Vertigo

This article is about the type of dizziness. For the Alfred Hitchcock film of the same name, see Vertigo (film). For other uses, see Vertigo (disambiguation).
Not to be confused with Vitiligo, a skin condition in which a loss of melanin pigment occurs.
Vertigo
Horizontal nystagmus,
a sign that may accompany vertigo
Pronunciation
SpecialtyOtorhinolaryngology
SymptomsFeeling of spinning or swaying, vomiting, difficulty walking[1][2]
CausesBenign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, stroke, brain tumors, brain injury, multiple sclerosis, migraine[1][2]
Differential diagnosisPresyncope, disequilibrium, non-specific dizziness[2]
Frequency20–40% at some point[3]

Vertigo is a condition in which a person has the sensation that they are moving, or that objects around them are moving, when they are not.[1] Often it feels like a spinning or swaying movement.[1][2] It may be associated with nausea, vomiting, perspiration, or difficulties walking.[2] It is typically worse when the head is moved.[2] Vertigo is the most common type of dizziness.[2]

The most common disorders that result in vertigo are benign paroxysmal positional vertigo (BPPV), Ménière's disease, and vestibular neuritis.[1][2] Less common causes include stroke, brain tumors, brain injury, multiple sclerosis, migraines, trauma, and uneven pressures between the middle ears.[2][4][5] Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed.[6][7] Other causes may include toxin exposures such as to carbon monoxide, alcohol, or aspirin.[8] Vertigo typically indicates a problem in a part of the vestibular system.[2] Other causes of dizziness include presyncope, disequilibrium, and non-specific dizziness.[2]

Benign paroxysmal positional vertigo is more likely in someone who gets repeated episodes of vertigo with movement and is otherwise normal between these episodes.[9] Benign vertigo episodes generally last less than one minute.[2] The Dix-Hallpike test typically produces a period of rapid eye movements known as nystagmus in this condition.[1] In Ménière's disease there is often ringing in the ears, hearing loss, and the attacks of vertigo last more than twenty minutes.[9] In vestibular neuritis the onset of vertigo is sudden, and the nystagmus occurs even when the person has not been moving.[9] In this condition vertigo can last for days.[2] More severe causes should also be considered,[9] especially if other problems such as weakness, headache, double vision, or numbness occur.[2]

Dizziness affects approximately 20–40% of people at some point in time, while about 7.5–10% have vertigo.[3] About 5% have vertigo in a given year.[10] It becomes more common with age and affects women two to three times more often than men.[10] Vertigo accounts for about 2–3% of emergency department visits in the developed world.[10]

  1. ^ a b c d e f Post, RE; Dickerson, LM (2010). "Dizziness: a diagnostic approach". American Family Physician. 82 (4): 361–369. PMID 20704166. Archived from the original on 2013-06-06.
  2. ^ a b c d e f g h i j k l m n Hogue, JD (June 2015). "Office Evaluation of Dizziness". Primary Care: Clinics in Office Practice. 42 (2): 249–258. doi:10.1016/j.pop.2015.01.004. PMID 25979586.
  3. ^ a b von Brevern, M; Neuhauser, H (2011). "Epidemiological evidence for a link between vertigo & migraine". Journal of Vestibular Research. 21 (6): 299–304. doi:10.3233/VES-2011-0423. PMID 22348934.
  4. ^ Wicks, RE (January 1989). "Alternobaric vertigo: an aeromedical review". Aviation, Space, and Environmental Medicine. 60 (1): 67–72. PMID 2647073.
  5. ^ Buttaro, Terry Mahan; Trybulski, JoAnn; Polgar-Bailey, Patricia; Sandberg-Cook, Joanne (2012). Primary Care – E-Book: A Collaborative Practice (4 ed.). Elsevier Health Sciences. p. 354. ISBN 978-0323075855. Archived from the original on 2017-09-08.
  6. ^ Falvo, Donna R. (2014). Medical and psychosocial aspects of chronic illness and disability (5 ed.). Burlington, MA: Jones & Bartlett Learning. p. 273. ISBN 9781449694425. Archived from the original on 2015-07-02.
  7. ^ Wardlaw, Joanna M. (2008). Clinical neurology. London: Manson. p. 107. ISBN 9781840765182. Archived from the original on 2015-07-02.
  8. ^ Goebel, Joel A. (2008). Practical management of the dizzy patient (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 97. ISBN 9780781765626. Archived from the original on 2015-07-02.
  9. ^ a b c d Kerber, KA (2009). "Vertigo and dizziness in the emergency department". Emergency Medicine Clinics of North America. 27 (1): 39–50. doi:10.1016/j.emc.2008.09.002. PMC 2676794. PMID 19218018.
  10. ^ a b c Neuhauser HK, Lempert T (November 2009). "Vertigo: epidemiologic aspects" (PDF). Seminars in Neurology. 29 (5): 473–81. doi:10.1055/s-0029-1241043. PMID 19834858. S2CID 260318174.