Diagnosed with Vertigo?

Vertigo is the sensation of movement or spinning when at rest.  Unfortunately many people get “diagnosed” with vertigo, but in reality vertigo is a symptom and not a disease itself (it would be like being “diagnosed” with a cough).  Vertigo can be caused by a number of conditions, many of which relate to the inner ear balance system.  Other times imbalance can be caused by the brain, or by changes in blood pressure.

Dizziness that comes in response to sudden head movements and lasts a few seconds may be benign paroxysmal positional vertigo.  While this can be very uncomfortable, fortunately it goes away quickly and can be cured by simple physical maneuvers done in the office.
Vertigo that is severe and lasts hours or days may be due to labyrinthitis – an acute infection or inflammation of the inner ear.  This is usually debilitating enough to stay home and in bed, leaving only to visit the emergency department for help.  While medicines can help settle it down a little, tincture of time is the real cure.  Usually this resolves in a few days.
Some vertigo may be associated with variant migraine headaches (even some migraine forms without headache).
Meniere’s Disease is a very specific kind of swelling in the inner ear that causes the fluctuating combination of symptoms: vertigo, hearing loss, and ringing in the ear.  Unfortunately Meniere’s Disease has become kind of catch-all diagnosis for a lot of dizzy disorders, with far more people now thinking they have Meniere’s than actually do.
A very curious disorder is Mal de Débarquement, where a person suffers a feeling of rocking or swaying after a boat ride or cruise.  This can go on for several weeks or months.
Other more worrisome causes of vertigo may include a stroke or aneurysm, a tumor of the balance nerve, or multiple sclerosis.  If there are other neurologic symptoms in addition to the onset of new vertigo (like hearing loss, numbness over the face, weakness of muscles, facial droop, vision loss, etc) then an urgent visit to the emergency department or your doctor may be needed.
Treatment of vertigo usually requires testing of the inner ear, including a good hearing test, examination under a microscope, neurologic examination of eye movement and often a special test called a videonystagmogram (VNG).  The VNG examines eye movements in response to physical motion and stimulation of the inner ear, to get an idea for how strong or weak each inner ear system is working.
The goals of treatment of balance disorders are to prevent falls or injuries related to balance, and to get the patient back to their usual level of pleasurable physical activity.  For most balance disorders, staying active is important for the cure.  The balance system is like a muscle – use it or lose it.  Balance rehab therapy (“vestibular rehabilitation”) is a very good option for many patients.