Though sometimes inaccurately called "dizziness," vertigo occurs because of a disturbance in the system for balance in the body (vestibular system). Vertigo is a unique symptom related to specific diseases of the nervous system (central nervous system: pathologic vertigo) or a mismatch in the body's normal systems of balance and position (peripheral nervous system: physiologic or positional vertigo). Vertigo is a rotating sensation giving individuals the false impression that their surroundings are spinning or moving. Examples of physiologic vertigo are seasickness, carsickness, and height vertigo.
A sudden (acute) attack of vertigo is usually due to inflammation of the semicircular canals of the inner ear (nonspecific labyrinthitis), possibly of viral origin. Generally, the attack is self-limited. Ongoing (chronic) vertigo occurs almost daily and usually indicates the presence of a serious disease.
The principal causes of vertigo are Ménière's disease, adverse reactions to drugs (gentamicin, anticonvulsant intoxication, certain antibiotics, etc.), toxins (notably alcohol intoxication), vestibular neuronitis, multiple sclerosis, vestibular migraine, an abnormal connection between the inner and middle ear spaces (perilymphatic fistula), and an imbalance created by certain head positions or movement (benign paroxysmal positional vertigo, or BPPV). Head trauma, upper respiratory infection, hypothyroidism, and diabetes may be associated with the disease. Since balance is partially maintained by receptors in the neck that sense position in space, trauma to the neck can also cause vertigo. Tumors can occur on the nerve for hearing in the ear (acoustic neuromas).
Autoimmune disorders such as rheumatoid arthritis, dry eye syndrome (Sjögren's syndrome), ulcerative colitis, Wegener's granulomatosis, scleroderma, allergies, systemic lupus erythematosus, and Cogan's syndrome may cause symptoms including vertigo. Autoimmune damage can be confined to the labyrinth, causing vertigo and hearing loss as isolated symptoms. Steroids and other hormones affect the peripheral vestibular system involved in balance, which may be one mechanism contributing to the symptom of vertigo.Risk: Females may be at slightly greater risk than males for benign paroxysmal positional vertigo (BPPV). Incidence and Prevalence: Dizziness is the third most common complaint for persons seeking outpatient care. Overall, the prevalence of dizziness, imbalance, and vertigo in the general population is 5% to 10%, rising to 40% for those over age 40 (Hamid).
BPPV is estimated to be the most common single cause of vertigo in the US (Li). Approximately 3,000 acoustic neuromas occur each year in the US. Vertigo is present with migraines in about 30% of individuals (Hamid). |
Source: Medical Disability Advisor