Causes of vertigo

Vertigo isa symptom ofseveral different conditions. There are two types of vertigo, known as peripheral and central, depending on the cause.

Peripheral vertigo

Peripheral vertigo is the most common type,often caused by a problem with the balance mechanisms of the inner ear. The most common causes include:

• benign paroxysmal positional vertigo (BPPV)
• head injury
• labyrinthitis
• vestibular neuronitis
• Mnire's disease
• takingcertain types of medication

Thesecausesare explained in more detail below.

Benign paroxysmal positional vertigo (BPPV)

This is one of the most common causes of vertigo.It canoccur during specific head movements, while standing up or bending over, crossing the road, or turning in bed.

BPPV involves short, intense, recurrent attacks of vertigo (usually lasting a few seconds to a few minutes). It is often accompanied by nausea, although vomiting is rare.You mayalsoexperience your eyes briefly movinguncontrollably (nystagmus).

Lightheadedness and a loss of balance can last for several minutes or hours after the attack.

BPPV is thought to be caused by small fragments of debris (calcium carbonate crystals), which break off from the lining of the channels in your inner ear. The fragments don't usually cause a problem, unless they get into one of the ear's fluid-filled canals.

When your head is still, the fragments sit at the bottom of the canal. However, certain head movements cause them to be swept along the fluid-filled canal, which sends confusing messages to your brain, causing vertigo.

BPPV usually affects older people, with most cases occurring in people older than 50 years of age.

BPPV may occur for no apparent reason, or it may develop after:

• an ear infection
• ear surgery
• a head injury
• prolonged bed rest for example, while recovering from an illness

Head injury

Vertigo can sometimes develop after a head injury. If you have symptoms ofdizziness or vertigo following a head injury, seek medical attention.

The labyrinth is a maze of fluid-filled channels that control hearing and balance.

When the labyrinth becomes inflamed, the information it sends to your brain is different from the information sent from your unaffected ear and your eyes. These conflicting signals cause vertigo and dizziness.

Labyrinthitis is usually caused by a viral infection, such as the Cold or flu , which spreads to the labyrinth. Less commonly, it's caused by a bacterial infection.

Vertigocaused by labyrinthitis may be accompanied by nausea, vomiting, hearing loss , tinnitus and sometimesa high temperature and ear pain.

Vestibular neuronitis

Vestibular neuronitis, also known as vestibular neuritis, is an inner ear condition that causes inflammation of the nerve connecting the labyrinth to the brain. In some cases, the labyrinth itself can also be inflamed.

The conditionis usually caused by a viral infection. It usually comes on suddenly and can cause other symptoms, such as unsteadiness, nausea (feeling sick) and vomiting (being sick). You won't normally have any hearing problems.

It usually lasts a few hours or days, but it may takethree tosix weeks to settle completely.

Mnire's disease

Severe vertigo is sometimes caused by a rare condition that affects the inner ear, called Mnire's disease .Thiscan cause vertigo, as well as hearing loss, tinnitus and aural fullness (a feeling of pressure in your ear).

If you have Mnire's disease, you may experience sudden attacks of vertigo that lastfor hours or days. The attacks often cause nausea and vomiting.

The cause is unknown, butsymptoms can be controlled by diet and medication. Rarely, you may need further treatment in the form of surgery.

Medication

Vertigo may occur as a side effect of some types of medication. Check the patient information leaflet that comes with your medicine to see if vertigo is listed as a possible side effect.

Don't stop taking prescribed medication without your doctor's advice, but speak to your GP if you're worried about the side effects. They may be able to prescribe an alternative medication.

Central vertigo

Central vertigo is caused by problems in part of your brain, such as the cerebellum (located at the bottom of the brain) or the brainstem (the lower part of the brain that's connected to the spinal cord). Causes of central vertigo include:

• migraines a severe headache that's usually felt as a throbbing pain at the front or on one side of your head, which is especially common in younger people
• multiple sclerosis a condition that affects the central nervous system (the brain and spinal cord)
• acoustic neuroma a rare, non-cancerous (benign) brain tumour that grows on the acoustic nerve, which is the nerve that helps to control hearing and balance
• a brain tumour in the cerebellum, located at the bottom of the brain
• a transient ischaemic attack (TIA) or a stroke where part of the blood supply to the brain is cut off
• taking certain types of medication