Types of Vertigo

If you've been on your share of amusement park rides, you probably know what vertigo is like -- the feeling that the world is spinning around you. But if you feel dizzy and didn't just step off a roller coaster, check with your doctor to see if you've got one of the two most common forms of vertigo: central and peripheral.

There are drugs and other treatments for both types. Finding out which one you've got -- and what's causing it -- can help you and your doctor decide how to manage it.

Keep in mind that vertigo is a symptom of a medical condition, not a disease by itself. Your doctor will try to figure out what's behind it.

What Causes Peripheral Vertigo?

If your doctor tells you that you have peripheral vertigo, you've got plenty of company. It's the most common type of vertigo. Most cases are caused by a problem in the inner ear, which controls your balance.

The most common causes of the inner ear trouble that leads to peripheral vertigo are:

• Benign paroxysmal positional vertigo (BPPV)
• Vestibular neuronitis
• Meniere's disease

BPPV is a condition that causes small crystals to get loose and start to float in the fluid of your inner ear. The movement of the crystals and the fluid leads you to feel dizzy. Sometimes an ear injury can lead to BPPV.

Vestibular neuronitis causes severe dizziness that comes on suddenly and lasts for 2 to 3 weeks. Doctors think an infection with a virus may be the cause.

Meniere's disease is condition that combines symptoms of dizziness with occasional hearing loss. Doctors aren't sure what causes it, though stress can be a trigger, along with eating salt or drinking caffeine and alcohol.

There are some other conditions of the inner ear that also lead to peripheral vertigo, including:

• Labyrinthitis
• Perilymph fistula
• Superior semicircular canal dehiscence syndrome (SSCDS)

Labyrinthitis may be caused by a viral infection of your inner ear. Perilymph fistula may be due to a head injury or sudden pressure change, such as from scuba diving. SSCDS may be due to a breakdown of part of a bony part of a canal that carries fluids in your inner ear.

What Other Symptoms May I Have With Peripheral Vertigo?

Nausea and vomiting, sweating, and ear problems are all common symptoms that you may have along with vertigo.

If your peripheral vertigo is caused by an inner ear infection or a disease, you may have some pain or a feeling of fullness in your ear.

In labyrinthitis and Meniere's disease, you may have hearing loss and tinnitus (ringing of the ears) in one or both ears along with the vertigo.

There are some common features of peripheral vertigo that can help your doctor make a diagnosis. Vertigo that starts without warning, and stops just as quickly, is more likely to be peripheral vertigo.

Your eyes may also move without your control. This movement may go away when you try to focus your vision on a fixed point. It also tends to only happen during the first few days of vertigo symptoms and then disappears.

How Is Peripheral Vertigo Treated?

You can treat peripheral vertigo by managing the condition that's causing it.

BPPV, the most common cause of peripheral vertigo, can be treated with a 15- minute exercise known as the Epley maneuver. This series of movements, done in your doctor's office, helps return the crystals that control balance to the correct place in your inner ear.

Anti-inflammatory drugs can sometimes help ease symptoms if your peripheral vertigo is caused by vestibular neuronitis, Meniere's disease, or labyrinthitis. Meniere's disease can also be controlled by cutting down on salt, caffeine, and alcohol and lowering your stress.

For some conditions, such as perilymph fistula or SSCDS, your doctor may recommend surgery to correct problems in your inner ear.

Some conditions causing peripheral vertigo may be chronic, meaning they are ongoing. In these situations, you'll need a combination of balance exercises, lifestyle changes, and medication to manage the vertigo. Motion sickness medicine may also help ease nausea. Your doctor may also prescribe medicines that help reduce balance problems.

What Causes Central Vertigo?

Central vertigo is caused by a disease or injury to the brain, such as:

• Head injuries
• Illness or infection
• Multiple sclerosis
• Migraines
• Brain tumors
• Strokes
• Transient ischemic attacks ("mini" strokes that last for a short time and don't cause permanent damage)

What Other Symptoms Could I Have From Central Vertigo?

While episodes of peripheral vertigo tend to pass quickly, central vertigo often comes without warning and may last for long periods of time. The episodes are generally much more intense than peripheral, and you may be unable to stand or walk without help.

Eye movement that you can't control happens in both types of vertigo. But in central vertigo this eye movement lasts longer (weeks to months during vertigo episodes) and it does not go away when you're asked to focus on a fixed point.

The hearing problems that frequently happen in peripheral vertigo or AICA strokeare rare with central vertigo. But other symptoms -- like headaches, weakness, or trouble swallowing -- are common with central vertigo.

How Is Central Vertigo Treated?

Finding out the root cause of the vertigo and treating it is the only way to manage central vertigo. If migraines are the cause, for instance, medication and reducing your stress may help.

For some ongoing conditions, such as multiple sclerosis stroke, and some tumors, treatment may consist of managing the symptoms. This may include medicines for nausea and drugs that help lessen the sensation of movement.

A stroke in the brain can trigger not only vertigo but dysarthria (slurred speech), ataxia (problems moving), weakness, and numbness/tingling. You should get emergency help right away.

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