Vertigo and Related Disorders

Vertigo and Related Disorders

According to Harvard Medical School, vertigo is different from dizziness and is characterized by a false sensation of movement or rotation. Vertigo is often accompanied by a lack of balance, nausea, vomiting, and excessive sweating.

Dizziness is an inaccurate term that people generally use to describe various related sensations, including

  • Fainting (feeling faint)
  • A feeling of impending faintness
  • Imbalance (feeling of imbalance or instability)
  • Vague disorientation or feeling of floating in the water
  • Vertigo (false sense of movement)

Vertigo is often a reason to visit a physician, specifically an otolaryngologist/ENT, such as those at Potomac ENT, or a neurologist, and requires specialized treatment.

Vertigo can be divided into two types:

  • Rotatory: a sensation of rotating movement of the medium in relation to the individual or the latter in relation to the medium;
  • Oscillatory: a feeling of imbalance, difficulty in standing, with multidirectional movements, as if on a boat in the ocean.

What are the causes of vertigo

Vertigo is associated with several diseases, the most frequent of which are:

Benign paroxysmal positional vertigo (BPPV)

It is the most frequent cause of vertigo. It is manifested by recurrent episodes of a sensation of rotation, lasting for seconds, associated or not with nausea. It is a type of positional vertigo, caused by changes in the position of the head, for example, when getting up and lying in bed or by the hyperextension of the neck. There are no other symptoms, such as hearing loss or tinnitus.

BPPV results from the abnormal presence of particles (so-called “crystals”) in the semicircular channels of the inner ear.

The treatment, after confirming the diagnosis by a doctor, consists of replacing these particles in the utricle through repositioning maneuvers.

Migraine Vertigo or Vertigo associated with migraine

It is the term that describes the vertigo episode in patients with the diagnosis or manifestations of migraine. Studies point to an estimated prevalence of 1% during life, predominantly in women and children.

It usually appears spontaneously, but it can be caused by changes in position, stress, or sleep deprivation.

Avoiding the factors that trigger migraines and medically controlling them relieves this type of vertigo.

Vestibular neuritis

It is a disease of the inner ear characterized by violent vertigo of sudden onset, lasting from minutes to hours, in the absence of hearing complaints. It appears in previously healthy people, usually after a viral respiratory infection. It is thought that the inflammation of the vestibular nerve (responsible for the conduction of stimuli from the inner ear to the central nervous system) is itself affected by the virus.

In addition to adequate medical treatment, vestibular rehabilitation should be started as early as possible in order to allow full recovery of vestibular function.


Labyrinthitis is distinguished from the previous problem by the fact that there is associated hearing loss (sensorineural). It results from a viral infection, acute otitis media, or chronic otitis media.

Ménière's disease

It is almost always characterized by the simultaneous occurrence of vertigo, tinnitus, decreased hearing, and, sometimes, the sensation of a blocked ear.

The attack here is usually of varying duration, ranging from minutes to 1-2 days, after which the sensation of instability or less intense vertigo remains.

Warning signs

In people with dizziness, certain symptoms and characteristics are of concern. They include;

  • Headache
  • Neck ache
  • Difficulty walking and feelings like they are spinning, tilting, swaying, or pulled in one direction.
  • Sweating
  • Other neurological symptoms (such as difficulty hearing, rapid eye movement)

When to see a doctor

An individual should immediately see a physician when symptoms are severe or have persisted for more than an hour and are associated with vomiting. People who have had a mild, simple, brief episode (less than 1 minute) and no other symptoms can decide to wait and see if another episode affects them.

Treatment and Diagnosis

It is very important that someone suffering from vertigo consult their physician so that, through history and clinical observation, and complementary exams, they can identify its origin and thus be able to prescribe the appropriate treatment. A very common treatment method is Vestibular Rehabilitation, which the physicians at Potomac ENT can devise and oversee for you to optimally recover.

Day-to-day activities such as driving, playing sports, or working can become difficult and dangerous when you have vertigo. Falls may also occur, so it is not advisable to go out alone. Your doctor will be the best counselor and the right person to help find and treat the cause of vertigo, allowing the patient to resume their normal routine.


Lydia Krause and Dana Robinson, Meredith Goodwin, MD, FAAFP, Vertigo, and Vertigo-Associated Disorders, 2019.

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