Vertigo

Conditions that affect or damage the inner ear can cause a host of symptoms related to your balance. That’s because the vestibular system — a sensory system that controls your balance and spatial awareness — is in the inner ear.

One of the most common symptoms of vestibular conditions is vertigo, or the feeling that objects are spinning around you. Vertigo can come on suddenly and dissipate quickly, while other times it can linger for days or weeks. No matter how you experience vertigo, it can be debilitating and frightening.

The ear, nose and throat (ENT) specialists at The Ohio State University Wexner Medical Center in Columbus, Ohio, have the expertise and compassion to help you identify what is causing your vertigo as we work with you to relieve those symptoms.

Our Department of Otolaryngology – Head and Neck Surgery is ranked as one of the best ear, nose and throat (ENT) programs in the country by U.S. News & World Report. We have several neurotologists on staff who specialize in vertigo conditions, and a vestibular rehabilitation program, so you’ll be in good hands as we walk you through a treatment plan for your vertigo.

What is vertigo?

Vertigo is the sensation that the room or environment around you is spinning, even though you’re standing or sitting still. Many people describe vertigo episodes as feeling dizzy or off-balance — but it’s different from lightheadedness.

Vertigo isn’t really a disease but rather a symptom of various conditions, most notably related to the vestibular (balance) system in the inner ear.

There are two main types of vertigo you may experience:

• Peripheral vertigo - an issue with the inner ear
• Central vertigo - an issue with the nervous system or brain

What causes vertigo?

The spinning or off-balance feeling can be caused by various conditions, including some related to the inner ear and others related to the brain or even heart.

Vestibular (inner ear) conditions that cause vertigo include:

• Benign paroxysmal positional vertigo – This is the most common form of vertigo, and it usually occurs with a rapid movement of the head.
• Meniere’s disease – This occurs because of an abnormality with the fluid in your inner ear — either the amount of the fluid or the composition of the fluid.
• Labyrinthitis – This is an inner ear infection that causes inflammation of the labyrinth, which contains the cochlea (hearing) and the vestibular system (balance).
• Vestibular neuritis – Also an inner ear infection, vestibular neuritis affects the vestibular nerve, which carries signals from the nerve to the brain to help with balance.
• Cholesteatomas – These are growths of tissue that develop behind the eardrum and typically cause hearing loss but, in some cases, can lead to vertigo.

Neurological or other conditions that cause vertigo include:

• Migraines
• Stroke
• Brain tumors
• Head injuries
• Multiple sclerosis
• Heart arrhythmias
• Low blood pressure
• Diabetes
• Hyperventilation (rapid breathing)

Vertigo can also be brought about by environmental or behavioral causes, such as certain medications or prolonged bedrest. Stress can be a contributing factor, too.

Symptoms of vertigo

While vertigo is a symptom itself, it’s usually accompanied by some other unpleasant symptoms. Those may include:

• Dizziness
• Lightheadedness
• Balance issues
• Headaches
• Nausea or vomiting
• Tinnitus (ringing in ear)

How long does vertigo last?

How long vertigo lasts depends on a variety of factors, including what is causing the symptoms. Sometimes vertigo symptoms last only a few seconds or minutes, but in more severe cases, it can last hours to days and have a profound impact on your quality of life.

Vertigo treatment options

Vertigo will typically go away on its own, but for cases that linger or keep coming back, we have various treatment methods to help ease your symptoms. Also, since vertigo is the symptom of another disorder, it’s important to see an ENT specialist, like the ones at the Ohio State Wexner Medical Center, to address any root causes of your issues.

Treatments we might use for vertigo include:

• Medications – Antibiotics can address ear infections that cause vertigo, while steroids and motion-sickness medications can help with symptoms.
• Surgery – Depending on the cause (brain tumors or neck injuries, for example), you might require surgery. Inner ear issues can also be treated with surgical techniques like mastoidectomy or tympanoplasty.
• Vestibular rehabilitation – You can learn in vestibular physical therapy to do balance exercises, like the Epley maneuver, which can lessen the effects of vertigo or prevent it from occurring.

Vestibular rehabilitation at Ohio State

We’re specially equipped to help people dealing with vertigo that impedes daily living. Not only do we have several neurotologists and other experts on our staff, but we also have a specialized Vestibular Disorders Rehabilitation Program to help those with vertigo and vestibular conditions.

Our therapists, who are certified in Herdman vestibular treatment approaches, will use methods like Frenzel goggles and liquid-crystal display (LCD) video to determine the best treatment plan for your individual needs. Then, their work with you will focus on eye movement control, balance retraining, and stretching and strengthening — all of which can help minimize the effects of vertigo.

This rehabilitation program is just one of the many benefits of being treated for a vestibular condition at the Ohio State Wexner Medical Center.

How to treat vertigo at home

While you should be evaluated by a doctor after a vertigo episode to rule out more serious causes, there are actions you can take at home to manage vertigo. Those at-home treatments include:

• Rest when symptoms occur.
• Turn off lights while dizzy.
• Avoid sudden movement changes.
• Don’t read while you have symptoms.
• Hydrate well.
• Slowly resuming activities once symptoms improve.
• Performing exercises, like the Epley maneuver, to reset balance.