helping guide clinicians to specific diagnoses.

What are the key differences between dizziness and vertigo?

Vertigo and dizziness are commonly used interchangeably, and many people will refer to all types of dizziness as vertigo and vice versa. However, vertigo only refers to the illusion of motion, such as spinning when none is present, and many times the inner ear is the culprit for these symptoms. Dizziness, on the other hand, is a vaguer term that, while it includes vertigo, may also refer to sensations of discomfort in the head, such as lightheadedness, wooziness, disorientation, disequilibrium or imbalance. Many of these forms of dizziness aren’t from the inner ear, but rather come from the brain or other parts of the body, such as with blood pressure changes.

What causes vertigo?

Vertigo can be caused by many different pathologies, but commonly results from an abnormality of the inner ear or brain. Common sources from the inner ear include benign paroxysmal positional vertigo, inner ear infection and Meniere’s disease. Less common sources of vertigo from the inner ear include skull base tumors and superior semicircular canal dehiscence. Migraine or vestibular migraine is a very common cause of vertigo that originates from the brain, and other less common sources of vertigo from the brain includes multiple sclerosis, seizures, stroke and many other systemic central nervous system disorders.

Are there any treatments for vertigo?

Treatments for vertigo vary depending upon the underlying cause. In general, vestibular physical therapy is helpful in improving symptoms and returning people to their highest-functioning self. This is particularly effective for patients with a known inner ear problem or if repositioning maneuvers are needed. Other effective treatments depend upon the underlying disease, but can include medications to treat nausea and vomiting (meclizine, ondansetron), steroids, salt restriction, blood pressure medications (diuretics), migraine medications, lifestyle changes (avoidance of vertigo triggers in vestibular migraine or Meniere’s disease) and, in some cases, surgery. Surgery is generally recommended once these conservative measures fail to relieve vertigo or with disease processes like skull base tumors (vestibular schwannomas).

Jameson Mattingly is an otolaryngologist at The Ohio State University Wexner Medical Center.

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