Ask Dr. Pat

Dr. Pat Consults: Vertigo—Causes, Symptoms, Diagnosis, and Treatment

240905980_149cdcb035_zVertigo is the sensation of movement when not moving, or significantly exaggerated feelings with minimal movement. (Image from Flickr via. Creative Commons License)

Dr. Patricia Yarberry Allen is a collaborative physician who writes a weekly Medical Monday” column for Women’s Voices for Change.  (Search our archives for her posts, calling on the expertise of medical specialists, on topics from angiography to vulvar melanoma.)

This week, Dr. Pat turns for expertise to another Dr. Allen—her son Baxter, a resident in the Department of Neurology at Weill Cornell Medical College/New York–Presbyterian Hospital. Dr. Baxter Allen is a third-year neurology resident who has been involved in head trauma research for the last five years. This week’s subject: the concerns of a woman who is experiencing vertigo symptoms.

 

Dear Dr. Pat,

I am 57 years old and was healthy until I woke up with strange dizziness two months ago that was accompanied by nausea and vomiting. The room felt like it was spinning every time I moved. I had never experienced anything like this and was really frightened. I saw my GP right away and he said I probably had an attack of vertigo brought on by a bad cold that I had suffered through six weeks before. He did tell me that dizzy spells like this were common and nearly always went away. He prescribed an antihistamine, along with rest, and sure enough, my symptoms disappeared. However, this vertigo came back two weeks later and still comes and goes with no special warning. My GP said he didn’t have any other treatments to recommend and that I would have to see someone at the university medical center for further evaluation. I have to travel quite a distance to see a specialist and wondered if there is anything that can really be done to solve this. It is really affecting my quality of life. By the way, what causes this anyway? Can something really be done to make this better?

Dora

 

Dr. Allen Responds:

Dear Dora,

The symptoms of vertigo are always unsettling. Patients often describe them like this: “The room is spinning; but I’m sitting still on my couch. I feel like I am on a boat, rocking in the ocean; even though I’m nowhere near either. When I try to walk, it’s like I’m drunk; except I haven’t had a glass of wine in weeks.”

These are some of the more common descriptions doctors hear from their patients suffering from vertigo. It has many causes; can be brief or chronic; completely benign, or, much less commonly, the first symptom of something serious, like a stroke.

When a doctor sees a patient complaining of dizziness, it’s important to figure out which category it falls under:

  • Vertigo, the most common form, is the sensation of movement when not moving, or significantly exaggerated feelings with minimal movement.
  • Lightheadedness, or “pre-syncope,” is feeling like you’re going to faint or pass out; usually occurs with quick changes in position while dehydrated, or with cardiovascular disease.
  • Disequilibrium is the feeling of being off balance or “tilted” toward one side, and is generally accompanied by frequent falls in one direction.
  • Non-specific dizziness is used to as a catch-all when the symptoms are vague or don’t fit neatly into one category or another.

600px-Blausen_0329_EarAnatomy_InternalEarSource: Wikimedia Commons

Next Page: Causes of Vertigo

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  • Louise Eldridge August 4, 2015 at 9:17 am

    My first episode last a few minutes, second one required an ambulance and a 3 day hospital stay with no vision in one eye and I was walking sideways due to loss of balance. Now, a year later, my head feels like a ‘bobblehead’. I have lost much of my peripheral vision, and am now seeing an ENT, who has prescribed exercises moving my head back and forth staring at an object. Also walking a balance beam width on the floor with eyes closed. He has determined after a year of testing that I have vestibular neuronitis. I am thankful I have improved this much, as a year ago, this was very scary.

    Reply
  • Jan-Michael August 4, 2015 at 7:54 am

    I have primary progressive MS am age 64 diagnosed at age 50. I last year was suddenly “sucked” to floor in a nano-second. I felt glued to floor and managed to get o a couch…the room was spinning though I had eyes closed. I now take Serc 2 twice daily. I had started to lower to once per day but as falls are back I am back to 2xpd. My ear on right feels full, my head seems inflated but without headache. I also have a feeling of pain in high area of right nostril so will see ENT doctor. I am able to walk carefully but have a walker in the house car and outside.

    Reply
  • Andrea July 27, 2015 at 12:25 pm

    Thank you Dr.Allen (Pat and Baxter) for an informative article !! I know several women experiencing these symptoms and have no information available.

    Reply
  • Jane Lockett July 27, 2015 at 7:32 am

    In addition there is Postural Orthostatic Tachycardia Syndrome. (POTS) or dysautonomia. How can you tell the diference between vertigo and dysautnomia without medical tests like tilt table and blood tests? This set of symptoms can be similar to vertigo at some point, and then change.

    Reply