Types of Vertigo – Peripheral, Central, Positional & More

Vertigo is a symptom of a medical condition, not a disease in itself. There are different types of vertigo, including peripheral, central, and positional vertigo. Understanding these types and their characteristics is crucial in managing this common symptom.

Key Takeaways:

• Vertigo is a symptom, not a disease.
• Peripheral vertigo is the most common type.
• Central vertigo is caused by a disease or injury to the brain.
• Positional vertigo is triggered by certain head positions.
• Consult a healthcare professional for an accurate diagnosis and personalized treatment plan.

Causes of Peripheral Vertigo

Peripheral vertigo is commonly caused by several underlying conditions. The most prevalent causes include:

• Benign Paroxysmal Positional Vertigo (BPPV): This occurs when small crystals in the inner ear become dislodged, leading to dizziness.
• Vestibular Neuronitis: A viral infection that results in severe dizziness.
• Meniere’s Disease: A condition characterized by dizziness and hearing loss.

In addition to these common causes, there are some less frequent contributors to peripheral vertigo. These include:

• Labyrinthitis: An infection that causes inflammation of the inner ear.
• Perilymph Fistula: A tear or opening in the membrane that separates the middle and inner ear.
• Superior Semicircular Canal Dehiscence Syndrome (SSCDS): A rare condition where the thin bone that covers the superior semicircular canal is absent or damaged.

Understanding the various causes of peripheral vertigo is crucial to effectively diagnosing and treating this condition.

Symptoms of Peripheral Vertigo

Peripheral vertigo can cause a range of symptoms that can significantly impact one’s daily life. Here are some of the common symptoms associated with peripheral vertigo:

• Dizziness: Individuals with peripheral vertigo often experience a spinning or whirling sensation, making it difficult to maintain balance.
• Nausea and vomiting: The dizziness associated with peripheral vertigo can lead to feelings of nausea, which may result in vomiting.
• Sweating: Excessive sweating is another symptom that may accompany peripheral vertigo, especially during episodes of dizziness.
• Balance problems: People with peripheral vertigo may have difficulty standing or walking steadily due to the feeling of unsteadiness.
• Ear-related symptoms: Peripheral vertigo can also present with ear symptoms such as pain, fullness, and hearing loss.

It is important to note that specific conditions like labyrinthitis and Meniere’s disease may have additional symptoms. Labyrinthitis, for example, can cause tinnitus (ringing in the ears) along with hearing loss, while Meniere’s disease is characterized by recurrent episodes of vertigo, hearing loss, tinnitus, and a feeling of fullness in the affected ear.

Individuals with peripheral vertigo may experience a range of symptoms, including dizziness, nausea, balance problems, and ear-related symptoms.

These symptoms can vary in severity and may come and go, depending on the underlying cause of peripheral vertigo. It is advisable to seek medical attention if you experience persistent or recurrent episodes of vertigo to determine the underlying cause and appropriate treatment.

Treatment Options for Peripheral Vertigo

When it comes to treating peripheral vertigo, the approach depends on the underlying cause. In most cases, specific exercises and maneuvers can help alleviate symptoms and improve balance. Let’s take a closer look at some common treatment options:

Epley Maneuver

The Epley maneuver is a simple exercise that can be effective in treating benign paroxysmal positional vertigo (BPPV). It involves a series of head movements that aim to reposition the crystals in the inner ear, reducing dizziness and vertigo. This maneuver is typically performed by a healthcare professional and can provide significant relief for individuals experiencing BPPV.

Medications

In some cases, medications may be prescribed to manage symptoms of peripheral vertigo. Anti-inflammatory drugs, such as corticosteroids, can help reduce inflammation in the inner ear caused by conditions like vestibular neuronitis or labyrinthitis. These medications can alleviate dizziness and improve overall comfort.

Surgery

While most cases of peripheral vertigo can be managed with exercises and medications, there are instances where surgical intervention may be necessary. Conditions like perilymph fistula or superior semicircular canal dehiscence syndrome (SSCDS) may require surgical repair to restore proper inner ear function. Surgery is typically considered when conservative treatments have failed to provide relief.

In chronic cases of peripheral vertigo, a combination of balance exercises, lifestyle changes, and medications may be necessary to manage symptoms and improve quality of life. It’s important to consult with a healthcare professional to determine the most appropriate treatment plan based on individual needs and the specific cause of peripheral vertigo.

Causes of Central Vertigo

Central vertigo, unlike peripheral vertigo, is predominantly caused by diseases or injuries affecting the brain. There are several common causes of central vertigo that range from head injuries to neurological conditions. These causes include:

Head injuries: Traumatic brain injuries resulting from accidents or falls can disrupt the brain’s normal function and lead to central vertigo.

Infections: Certain infections, such as meningitis or encephalitis, can cause inflammation in the brain and result in vertigo symptoms.

Multiple sclerosis: This chronic autoimmune disease affects the central nervous system, including the brain, and can lead to episodes of vertigo.

Migraines: Severe headaches characterized by throbbing pain and other symptoms may also include episodes of central vertigo.

Brain tumors: The presence of tumors in the brain can disrupt the brain’s normal function and cause vertigo as a symptom.

Strokes: A stroke occurs when the blood supply to the brain is interrupted, leading to a variety of neurological symptoms, including central vertigo.

Transient ischemic attacks (mini strokes): These are brief episodes of reduced blood flow to the brain, which can cause temporary vertigo symptoms.

Central vertigo is often more severe and long-lasting compared to peripheral vertigo. It can also be accompanied by other neurological symptoms such as weakness and difficulty swallowing. Proper diagnosis and identification of the underlying cause are crucial for determining the appropriate treatment approach.

Understanding the various causes of central vertigo is essential in order to provide appropriate medical intervention and management strategies. If you experience persistent vertigo or other concerning symptoms, it is important to seek medical attention for an accurate diagnosis and personalized treatment plan.

Symptoms of Central Vertigo

Central vertigo is characterized by specific symptoms that differentiate it from peripheral vertigo. Unlike peripheral vertigo, central vertigo is usually not associated with hearing problems. However, individuals with central vertigo may experience intense spinning sensations that make it difficult to stand or walk without assistance. They may have a constant sensation of motion even when they are still.

In addition to the sensation of motion, central vertigo can also cause uncontrolled eye movement, known as nystagmus. This involuntary movement of the eyes can further contribute to feelings of dizziness and disorientation. Other symptoms that may accompany central vertigo include headaches, weakness, and trouble swallowing.

It is important to note that symptoms of central vertigo can vary depending on the underlying cause. For example, individuals with central vertigo caused by migraines may experience additional symptoms such as visual disturbances, sensitivity to light, and nausea. Proper diagnosis by a healthcare professional is crucial in order to determine the cause of central vertigo and develop an appropriate treatment plan.

“Central vertigo is characterized by intense spinning sensations and uncontrolled eye movement. Unlike peripheral vertigo, it is typically not associated with hearing problems. Other symptoms like headaches and weakness may also be present. Accurate diagnosis is essential for effective treatment.”

Treating Central Vertigo

The treatment of central vertigo depends on the underlying cause. In cases where central vertigo is caused by migraines, medication and lifestyle changes can help manage symptoms. For individuals with central vertigo due to multiple sclerosis, treatment may involve disease-modifying medications and therapies to manage neurological symptoms.

In some cases, addressing the underlying condition may alleviate symptoms of central vertigo. For example, individuals with central vertigo caused by a brain tumor may require surgery or radiation therapy to remove or shrink the tumor. Physical therapy and vestibular rehabilitation can also be beneficial for improving balance and reducing symptoms in individuals with central vertigo.

Diagnosis of Vertigo

Diagnosing vertigo can be a complex process that involves a combination of medical history, physical examination, and specialized tests. The healthcare professional will begin by asking detailed questions about the symptoms, such as the frequency and intensity of the vertigo episodes, associated symptoms, and any triggers. They will also inquire about other medical conditions, medications, and previous head injuries.

The physical examination may include assessing eye movements, coordination, and balance. The healthcare professional may perform specific maneuvers or positional tests to provoke dizziness and observe the individual’s response. These tests help determine if the vertigo is peripheral or central in nature.

In some cases, specialized tests may be required to confirm the diagnosis and identify the underlying cause of vertigo. Electro/videonystagmography is a test that records eye movements to evaluate the functioning of the vestibular system. Computerized dynamic posturography assesses balance and postural control. Vestibular-evoked myogenic potentials measure the response of the inner ear muscles to sounds.

A bedside test called the HINTS test (head impulse test, nystagmus, and skew deviation) is often used to differentiate between peripheral and central vertigo. This test involves evaluating eye movements, particularly looking for abnormal eye responses when the head is moved rapidly. The results of these tests help guide further management and treatment options.

These diagnostic tools, along with a thorough evaluation, enable healthcare professionals to accurately diagnose vertigo and develop a personalized treatment plan tailored to the individual’s specific needs.

Treatment of Vertigo

When it comes to treating vertigo, the approach depends on the underlying cause of the condition. Peripheral vertigo can often be managed through specific exercises, medications to alleviate symptoms, and lifestyle changes. These interventions aim to improve the function of the inner ear and restore balance. In some cases, the Epley maneuver, a simple exercise that involves repositioning the head, can effectively treat benign paroxysmal positional vertigo (BPPV).

Central vertigo, which is caused by brain-related conditions, may require treatment of the underlying cause. For example, individuals with migraines may benefit from medication to reduce the frequency and intensity of their migraines, which can help alleviate vertigo symptoms. Managing symptoms and preventing further neurological damage are the primary goals when treating central vertigo.

It is important to consult a healthcare professional for an accurate diagnosis and personalized treatment plan tailored to the individual’s specific needs and medical history.

In some cases, emergency treatment may be necessary, especially if the vertigo is accompanied by other neurological symptoms. It is crucial to seek immediate medical attention if you experience severe, sudden-onset vertigo along with symptoms such as weakness, trouble swallowing, or changes in vision or speech.

Treatment Options for Peripheral Vertigo:

• Exercises: Epley maneuver, Brandt-Daroff exercises
• Medications: Anti-inflammatory drugs, anti-nausea medications
• Lifestyle changes: Avoiding triggers, maintaining a healthy diet

Treatment Options for Central Vertigo:

• Medications: Migraine medications, anti-seizure drugs
• Management of underlying conditions: Multiple sclerosis treatments, brain tumor treatments
• Symptom management: Physical therapy, balance exercises

Remember, the treatment approach for vertigo should always be customized to fit the individual’s specific needs, medical history, and the underlying cause of their vertigo. Consulting with a healthcare professional is crucial for an accurate diagnosis and the most effective treatment plan.

Vestibular Rehabilitation

Vestibular rehabilitation is a highly effective form of physical therapy that focuses on improving balance and reducing vertigo symptoms. This specialized therapy is designed to help individuals with both peripheral and central vertigo regain their equilibrium and enhance their quality of life. By performing specific exercises and movements, vestibular rehabilitation helps to retrain the brain to compensate for vestibular dysfunction.

During vestibular rehabilitation, patients work closely with a physical therapist who tailors a program to their specific needs and goals. The therapist will guide the individual through a series of exercises that gradually challenge their balance and coordination. These exercises may include head and eye movements, postural stability exercises, and walking exercises. Over time, the brain learns to rely on other sensory information to maintain balance, reducing the occurrence and severity of vertigo episodes.

Benefits of Vestibular Rehabilitation

• Reduces frequency and intensity of vertigo episodes
• Improves balance and coordination
• Enhances overall quality of life
• Increases confidence and independence in daily activities

Vestibular rehabilitation is a long-term treatment approach that requires commitment and consistency. Patients are typically advised to continue their exercises at home to maintain the progress made during therapy sessions. The duration of treatment varies depending on the individual and the severity of their vertigo symptoms, but most people start experiencing improvements within a few weeks of starting vestibular rehabilitation.

Conclusion

Vertigo is a common symptom that can greatly impact an individual’s daily life. By understanding the different types of vertigo, their causes, symptoms, and treatment options, individuals can take proactive steps towards managing their vertigo effectively.

Whether someone is experiencing peripheral vertigo, which is often caused by inner ear problems, or central vertigo, which is associated with brain diseases or injuries, there are treatment options available. The specific treatment for vertigo depends on the underlying cause, and it is important to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.

For peripheral vertigo, treatments may include exercises like the Epley maneuver, anti-inflammatory drugs, or in some cases, surgery. Central vertigo may require addressing the underlying condition with medication or other management strategies. In both cases, lifestyle changes and balance exercises can also play a significant role in alleviating symptoms and improving quality of life.

Remember, managing vertigo is a journey, and it may require patience and persistence. With the right guidance and support, individuals can find relief from vertigo and regain their balance and well-being.