Vertigo: the most common causes, according to an ENT

“Vertigo is an illusion of movement of the surroundings (walls, ceiling, objects, etc.) or a sensation of movement of oneself in space”, can we read on the website of health insurance. Dizziness is often a symptom of an illness or health problem. We must therefore understand its cause in order to be able to remedy it.

“If your dizziness only lasts a few seconds, you probably have BPPV”

Dizziness is caused by a balance disorder. In the body, balance is ensured by the vestibular system, a part of the inner ear which has semicircular canals. These canals are filled with a liquid in which float some sort of microscopic pebbles or small crystals called otoliths. These always remain horizontal and therefore adapt to the position of the body.

Movement information from the inner ear is transmitted by the vestibular nerve to the nerve centers of the brain. Armed with this information, the brain commands the body to take the necessary actions to maintain balance.

An abnormal deposition of otoliths in one of the semicircular canals can be the cause of benign paroxysmal positional vertigo (BPPV). So, when there is a movement such as a change in position, the otoliths malfunction and the brain interprets this as a sudden rotation of the head. People who suffer from it have no symptoms other than dizziness.

“If your dizziness lasts only a few seconds and happens when you turn your head or turn over in bed, you probably have BPPV. explains Dr. Mina Le, an otolaryngologist and head and neck surgeon at Mountainside Medical Group in New Jersey, United States, in this article. A doctor can confirm this diagnosis with a Dix-Hallpike test.“The treatment consists of replacing the otoliths in the inner ear through the Epley maneuver.

Ménière’s disease can also cause dizziness

Another possible cause of dizziness: Ménière’s disease, which is defined by the MSD Manual as an inner ear disorder that causes dizziness, nausea, fluctuating sensorineural hearing loss, and tinnitus. It is caused by an imbalance in the pressure of fluids contained in the inner ear.

Vertigo attacks last from 20 minutes to 12 hours and, more rarely, up to 24 hours. “Treatment begins with a low-salt diet, reduced caffeine intake, and diuretic pills to decompress the inner ear.“, says Dr. Mina Le. The goal is to reduce fluid pressure in the inner ear. But, according to Dr. Vidalthe progressive loss of hearing persists in the affected ear in the majority of cases.

Other possible causes of dizziness

Vestibular neuritis is another possible cause of dizziness. It is an inflammatory damage to the vestibular nerve, generally of viral origin. The affected person has attacks of vertigo so severe that he or she often has to lie down. Dr. Mina Le indicates that this dizziness “cause nausea and vomiting, (vestibular neuritis) improves within a few days and disappears within a few weeks.“

Health Insurance describes other possible causes:

• Damage to the inner ear which may be due to head trauma affecting the area behind the ear, chronic otitis, taking certain medications that are toxic to the ear or even lead poisoning , mercury or carbon monoxide.
• Damage to the auditory nerve, which is often associated with tinnitus and unilateral deafness.
• A disease of the brainstem or cerebellum.

If your dizziness is not due to any of these causes, it could come from a vestibular migraine. “The first step is to identify and eliminate common migraine factors such as stress, lack of sleep, overload and dietary elements such as monosodium glutamate (MSG), preservatives, alcohol and caffeine”, assures Dr. Mina Le.

In any case, if the dizziness persists, the ideal is to consult your general practitioner to make the correct diagnosis and begin appropriate treatment.