Vertigo - Causes of vertigo

Vertigo is a symptom of several different conditions.

It's most often caused by a problem with the balance mechanisms of the inner ear, although it can also be because of a problem within the brain or the nerves.

Some of the more common causes of vertigo are explained in more detail below.

Labyrinthitis

Labyrinthitis is an inner ear infection that causes a delicate structure deep inside your ear (the labyrinth) to become inflamed. The labyrinth is a maze of fluid-filled channels that control hearing and balance.

If the labyrinth becomes inflamed, the information it sends to your brain will be different from the information sent from your unaffected ear and your eyes. These conflicting signals can cause vertigo and dizziness.

Labyrinthitis is usually caused by a viral infection, such as the common cold or flu, which spreads to the labyrinth. Less commonly, it's caused by a bacterial infection.

Vertigo caused by labyrinthitis may be accompanied by nausea, vomiting, hearing loss, tinnitus and sometimes a high temperature and ear pain.

Vestibular neuronitis

Vestibular neuronitis, also known as vestibular neuritis, is an inner ear condition that causes inflammation of the nerve connecting the labyrinth to the brain. In some cases, the labyrinth itself can also be inflamed.

The condition is usually caused by a viral infection. It usually comes on suddenly and can cause other symptoms such as unsteadiness, nausea (feeling sick) and vomiting (being sick). You won't normally have any hearing problems.

It usually lasts a few hours or days, but it may take three to six weeks to settle completely.

Benign paroxysmal positional vertigo (BPPV)

This is one of the most common causes of vertigo. It is usually brought about and made worse by positional changes and head movements. BPPV involves short, intense, recurrent attacks of vertigo (usually lasting a seconds to a few minutes).

BPPV can occur when you make a sudden movement, such as turning your head, standing up or bending over, crossing the road, or turning in bed.

BPPV is often accompanied by nausea, although vomiting is rare. During the attack, you may also experience brief nystagmus (where your eyes move uncontrollably and you are unable to focus). Lightheadedness and a loss of balance can last for several minutes or hours after the attack.

You won't experience tinnitus (hearing noise that comes from inside the body) or hearing loss.

BPPV is thought to be caused by small fragments of debris (calcium carbonate crystals), which break off from the lining of the channels in your inner ear. The fragments don't usually cause a problem unless they get into one of the ear's fluid-filled canals.

When your head is still, the fragments sit at the bottom of the canal. However, certain head movements cause them to be swept along the fluid-filled canal, setting off abnormal fluid movements. This sends confusing messages to your brain, causing vertigo.

BPPV usually affects older people, with most cases occurring in people older than 50 years of age. However, it can sometimes affect younger people.

BPPV may occur for no apparent reason, or it may develop after:

• an ear infection
• ear surgery
• a head injury
• prolonged bed rest – for example, while recovering from an illness

Attacks of BPPV can clear up within a few days, but persistent BPPV may need a simple corrective manoeuvre that your GP or specialist can do.

Ménière's disease

Severe vertigo is sometimes caused by a rare condition that affects the inner ear called Ménière's disease. This can cause vertigo as well as hearing loss, tinnitus and aural fullness (a feeling of pressure in your ear).

If you have Ménière's disease, you may experience sudden attacks of vertigo that last for hours or days. The attacks often cause nausea and vomiting.

The cause is unknown, but symptoms can be controlled by diet and medication. Rarely, you may need further treatment in the form of surgery. 

Migraines

A migraine is a severe headache that's usually felt as a throbbing pain at the front or on one side of your head. Some people also experience other symptoms, such as nausea and sensitivity to light (photophobia).

It's thought that migraines may be one of the most common causes of vertigo and are especially common in younger people. Avoiding migraine triggers and controlling the migraine usually relieves the vertigo.

Head injury

Vertigo can sometimes develop after a head injury. If you have symptoms following a head injury, such as dizziness or vertigo, you should visit your GP as soon as possible. Alternatively, go to your nearest hospital's accident and emergency (A&E) department.

Read more about severe head injury and minor head injury.

Other causes

Other less common causes of vertigo include:

• medication – vertigo may also occur as a side effect of some types of medication: check the patient information leaflet that comes with your medicine to see if vertigo is listed as a possible side effect
• multiple sclerosis – a condition that affects the central nervous system (the brain and spinal cord)
• acoustic neuroma – a rare, non-cancerous (benign) brain tumour that grows on the acoustic nerve, which is the nerve that helps control hearing and balance
• a brain tumour in the cerebellum, located at the bottom of the brain