Vertigo is a sensation of motion or spinning that is often described as dizziness.

Vertigo is not the same as light-headedness. People with vertigo feel as though they are actually spinning or moving, or that the world is spinning around them.

There are two types of vertigo:

• Peripheral vertigo occurs if there is a problem with the part of the inner ear that controls balance (vestibular labyrinth or semicircular canals) or with the vestibular nerve, which connects the inner ear to the brainstem.
• Central vertigo occurs if there is a problem in the brain, particularly in the brainstem or the back part of the brain (cerebellum).

Vertigo related to the inner ear may be caused by:

• Benign positional vertigo (also called benign paroxysmal positional vertigo)
• Drugs called aminoglycoside antibiotics
• Injury (such as head injury)
• Labyrinthitis
• Ménière's disease

Vertigo related to the vestibular nerve may be caused by:

• Inflammation (neuronitis)
• Nerve compression (usually a noncancerous tumor such as a meningioma or schwannoma)

Vertigo related to the brainstem may be caused by:

• Blood vessel disease
• Drugs (anticonvulsants, aspirin, alcohol)
• Migraine
• Multiple sclerosis
• Seizures (rarely)

The primary symptom is a sensation that you or the room is moving or spinning. With central vertigo, there are usually other symptoms from the condition causing the vertigo. Symptoms can include:

• Difficulty swallowing
• Double vision
• Eye movement problems
• Facial paralysis
• Slurred speech
• Weakness of the limbs

The spinning sensation may cause nausea and vomiting in some people.

A physical exam may reveal:

• Eye movement problems, involuntary eye movements (nystagmus)
• Lack of coordination and balance, difficulty walking
• Hearing loss
• Weakness

Tests to determine the cause of vertigo may include:

• Blood tests
• Brainstem auditory evoked potential studies
• Caloric stimulation
• EEG
• Electronystagmography
• Head CT
• Lumbar puncture
• MRI scan of head and MRA scan of blood vessels of the brain