Vertigo Dr Rob Hicks Vertigo is the illusion of movement, the feeling that our surroundings are spinning around us or that we're spinning within our surroundings.

In this article

What causes it?

What are the symptoms?

How is it diagnosed?

Vertigo usually occurs when there's a problem with the middle ear balance mechanisms, or with the brain, or with the nerve connections between the brain and the middle ear.

Possible causes of vertigo include:

• Middle ear infection
• Middle ear inflammation
• Benign positional vertigo
• Ménière's disease
• Circulation problems
• Head injury
• Ear surgery
• Side-effects of medication
• Recreational drugs
• Alcohol
• Neurological disease

Vertigo is different from dizziness, which is usually a feeling of unpleasant fuzziness in the head. Vertigo makes trying to move difficult because of a loss of balance, as well as the nausea and vomiting that often accompany it. Vertigo attacks can confine people to their homes and even their beds.

Benign positional vertigo tends to affect older people and any sudden movement of the head (usually head turning) can bring on an acute attack without warning. Although episodes tend to last less than a minute, it can be unpleasant and disabling.

As with other causes, this usually follows a viral infection, or is a result of inflammation or damage to the middle ear.

Fortunately, it often settles after a few months without treatment. Specialist physiotherapy can benefit some people if the symptoms persist.

Ménière's disease is a more disabling condition caused by problems affecting the inner ear. It's believed an increased amount of fluid collects and puts pressure on the balance mechanisms.

A vertigo attack can last from a few minutes to as long as 12 hours, usually leaving the sufferer vomiting and prostrate.

Ménière's disease also causes tinnitus (ringing in the ears) and difficulty hearing.

If the attacks are sporadic, treatment to calm symptoms is used. If, however, attacks occur regularly and prevent someone living an enjoyable life, medication can be taken daily. Occasionally, surgery may be recommended to reduce swelling or selectively destroy balance receptors.

It's important vertigo is taken seriously. Most people will see a specialist and have tests to establish the cause of the vertigo. Once this is known, the most appropriate treatment can be provided.

This article was last medically reviewed by Dr Rob Hicks in May 2008