How common are vertigo and dizziness. What are the main types and causes of these conditions. How are vertigo and dizziness diagnosed and treated effectively. What is the relationship between vertigo, dizziness, and headaches.

Understanding Vertigo and Dizziness: Definitions and Distinctions

Vertigo and dizziness are often used interchangeably, but they represent distinct sensations. Vertigo specifically refers to a false sense of rotational movement, while dizziness is a broader term encompassing various sensations of imbalance or disorientation. To clarify these concepts:

• Vertigo: A sensation of spinning or movement when stationary
• Dizziness: A general feeling of unsteadiness, lightheadedness, or disorientation
• Presyncope: A near-fainting sensation
• Disequilibrium: A loss of balance or feeling of unsteadiness

Understanding these distinctions is crucial for accurate diagnosis and treatment. Can vertigo occur without spinning sensations? While vertigo typically involves a rotational component, some individuals may experience a sense of tilting, swaying, or falling instead of spinning.

Prevalence of Vertigo and Dizziness: Insights from Recent Studies

Recent research has shed light on the prevalence of vertigo and dizziness in the general population. A study involving 2,672 subjects revealed significant findings:

• Vertigo prevalence: Approximately 5% of the population
• Dizziness prevalence: Around 12-15% of the population
• Combined prevalence: Up to 20% experience vertigo or dizziness

These statistics highlight the widespread nature of these conditions. Are certain demographics more susceptible to vertigo and dizziness? Studies indicate that women and older adults are more likely to experience these symptoms, with prevalence increasing with age.

Benign Paroxysmal Positional Vertigo (BPPV): The Most Common Cause of Vertigo

Benign Paroxysmal Positional Vertigo (BPPV) stands out as the most prevalent form of vertigo. This condition is characterized by brief episodes of intense dizziness triggered by specific head movements. Key aspects of BPPV include:

• Affects approximately 50% of people at some point in their lives
• Becomes more common with age
• Causes short bursts of vertigo lasting up to one minute
• Triggered by position changes like lying down, sitting up, or turning in bed

Is BPPV a serious condition? While BPPV can be disabling and distressing, it is considered benign as it is not caused by a serious underlying disease. However, its impact on quality of life can be significant, necessitating proper diagnosis and treatment.

The Mechanism Behind BPPV: Understanding Inner Ear Dynamics

BPPV occurs due to a disruption in the inner ear’s balance mechanisms. The condition is caused by the displacement of calcium carbonate crystals, known as otoconia, within the semicircular canals of the inner ear. This process can be broken down as follows:

1. Otoconia normally reside in the utricle, a gravity-sensing structure
2. Over time, these crystals can break free and enter the semicircular canals
3. When the head moves, the displaced crystals stimulate the wrong sensory receptors
4. This mismatch in sensory information results in vertigo sensations

Why do these crystals become dislodged? Factors such as age, head trauma, or inner ear infections can contribute to the loosening of otoconia. However, in many cases, the exact cause remains unknown.

Diagnosing Vertigo and Dizziness: Clinical Approaches and Challenges

Accurate diagnosis of vertigo and dizziness requires a comprehensive approach. Healthcare providers typically employ a combination of methods:

• Detailed patient history
• Physical examination
• Specialized tests like the Dix-Hallpike maneuver for BPPV
• Imaging studies (CT or MRI) when central causes are suspected
• Balance and vestibular function tests

For BPPV specifically, the Hallpike positional test is considered diagnostic. This test involves moving the patient’s head into positions that typically trigger symptoms. How accurate is the Hallpike test for diagnosing BPPV? When performed correctly, the Hallpike test has a high sensitivity and specificity for BPPV, making it a valuable diagnostic tool.

Treatment Options for Vertigo and Dizziness: From Maneuvers to Medications

The treatment of vertigo and dizziness varies depending on the underlying cause. For BPPV, which accounts for a significant portion of cases, non-pharmacological approaches are preferred:

• Particle Repositioning Maneuvers (e.g., Epley maneuver)
• Vestibular rehabilitation exercises
• Lifestyle modifications to avoid triggering positions

For other forms of vertigo and dizziness, treatment may include:

• Medications to suppress vestibular symptoms
• Treatment of underlying conditions (e.g., migraines, infections)
• Balance therapy and physical rehabilitation
• In rare cases, surgical interventions

How effective are particle repositioning maneuvers for BPPV? The Epley maneuver, when performed correctly, has been shown to provide immediate relief in up to 90% of BPPV cases, making it a highly effective first-line treatment.

The Connection Between Vertigo, Dizziness, and Headaches: Exploring Comorbidities

Research has revealed a significant correlation between vertigo, dizziness, and headaches, particularly migraines. Key findings include:

• Up to 40% of migraine sufferers experience vestibular symptoms
• Vestibular migraines can cause both headaches and vertigo
• Tension headaches may also be associated with dizziness

This relationship highlights the importance of considering headache disorders in the evaluation of vertigo and dizziness. Does treating migraines help alleviate vertigo symptoms? In many cases, managing migraine headaches through lifestyle changes, medications, or other interventions can significantly reduce associated vertigo and dizziness symptoms.

Vestibular Migraine: A Distinct Entity

Vestibular migraine is now recognized as a distinct condition characterized by episodes of vertigo associated with migraine features. Key aspects include:

• Vertigo episodes lasting minutes to hours
• May occur with or without headache
• Often accompanied by sensitivity to light and sound
• Can be triggered by similar factors as traditional migraines

Recognizing vestibular migraine is crucial for appropriate management, as treatment approaches may differ from those used for other forms of vertigo.

Living with Vertigo and Dizziness: Coping Strategies and Quality of Life Impact

Vertigo and dizziness can significantly impact an individual’s quality of life, affecting daily activities, work performance, and social interactions. Coping strategies and lifestyle modifications can help manage symptoms:

• Avoiding sudden head movements
• Practicing stress reduction techniques
• Maintaining good sleep hygiene
• Staying hydrated and following a balanced diet
• Engaging in regular, gentle exercise as tolerated

Support groups and patient education programs can also play a crucial role in helping individuals cope with chronic vertigo or dizziness. How can patients effectively communicate their symptoms to healthcare providers? Keeping a symptom diary detailing the frequency, duration, and triggers of vertigo or dizziness episodes can provide valuable information for diagnosis and treatment planning.

The Role of Vestibular Rehabilitation

Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy aimed at reducing vertigo and dizziness symptoms. VRT programs typically include:

• Gaze stabilization exercises
• Balance training
• Habituation exercises to reduce sensitivity to certain movements
• Cardiovascular conditioning

VRT has shown significant success in improving symptoms and quality of life for many patients with vestibular disorders.

Future Directions in Vertigo and Dizziness Research

As our understanding of vertigo and dizziness continues to evolve, several areas of research hold promise for improved diagnosis and treatment:

• Advanced imaging techniques to visualize inner ear structures
• Genetic studies to identify risk factors for vestibular disorders
• Development of targeted pharmacological treatments
• Exploration of the gut-brain axis in vestibular health
• Advancements in virtual reality-based rehabilitation techniques

These research directions aim to enhance our ability to diagnose vertigo and dizziness accurately and provide more effective, personalized treatments. What role might artificial intelligence play in diagnosing vertigo? AI algorithms could potentially analyze patterns in patient data, vestibular test results, and imaging studies to assist in more accurate and efficient diagnosis of vertigo and dizziness.

The Potential of Wearable Technology

Wearable devices equipped with accelerometers and gyroscopes show promise in objectively measuring balance and vertigo symptoms. These technologies could provide:

• Continuous monitoring of vestibular function
• Early detection of balance problems
• Personalized feedback for rehabilitation exercises
• Valuable data for researchers studying vertigo and dizziness

As these technologies advance, they may become integral tools in the management and study of vestibular disorders.

In conclusion, vertigo and dizziness represent complex and common health issues affecting a significant portion of the population. While conditions like BPPV are well understood and treatable, many aspects of vertigo and dizziness continue to challenge medical professionals. Ongoing research and technological advancements offer hope for improved diagnostic accuracy, more effective treatments, and enhanced quality of life for those affected by these disorienting conditions.

What is BPPV? | Ménière’s Society

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common causes of vertigo. BPPV stands for:

• Benign as although it can be quite disabling, it is not due to serious disease
• Paroxysmal because it occurs in short bursts of up to one minute
• Positional as it is provoked specifically by movement to or from certain positions
• Vertigo – dizziness defined as an illusion of movement.

Who is affected by BPPV?

BPPV is estimated to affect roughly 50% of all people at some time in their lives and becomes progressively more common with age.

Symptoms of BPPV

The vertigo is generally rotational (like getting off a roundabout) but sometimes sufferers, on lying down, will feel that they are falling through the bottom of the bed or, on getting up, that they are being thrown back onto it. The classic provoking movements to induce BPPV are: lying flat, sitting up from lying flat; turning over in bed; looking up (e.g. hanging washing) or bending down, especially if also looking to the side. The duration of the vertigo is brief; usually five to 30 seconds but very occasionally lasts up to two minutes.

What causes BPPV?

BPPV is caused when loose chalk crystals get into the wrong part of the inner ear. These microscopic crystals should be embedded in a lump of jelly. The crystals weigh the jelly down and make that part of the ear sensitive to gravity. The crystals are constantly being re-absorbed and re-formed and over time fragments come loose. Lying flat can then occasionally cause some of the loose debris to fall into one of the semi-circular canals; the parts of the ear responsible for sensing rotation. Movement in the plane of the affected canal causes the crystals to move along the canal, stimulating it and giving the sensation of rotation.

How is BPPV diagnosed?

During periods when attacks are not occurring, the diagnosis is made from the characteristic history and by the exclusion of other disorders that can cause similar dizzy symptoms. When attacks are occurring, the Hallpike positional test is diagnostic. In the commonest form of BPPV the Hallpike test is positive (i.e. induces vertigo and nystagmus) when the affected ear is down most. Up to 10% of cases may involve both ears.

How is BPPV treated?

At least a half of all cases will get better without treatment though this may take months. As BPPV is basically a mechanical disorder, drugs have no effect and should be avoided. Most cases that do not resolve rapidly can now be relieved by the appropriate Particle Repositioning Manoeuvre; of which the most commonly performed is the Epley manoeuvre which offers instant relief of symptoms in nine out of 10 patients.

Further information about BPPV

Please contact us for further information about BPPV or to chat with a member of our team.  

The Ménière’s Society can provide general information, but is unable to provide specific medical advice. You should always check with your medical professional for information and advice relating to your symptoms/condition.

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If you have found our information helpful, why not become a member. As well as supporting our work, we’ll keep you informed about the latest management/treatment options for vestibular disorders and what research is taking place. Find out more about membership.

If membership isn’t for you, please consider making a donation to support our work and help us continue to supporting people affected by BPPV and other vestibular conditions. 

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What is Vertigo and Dizziness?

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Vertigo and dizziness are common terms used to describe several sensations, such as spinning (vertigo), light-headedness or near fainting (presyncope), and loss of balance or unsteadiness (disequilibrium).

Vertigo is just one form of dizziness and is usually described as the sensation of movement, especially spinning sensations. When dizziness is described this way we refer to it as vertigo. Vertigo can be divided into two broad categories:

• Peripheral vertigo is related to the inner ear.
• Central vertigo is related to the central nervous system regions (that is, the brain) that receive and process inner ear signals.

Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo. BPPV is a type of peripheral vertigo and is the most common disorder of the vestibular system, which is responsible for balance and sense of spatial orientation. BPPV occurs when small pieces of calcium carbonate called otoconia break free from the gravity-sensing structures of the inner ear and move by the effect of gravity (the crystals are heavy and sink) within the fluid-filled tubes in the inner ear called semicircular canals. As the crystals move within the canal, they set off the sensors causing vertigo.

Near-syncope

Near-syncope is another form of dizziness that is due to transient underperfusion of the brain by blood flow. This is basically the same mechanism that leads to fainting (syncope). When it is a little milder, the person may just feel lightheaded, but not actually pass out.

Imbalance or Disequilibrium

Imbalance or disequilibrium refers to a sensation of dizziness in which a person feels unsteady and unsure of balance. There is not a sensation of near fainting, nor is there a spinning sensation, but rather a feeling like the person might fall or lose balance. This sensation is usually present when standing or walking and not when sitting down or lying down. There are many possible causes for this symptom and neurological consultation is appropriate.

Dizziness and Vertigo Symptoms

The main symptom of vertigo is the sudden sensation that you or your surroundings are spinning. It is usually triggered by moving your head, such as rolling over in bed or looking up, and it can last a few seconds to minutes. Additional symptoms that may help explain the cause of peripheral vertigo include:

• Hearing loss or muffled hearing in one ear
• Ringing in only one ear

Central vertigo may have other symptoms such as:

• Difficulty swallowing
• Double vision
• Eye movement problems
• Facial paralysis
• Slurred speech
• Numbness on only one side of the body or face

Contact your doctor if you have symptoms of vertigo. Call 9-1-1 if you suddenly experience severe dizziness accompanied by other symptoms, such as double vision, slurred speech, or loss of coordination.

Dizziness and Vertigo Treatments

Some forms of vertigo get better without treatment.

The canalith repositioning procedure, or Epley maneuver, can improve symptoms resulting from benign paroxysmal positional vertigo (BPPV), usually on the same day.

Other forms of peripheral vertigo such as vestibular neuritis may require vestibular rehabilitation physical therapy.

Meniere’s disease is often treated with low sodium diet and diuretics, and sometimes with other approaches which occasionally include surgery.

Vestibular migraine is thought to be a neurotransmitter or ion channel disorder of the brain and can cause recurrent vertigo that can sometimes be disabling. It can sometimes be managed by dietary and lifestyle changes, but many times requires medications to treat the underlying cause.

There are many causes of dizziness, each with its own treatment. Other conditions we treat include:

• Superior canal dehiscence
• Chronic subjective dizziness and phobic postural vertigo
• Bilateral peripheral vestibular loss (Dandy’s syndrome)
• Mal de debarquement
• Perilymphatic fistula
• Isolated utriculosaccular functional loss
• Many others

Our program can manage all forms of dizziness, whether vestibular (inner ear causes, vestibular migraine, central vertigo, etc. ), hemodynamic (e.g., low blood pressure or autonomic including POTS), anxiety-related, or whether the dizziness is due to disequilibrium caused by any of a variety of disorders.

Additional Information

How common is vertigo?

Vertigo and dizziness are common symptoms that affects more than 90 million Americans. It has been reported to be the most common medical complaint in patients age 75 and older.

Benign paroxysmal positional vertigo (BPPV) affects about 64 of every 100,000 Americans.

Who gets vertigo?

BPPV can occur at any age but is most common in people over 60, possibly because otoconia erode as we age.

Other possible peripheral vertigo causes include:

• Inflammation of the vestibular nerve (vestibular neuritis)
• Meniere’s disease
• Superior canal dehiscence
• Perilymphatic fistulae
• Bilateral peripheral vestibular loss.

Some of these forms of peripheral vertigo can result from head trauma.   Sometimes dizziness is caused by taking medication.

Central vertigo may be caused by:

• Certain medications
• Migraine mechanisms
• Multiple sclerosis
• Stroke
• Tumors or any kind of lesion that interferes with the brain’s ability to process balance information coming from the inner ears

How is vertigo diagnosed?

Your doctor may do a series of tests to determine the cause of your dizziness.

If you have dizziness that seems to be trigger by changes in head position, your doctor may perfrom a Dix-Hallpike maneuver. During this test:

1. Your head is turned 45 degrees toward one shoulder.
2. You are laid back with head hanging slightly off the end of the exam table.
3. If you have BPPV on that side, vertigo will occur and the doctor will see characteristic nystagmus (eye movements).
4. This confirms the diagnosis, and once confirmed there is a very effective bedside treatment maneuver called canalith repositioning procedure (sometimes referred to as Epley’s maneuver) that can be done to eliminate the vertigo often in one visit.

The Vestibular and Oculomotor Laboratory and Balance Center at Barrow Neurological Institute at Dignity Health St. Joseph’s Hospital and Medical Center offers a range of diagnostic tests to evaluate vertigo, dizziness, ataxia (lack of muscle control during voluntary movements), and hearing disorders.

Treatment of dizziness in a neurological clinic in Moscow

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Success in the treatment of dizziness depends primarily on its cause and how correctly it is established. A neurologist treats dizziness in Moscow. Our clinic specializes in the treatment of any neurological pathology, including the diagnosis and treatment of dizziness. We have all the necessary infrastructure to determine the exact cause and offer the most effective therapy.

Methods for the treatment of dizziness

Non-drug methods:

• Vestibular exercises – reduces the excitability of the vestibular apparatus.
• Breathing exercises – eliminates the problems of hyperventilation that accompany dizziness. In some cases, biofeedback therapy, psychotherapy, hirudotherapy, and acupuncture can be used to treat dizziness.

Medicinal treatments for dizziness:

• Modern drug therapy for dizziness consists in the use of antidepressants, neuroleptics and benzodiazepines in accordance with modern international recommendations and standards of the Ministry of Health of the Russian Federation. Drug therapy allows you to get rid of psychogenic conditions such as “lightheadedness”, “staggering”, etc. in the shortest possible time. Restore the patient’s sense of control and well-being.

Drug therapy for vertigo is used only in accordance with current international standards. As a rule, for the treatment of dizziness and other vegetative diseases, an integrated approach is used, including both non-drug methods and medication, depending on the individual characteristics of the person. Treatment of dizziness in our clinic is a high-quality diagnostics and a guaranteed positive effect. We are responsible for the result! Clinic doctors are our main asset! We represent a team of true professionals whose attitude to their work – collegiality, responsibility and a sincere desire to provide assistance – is especially valuable in modern medicine.

Difficulties in the treatment of dizziness

The concept of “dizziness” is too common today. It is very often included in the complex of complaints of patients at the reception who applied with a variety of diseases. Vertigo is understood to mean all sorts of manifestations and conditions: from the real whirling of objects before the eyes to a slight feeling of instability, “lightheadedness” or lightness in the head. Such manifestations may indicate neurological, cardiological, neurotic and emotional disorders. Descriptions of dizziness and causes can be a great many.

However, there are two main types of dizziness:

• true dizziness (systemic dizziness or vertigo),
• non-systemic dizziness.

In systemic – true – vertigo, objects are spinning before the eyes, or there is a feeling that your body is spinning / moving in space – often this is like spinning on a carousel. At the same time, walking is extremely difficult and often impossible at all.

All other sensations – swaying, instability, spinning inside the head, uncertainty, feeling that the floor is uneven or wadded, that you are being “led” or “carried” somewhere, if others do not notice this – this is the so-called non-systemic dizziness, then there is no dizziness at all in the truest sense of the word.

The most common cause of true (systemic) vertigo is benign paroxysmal positional vertigo . It is easy to diagnose and you can quickly carry out effective treatment in our clinic and relieve symptoms.

IMPORTANT! If dizziness is not positional in nature and lasts more than a few minutes, should see a doctor as soon as possible.

Types of vertigo:

• Positional vertigo
• Vestibular neuronitis
• Vestibular migraine
• Meniere’s disease

Diagnosis in the treatment of dizziness

There can be quite a few causes of dizziness – from cardiovascular to neurological diseases. Most often, patients complain of dizziness, as they are afraid of further deterioration of the condition. First of all, it is necessary to conduct a thorough diagnosis in order not only to get rid of the symptoms, but also to eliminate their cause.

In the clinic of vegetative disorders, prior to the treatment of vertigo, a two-stage examination is carried out:

• Negative diagnosis , which reveals all disorders except psychogenic ones, for example, problems with the vestibular apparatus, neurological diseases, etc. For this, doctors from different fields are involved, who can determine the symptoms of these diseases, as well as ultrasound and EEG diagnostic methods.
• Positive diagnosis is aimed at identifying neurotic disorders that are associated with stress. Most often, dizziness is accompanied by anxiety, headache, panic attacks, tension, stiffness, and fainting.

The first step in the treatment and diagnosis of dizziness should be your visit to a neurologist. Only a doctor of a specialized clinic will be able to build the correct tactics for the treatment of dizziness and, if necessary, prescribe additional examinations. Contact one of our specialists.

Doctors for the treatment of vertigo:

Referring to a neurologist through the site for the first time, you get a 5% discount

• Naprienko Margarita Valentinovna
  Chief physician, doctor of medical sciences, professor, neurologist of the highest category

• 9 0010 Filatova Elena Glebovna
  Neurologist , Professor, Doctor of Medical Sciences

• Oknin Vladislav Yurievich
  Neurologist, Doctor of Medical Sciences

• Ekusheva Evgenia Viktorovna
  Neurologist, Doctor of Medical Sciences, Professor

• Latysheva Nina Vladimirovna
  Neurologist, Doctor of Medical Sciences

• Sazonova Angelina Gennadievna
  Neurologist, functional diagnostician, Candidate of Medical Sciences

  9000 4

• Mikhailova Svetlana Anatolyevna
  Neurologist, candidate of medical sciences

• Gubanova (Kadymova) Natalya Borisovna
  Neurologist, candidate of medical sciences functional diagnostician

• Ivanova Tatyana Andreevna
  Neurologist, Candidate of Medical Sciences

• Gubareva Yuliya Alexandrovna
  Neurologist, cephalologist

• Prishchepa Anastasia Vasilievna
  Neurologist, candidate of medical sciences, biofeedback specialist, post-graduate student of the Department of Nervous Diseases . THEM. Sechenov.

• Andreeva Olga Vladimirovna
  Neurologist, epileptologist, functional diagnostician, candidate of medical sciences

• Bayushkina Lyudmila Igorevna
  Neurologist

• Anna Vladimirovna Berdnikova
  Neurologist, postgraduate student

The main thing is to notice symptoms in time

The year declared by the President of the Russian Federation as the National Year of Combating Cardiovascular Diseases is coming to an end. Shukyur Kurbanov, a cardiologist at the Megion City Hospital No. 1, spoke about the situation of morbidity and the prevention of these ailments.

Shukur Yaverovich, how common are cardiovascular diseases now?

– These are by far the most frequent diseases in the structure of mortality and disability of the population. Most often die from myocardial infarction and stroke. The most common cardiovascular disease is hypertension.

We have such a situation that patients turn to a cardiologist when they already have damage to target organs: both the heart (left ventricular hypertrophy) and the brain, and the optic nerve, with renal failure, that is, at the stage of secondary changes in the body. There is a stage of reversibility of changes, when we can achieve regression of hypertrophy and improve renal function, but, as a rule, patients neglect treatment for a long time.

What are the main causes of the development of diseases of the heart and blood vessels?

– To date, the concept of risk factors is widespread. If a person has a hereditary predisposition, they are of particular importance. Sooner or later, a person will face cardiovascular problems if he smokes, abuses alcohol, does not follow the principles of a healthy diet, is overweight and does not move much. And these are modifiable risk factors that, if desired, can be influenced and completely eliminated. A lot of our patients are overweight or obese, every second smokes, every second leads a hypodynamic lifestyle according to the specifics of their work: drivers who spend the whole day behind the wheel of a car in a sitting position, or programmers working while sitting at a monitor – a list of such professions you can continue. But in the case of engaging in activities on duty that do not involve physical activity, you can actively and interestingly spend your leisure time.

At what age do patients begin to complain of pain in the heart?

– It all depends on the stage of the disease. If its course is acute, with a sharp increase in pressure, usually against the background of diseases of the endocrine, renal systems, then the patient turns early, because pressure surges make themselves felt in the form of dizziness, pain in the heart, and a decrease in exercise tolerance. But in most cases, hypertension for a long time proceeds without tangible symptoms. Therefore, a person may not know about the presence of a disease. Most often, patients first go to therapists, are treated with motherwort, hawthorn, and only then come to us, having missed the time when the most effective treatment could have been achieved.

And what are the limitations in the usual pace of life for a person with cardiovascular disease?

– At the first stage of hypertension, even at the second and third stages, when there is no damage to target organs, we achieve normotension with medication and the patient is not limited in anything – we even recommend to lead an active lifestyle, regular physical activity, for example, daily walking, is very important. At the same time, it is necessary, at least twice a day, to measure blood pressure at any stage of the disease. And of course, the patient must take the prescribed medication exactly as prescribed by the doctor.

So, we can conclude that often only after the symptoms of a long-term developing disease begin to be unbearable, people remember about blood pressure and visits to specialists.