Kids may enjoy spinning in circles, getting dizzy and falling down, but for adults the sensation of the world spinning – commonly diagnosed as vertigo – can range from discomfort to debilitation.
Equally frustrating for those suffering with vertigo is the lack of a one-size-fits-all fix. That’s not to suggest there aren’t treatments that work for some.
Brian Fahey, DO, a neurologist at Ohio State Wexner Medical Center Neurological Institute, says understanding the type of vertigo you’re experiencing is crucial before heading to the pharmacist.
What is vertigo?
Vertigo is dizziness that has movement quality, such as the feeling that you’re spinning or the world is spinning around you. You may feel like you have to hold onto something to not fall down.
Dr. Fahey explains a common misconception is that dizziness is the same as vertigo. For example, lightheadedness is not vertigo because there is no side-to-side movement or sense of spinning.
“Vertigo is a miserable condition, it really is. It can cause nausea and vomiting, and it can certainly cause people to miss work,” says Dr. Fahey.
The cause of a person’s vertigo can vary greatly, from innocent causes such as an inner ear infection or migraine-related dizziness to more severe origins, such as a stroke in the back of the brain. Dr. Fahey notes a stroke would be accompanied by vomiting, double vision and sudden onset of vertigo.
What are the treatment options for vertigo?
The specific diagnosis dictates which of these treatment options is the best for each patient:
- Migraine-related vertigo typically responds to medications that can prevent migraines.
- Acute vertigo is best treated with nonspecific medication such as dimenhydrinate (Dramamine®) and meclizine (Bonine®). These medications are eventually weaned as they can prevent healing over the long-term, explains Dr. Fahey.
- Vertigo that only occurs within the first five minutes of standing is typically due to blood pressure dropping (orthostatic hypotension). There are medications that can be used in this situation including (Dramamine®) and meclizine (Bonine®). Patients can also wear thigh-high compression stockings or abdominal binders, or raise the head of the bed, increase salt intake and increase fluids.
- Intermittent vertigo provoked by movement of the head or neck typically responds to a special type of physical therapy called vestibular rehabilitation.
- Intermittent vertigo provoked by very specific movements such as lying down in bed or rolling over in bed may be Benign Paroxysmal Positional Vertigo – which typically responds very well to a specific sequence of movements known as the Epley maneuver. “These movements can be found online but I always think it best to have them performed by a professional.”
When to see a neurologist?
Frequency of your feelings of vertigo is perhaps the most important factor when considering if you need to see a doctor.
Is it intermittent? Is it persistent? Is it a single event or episodic?
“Someone who had an upper respiratory infection then is horribly dizzy a few days later – this vertigo is being caused by a virus affecting the inner ear. Bottom line is it will go away on its own,” explains Dr. Fahey.
Conversely, a person who has had dizziness two to three times a month, lasting multiple hours each time, is experiencing vertigo that should be evaluated by a doctor.
“An important point is that vertigo is not a diagnosis but the medical term for dizziness with the quality of movement such as spinning. Arriving at a specific diagnosis and treating the cause are optimal. Many causes of vertigo are innocent. However, from time to time vertigo is a symptom of a serious disorder,” Dr. Fahey says.
Schedule directly with a neurologist
Ohio State now offers direct online scheduling with our neurologists to address conditions such as vertigo without needing a referral from your primary care doctor.
Dr. Fahey says the advantage of going straight to a neurologist is seeing a doctor who has more experience with neurological issues and is focused on the latest research and treatments in the field.
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