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Vertigo: A Comprehensive Guide to the Symptom That Disrupts Balance

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Vertigo is one of the most common symptoms experienced by many people at least once in their lives. This sensation of movement or spinning, often accompanied by instability, nausea, and disorientation, can significantly impact quality of life. But what lies behind this symptom? Understanding it is essential to embarking on an effective therapeutic journey. In this article, we will explore the main causes of vertigo, the diagnostic process, and various treatment options, providing a comprehensive and engaging guide to understanding and managing this condition.

What Is Vertigo?

Vertigo is an altered perception of movement, often described as the sensation that the surrounding environment is spinning or that the body itself has lost its sense of balance. It is not a disease in itself but a symptom that can indicate a wide range of conditions, both benign and more serious.

Types of Vertigo: A Crucial Classification

To better understand vertigo, it is useful to divide it into two main categories:

  1. Peripheral vertigo: This type of vertigo is caused by dysfunctions in the inner ear or vestibular nerve. Common causes include:

    • Benign paroxysmal positional vertigo (BPPV): Triggered by the movement of small crystals, called otoliths, within the semicircular canals. This is one of the most common causes of vertigo.

    • Ménière's disease: A chronic condition that causes episodes of vertigo accompanied by hearing loss, tinnitus, and a feeling of fullness in the ear.

    • Vestibular neuritis: An inflammation of the vestibular nerve that can cause sudden and severe vertigo.

  2. Central vertigo: This type is linked to dysfunctions of the central nervous system and may have more complex causes, such as:

    • Vestibular migraine: A type of migraine that includes episodes of vertigo.

    • Ischemic or hemorrhagic lesions of the brainstem: Interruptions in blood flow to the brain.

    • Multiple sclerosis: An autoimmune disease that affects the central nervous system.

How Is Vertigo Diagnosed?

Proper diagnostic evaluation is crucial to identifying the cause of vertigo. An accurate diagnosis requires a combination of detailed medical history, physical examination, and, if necessary, instrumental tests.

1. The Importance of Medical History

Taking a thorough medical history is the first step in understanding the nature of vertigo. The doctor gathers detailed information about:

  • Duration and frequency of episodes

  • Triggering factors (e.g., changes in position, stress, or fatigue)

  • Associated symptoms such as nausea, vomiting, hearing loss, or headaches

This information helps distinguish between peripheral and central vertigo and guides the doctor toward further investigations.

2. The Physical Examination

The physical examination includes an evaluation of nystagmus, an involuntary eye movement often present in vertigo. Specific tests, such as the Dix-Hallpike test, can confirm a diagnosis of BPPV. Additionally, the doctor will perform a neurological examination to rule out central causes.

3. Instrumental Tests

If the clinical examination is not sufficient for a definitive diagnosis, instrumental tests may be used, including:

  • Audiometry and vestibular tests, such as videonystagmography (VNG), to evaluate the functionality of the inner ear

  • Magnetic resonance imaging (MRI) to identify any lesions or pathologies of the central nervous system

How Is Vertigo Treated?

The treatment of vertigo depends on the underlying cause. Once the source of the problem is identified, targeted therapies can be implemented.

Treatment of Peripheral Vertigo

  • BPPV: The first-line therapy involves repositioning maneuvers for otoliths, such as the Epley maneuver. These simple movements help move the otoliths back to their correct position, relieving symptoms.

  • Ménière's disease: Treatment includes a low-sodium diet, diuretics to reduce pressure in the inner ear, and, in some cases, corticosteroids or surgical interventions.

  • Vestibular neuritis: Corticosteroids are often used to reduce inflammation, while vestibular rehabilitation helps restore balance.

Treatment of Central Vertigo

For central vertigo, treatment focuses on managing the underlying condition. For example:

  • Vestibular migraine can be treated with specific migraine medications.

  • Ischemic lesions require anticoagulant therapy and strict control of cardiovascular risk factors.

Practical Tips for Managing Vertigo

In addition to medical treatments, there are strategies that can help better manage vertigo in daily life:

  • Avoid sudden head movements

  • Reduce stress with relaxation techniques

  • Maintain adequate hydration

  • Practice vestibular rehabilitation exercises if recommended by the doctor


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The Health Guard S.T.P.

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