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Vertigo is a sensation of spinning or dizziness that is often linked to a problem with the inner ear or the vestibular system, which helps control balance. There are several potential causes of vertigo, including:

Benign Paroxysmal Positional Vertigo (BPPV): This is one of the most common causes of vertigo. It occurs when tiny calcium particles (canaliths) clump up in the canals of the inner ear, affecting the balance signals to the brain. Certain head movements can trigger sudden, intense vertigo episodes.

Meniere’s Disease: This inner ear disorder is characterized by a buildup of fluid and changes in pressure in the ear. It can cause vertigo, along with ringing in the ear (tinnitus) and hearing loss. The exact cause of Meniere’s disease is not known.

Vestibular Neuritis or Labyrinthitis: These conditions are often caused by viral infections that affect the inner ear. They can lead to inflammation of the vestibular nerve (vestibular neuritis) or the labyrinth of the inner ear (labyrinthitis), resulting in vertigo, dizziness, and sometimes hearing loss.

Migraine-Associated Vertigo: Some people experience vertigo as a symptom of migraines. This type of vertigo can occur with or without a headache and is often accompanied by other migraine symptoms like sensitivity to light and sound.

Head Injury or Concussion: Trauma to the head, such as a concussion, can disrupt the inner ear or the balance centers of the brain, leading to vertigo.

Medication Side Effects: Certain medications, especially those that affect the inner ear or brain, can cause vertigo as a side effect. Examples include some antibiotics, antidepressants, and drugs used to treat high blood pressure.

Anxiety Disorders: Severe anxiety or panic attacks can sometimes cause symptoms of vertigo, as the body’s stress response can affect the inner ear and balance.

Tumors: Although rare, tumors such as acoustic neuroma can grow on the nerves that control hearing and balance. These tumors can cause vertigo along with hearing loss.

Stroke or Transient Ischemic Attack (TIA): In some cases, vertigo can be a symptom of a stroke or a TIA, which is often accompanied by other neurological symptoms like slurred speech or weakness in the limbs.

It’s important to note that sometimes the exact cause of vertigo is not identified (idiopathic), especially if it’s a one-time or infrequent episode. However, recurrent or persistent vertigo should always be evaluated by a healthcare professional to determine the underlying cause and appropriate treatment.

Diagnosing vertigo typically involves a combination of medical history taking, physical examination, and sometimes specialized tests. Here are some common steps and tests that doctors use to diagnose vertigo:


Medical History: The doctor will start by asking about your symptoms, including when they started, how long they last, and what seems to trigger them. They will also inquire about any other medical conditions you have and medications you are taking.

Physical Examination: A physical examination will focus on the neurological and ear, nose, and throat (ENT) systems. The doctor may check for signs of inner ear problems, such as nystagmus (involuntary eye movements), hearing loss, or abnormalities in the ear.

Dix-Hallpike Test: This is a common test for Benign Paroxysmal Positional Vertigo (BPPV). During this test, the doctor will have you sit on the examination table and then lie back quickly with your head turned to one side. This can trigger vertigo and nystagmus in people with BPPV.

Balance Tests: There are several tests to assess balance and gait. One common test is the Romberg test, where you stand with your feet together and eyes closed to see if you sway, which can indicate balance issues.

Videonystagmography (VNG): This is a specialized test to evaluate the function of the vestibular system. It involves wearing goggles with cameras that record eye movements while you follow visual targets and undergo various head movements.

Caloric Stimulation: This test involves irrigating the ear canal with warm or cold water to stimulate the inner ear. The resulting eye movements (nystagmus) can help determine if one ear is functioning differently from the other.

MRI or CT Scan: In some cases, imaging tests like magnetic resonance imaging (MRI) or computed tomography (CT) scans may be ordered. These can help rule out other causes of vertigo, such as tumors or strokes.

Blood Tests: Blood tests may be done to check for infections or other conditions that could be causing vertigo, such as diabetes or thyroid disorders.

Electronystagmography (ENG): Similar to VNG, ENG is a test that evaluates the function of the inner ear and the pathways to the brain that control eye movements. It can help diagnose vestibular disorders.

Rotary Chair Test: This test involves sitting in a computer-controlled chair that moves very slowly in the dark. It helps assess how well the vestibular system is functioning by measuring eye movements.

The specific tests used will depend on the suspected cause of vertigo and the individual’s symptoms. It’s important to consult with a healthcare professional if you are experiencing vertigo, as they can determine the most appropriate tests based on your situation.