SymptomsVertigo is different from dizziness, which is usually a feeling of unpleasant fuzziness in the head. It 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. An acute attack can start very suddenly and last from a few minutes to as long as 12-24 hours. Causes and risk factorsVertigo usually occurs when there's a problem with the inner ear balance mechanisms, or with the brain, or with the nerve connections between the brain and the middle ear. Possible causes of vertigo include: - An inflammation called labrinthitis, caused either by a viral upper respiratory infection, or secondary to an acute middle ear infection.
- 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. Fortunately, it often settles after a few months without treatment. Specialist physiotherapy can benefit some people if the symptoms persist.
- Ménière's disease, a more disabling condition caused by problems affecting the inner ear. It also causes tinnitus (ringing in the ears) and difficulty hearing.
- Circulation problems.
- Head injury.
- Ear surgery.
- Side-effects of medication.
- Recreational drugs.
- Alcohol.
- Neurological disease.
Treatment and recovery Although most likely to be caused by a viral infection, it's important that vertigo is taken seriously. Initial treatment includes simple medication such as prochlorperazine or cyclizine. Occasionally steroids may help. Persistent vertigo may need specialist investigation to exclude the rarer, more serious, causes. Rarely, surgery may be needed to treat vertigo.
This article was last medically reviewed by Dr Gill Jenkins in April 2009.

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