Vertigo is a symptom and not a condition in itself. In most cases there is a medical condition that causes vertigo. However, sometimes the cause is unknown. The most common cause of vertigo is a problem with the inner part of the ear - for example, an infection or inflammation. When we move our head, the inner part of the ear tells us where our head is.
It does this by sending signals to the brain and this helps us to keep our balance. If there are problems with the inner part of the ear then this causes us to feel sick nausea and dizzy. A common cause of vertigo in older people is benign paroxysmal positional vertigo. This causes intense dizziness short episodes of vertigo when you move your head in certain directions. It it thought to be caused by tiny fragments of debris in the inner ear.
Less commonly, vertigo may be caused by conditions that make changes to certain parts of the brain - for example:. The treatment of vertigo depends on what has caused it. For example, if you have an ear infection your doctor may prescribe an antibiotic.
For other causes of vertigo your doctor may give you special exercises to do. The rest of this leaflet only discusses medicines that help to ease the symptoms of dizziness and nausea caused by vertigo. Note : vertigo is sometimes referred to as a 'fear of heights' - this is not correct. The right term for the fear of heights is acrophobia. A number of medicines can be prescribed to help with the symptoms of vertigo. They include prochlorperazine or antihistamines such as cinnarizine , cyclizine or promethazine.
These medicines are the same ones that are used to help treat any feeling of sickness nausea and motion sickness. They work by blocking certain chemicals in the brain. Prochlorperazine blocks a chemical called dopamine; this helps with severe sickness. Antihistamines block histamine, which helps with mild sickness and being sick vomiting as well as vertigo. It is thought that this medicine improves the blood flow around the ear. These medicines come in various brand names and are available as tablets, capsules, liquids and injections.
Some are available as tablets that dissolve between the upper gum and lip sublingual tablets. Give yourself a check-up with a general blood profile, now available in Patient Access. There are no good studies that tell us how well these medicines work. However, they have been prescribed to treat vertigo for many years. The choice of medicine depends on what is causing your vertigo and how severe your symptoms are.
If you have a severe feeling of sickness nausea , your doctor may prescribe prochlorperazine. The advantage of this medicine is that it is available as an injection or as a tablet to dissolve between the upper gum and lip a sublingual tablet. It may be more suitable for people who are very sick and being sick vomiting. Like prochlorperazine, antihistamines can also make you feel sleepy. Headaches and an upset stomach are also possible side effects.
Check the patient information leaflet that comes with your medicine for the full list of possible side effects. A medication called betahistine works in a similar way to antihistamines. It may have to be taken for a long period of time. The beneficial effects vary from person to person. Vertigo could also affect your ability to drive. You should avoid driving if you've recently had episodes of vertigo and there's a chance you may have another episode while you're driving.
Visit the GOV. UK website for more information on driving with a disability. Home Illnesses and conditions Ears, nose and throat Vertigo. Vertigo See all parts of this guide Hide guide parts 1. About vertigo 2. Causes of vertigo 3. Diagnosing vertigo 4. Treating vertigo. About vertigo Vertigo is a symptom, rather than a condition itself.
Other symptoms associated with vertigo may include: loss of balance — which can make it difficult to stand or walk feeling sick or being sick dizziness Seeking medical help You should see your GP if you have persistent signs of vertigo or it keeps coming back. Read more about diagnosing vertigo What causes vertigo?
Causes of vertigo may include: benign paroxysmal positional vertigo BPPV — where certain head movements trigger vertigo migraines — severe headaches labyrinthitis — an inner ear infection vestibular neuronitis — inflammation of the vestibular nerve, which runs into the inner ear and sends messages to the brain that help to control balance Depending on the condition causing vertigo, you may experience additional symptoms, such as a high temperature, ringing in your ears tinnitus and hearing loss.
Read more about the causes of vertigo How is vertigo treated? Read more about treating vertigo Self care Depending on what's causing your vertigo, there may be things you can do yourself to help relieve your symptoms.
Your GP or the specialist treating you may advise you to: do simple exercises to correct your symptoms sleep with your head slightly raised on two or more pillows get up slowly when getting out of bed and sit on the edge of the bed for a minute or so before standing avoid bending down to pick up items avoid extending your neck — for example, while reaching up to a high shelf move your head carefully and slowly during daily activities do exercises that trigger your vertigo, so your brain gets used to it and reduces the symptoms do these only after making sure you won't fall, and have support if needed Fear of heights The term vertigo is often incorrectly used to describe a fear of heights.
Causes of vertigo Vertigo is a symptom of several different conditions. Peripheral vertigo Peripheral vertigo is the most common type, often caused by a problem with the balance mechanisms of the inner ear.
Lightheadedness and a loss of balance can last for several minutes or hours after the attack. 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 Head injury Vertigo can sometimes develop after a head injury. Read more about severe head injuries and minor head injuries Labyrinthitis Labyrinthitis is an inner ear infection that causes a structure deep inside your ear the labyrinth to become inflamed.
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. It usually lasts a few hours or days, but it may take three to six weeks to settle completely. Medication Vertigo may occur as a side effect of some types of medication.
Central vertigo Central vertigo is caused by problems in part of your brain, such as the cerebellum located at the bottom of the brain or the brainstem the lower part of the brain that's connected to the spinal cord. Causes of central vertigo include: migraines — a severe headache that's usually felt as a throbbing pain at the front or on one side of your head, which is especially common in younger people 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 to control hearing and balance a brain tumour in the cerebellum, located at the bottom of the brain a transient ischaemic attack TIA or a stroke — where part of the blood supply to the brain is cut off taking certain types of medication.
Diagnosing vertigo Your GP will ask about your symptoms and carry out some simple tests to help them make an accurate diagnosis. In some cases, you may be referred for some further tests. Important questions Your GP will first want to know: details of the first episode of your symptoms and what they were — for example, whether you felt lightheaded or if your surroundings were spinning if you also experience other symptoms — such as hearing loss, tinnitus, nausea, vomiting or fullness in the ear how often your symptoms occur and how long they last for if your symptoms are affecting your daily activities — for example, whether you're unable to walk during an episode of vertigo whether anything triggers your symptoms or makes them worse, such as moving your head in a particular direction what makes your symptoms better Physical examination Your GP may also carry out a physical examination to check for signs of conditions that may be causing your vertigo.
Further tests Depending on your symptoms, your GP may refer you to a hospital or specialist for further tests. Hearing tests If you have tinnitus ringing in your ears or hearing loss, your GP may refer you to an ear, nose and throat ENT specialist, who can carry out some hearing tests. These may include: an audiometry test — a machine called an audiometer produces sounds of different volume and pitch. You listen to the sounds through headphones and signal when you hear a sound, either by raising your hand or pressing a button.
The tester will tap the tuning fork before holding it at each side of your head. Read more about how hearing tests are carried out. Videonystagmography Videonystagmography VNG is sometimes used to check for signs of nystagmus in more detail.
Caloric testing A caloric test involves running warm or cool water or air into your ear for about 30 seconds. Posturography A machine to test your balance may be used to give valuable information about how you are using your vision, proprioception sensations from your feet and joints and the input from your ear to maintain balance.
Scans In some cases, a scan of your head may be used to look for the cause of your vertigo, such as an acoustic neuroma a non-cancerous brain tumour. Treating vertigo Treatment for vertigo depends on the cause and severity of your symptoms. Read more about what to do if you're struggling with stress Labyrinthitis Labyrinthitis is an inner ear infection that causes the labyrinth a delicate structure deep inside your ear to become inflamed. See treating labyrinthitis for more information Vestibular neuronitis Vestibular neuronitis, also known as vestibular neuritis, is inflammation of the vestibular nerve one of the nerves in your ear that's used for balance.
You may find your balance is particularly affected if you: drink alcohol are tired have another illness Avoiding these can help to improve your condition. Vestibular neuronitis can also be treated with vestibular rehabilitation and medication. Benign paroxysmal positional vertigo BPPV Like vestibular neuronitis, benign paroxysmal positional vertigo BPPV often clears up without treatment after several weeks or months.
Until the symptoms disappear or the condition is treated, you should: get out of bed slowly avoid activities that involve looking upwards, such as painting and decorating or looking for something on a high shelf BPPV can be treated using a procedure called the Epley manoeuvre.
The Epley manoeuvre The Epley manoeuvre involves performing four separate head movements to move the fragments that cause vertigo to a place where they no longer cause symptoms. Brandt-Daroff exercises If the Epley manoeuvre doesn't work, or if it's not suitable — for example, because you have neck or back problems — you can also try Brandt-Daroff exercises.
Referral to a specialist Your GP may refer you to a specialist, such as an ear, nose and throat ENT specialist if: the Epley manoeuvre doesn't work or can't be performed you still have symptoms after four weeks you have unusual signs or symptoms In rare cases, where the symptoms of vertigo last for months or years, surgery may be recommended. Treating your migraine should relieve your vertigo if it's caused by a migraine.
Vestibular rehabilitation Vestibular rehabilitation, also called vestibular rehabilitation training or VRT, is a form of "brain retraining". The two medicines that are usually prescribed are: prochlorperazine antihistamines If these medicines are successful in treating your symptoms, you may be given a supply to keep at home, so you can take them the next time you have an episode of vertigo.
Prochlorperazine Prochlorperazine can help relieve severe nausea and vomiting associated with vertigo. Antihistamines Antihistamines can be used to help relieve less severe nausea, vomiting and vertigo symptoms. Possible antihistamines that may be prescribed include: cinnarizine cyclizine promethazine teoclate Like prochlorperazine, antihistamines can also make you feel sleepy. Safety If you have vertigo, there are some safety issues to consider. For example: you should inform your employer if your job involves operating machinery or climbing ladders you may be at increased risk of falls — see preventing falls for advice on making your home safer and reducing your risk Vertigo could also affect your ability to drive.
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Last updated:. How can we improve this page? Email Address e. It is effective in acute episodes of vertigo. It also suppresses the vomiting centre in the central nervous system. However, it should not be prescribed for long durations as it may lead to drug — induced Parkinsonism. Cinnarizine is also useful in prevention of motion sickness. Dimenhydrinate is an antihistamine which is available over the counter.
It is an effective medicine to control nausea and vomiting which may be associated along with vertigo. It is used only during acute symptoms. Drug combinations having cinnarizine with dimenhydrinate are now available to control the dizziness along with the vomiting. Dimenhydrinate may cause dryness of mouth and drowsiness. Hence patients on this medication should avoid driving.
It should not be given to patients suffering from glaucoma or urinary problems. Meclizine is a medicine belonging to the anti-histaminic group. It is effective in reducing vertigo during acute phase. It is the only anti-vertigo medicine which is safe during pregnancy and lactation. It is also useful to treat motion sickness and sea sickness. Similar to other antihistamine drugs, meclizine also can cause drowsiness and dryness of mouth. Metaclopromide, promethazine and ondansterone are medicines given to control nausea and vomiting.
Patients should avoid taking anything by mouth for at least 30 minutes after taking these medicines to be more effective. Piracetam is a nootropic agent which is a derivative of the neurotransmitter gamma-amino butyric acid GABA.
It is said to improve the neuroplasticity and provide neuroprotective effects. It reduces the adhesion of red blood cells, prevents spasm of smaller blood vessels and improves microcirculation. It is also said to improve cognition.
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