DESCRIPTION

• Vertigo is a sensation of perceived motion (“room spinning”) with no motion is happening. Differs from dizziness which is a disturbance of orientation without movement.
• One of the four types of dizziness (vertigo, presyncope, light-headedness, disequilibrium)
• A symptom, not a disease process; causes can be peripheral or central
• System(s) affected: nervous, cardiovascular, psychiatry
• Synonym(s): dizziness.

EPIDEMIOLOGY

ETIOLOGY AND PATHOPHYSIOLOGY

• Dysfunction of the rotational velocity sensors of the inner ear results in asymmetric central processing; combination of sensory disturbance of motion and malfunction of the central vestibular apparatus (3).
• Peripheral causes: acute vestibular neuritis, BPPV caused by otoliths in the posterior canal 85–95% and lateral canal 5–15%, Ménière disease, otosclerosis, acute labyrinthitis, cholesteatoma, perilymphatic fistula, superior canal dehiscence syndrome, motion sickness.
• BPPV, vestibular neuritis, and Ménière disease account for the majority of peripheral causes (3).
• Central causes: cerebellar tumor, stroke, migraine, vestibular ischemia (3)
• Numerous drug causes (1),(3)

RISK FACTORS

• History of migraines
• History of CVD/risk factors for CVD
• Use of ototoxic medications
• Trauma/barotrauma/heavy weight-bearing
• Psychosocial stress/depression
• Exposure to toxins

GENERAL PREVENTION

If due to motion sickness, consider pretreatment with anticholinergics, such as scopolamine.