What are the four types of vertigo?

Dr.Madhukar Bhardwaj, 3 mins read

Vertigo is a false sensation that feels like the environment around you is spinning in circles. It can make you feel dizzy and off-balanced. The problem is often associated with inner ear problems or neurological disorders.

Many people complain of other symptoms as well like nausea and vomiting. Vertigo is primarily categorised into two types: peripheral vertigo and central vertigo. Each type has distinct causes and symptoms. Here, we have covered everything you should know about them.

Peripheral Vertigo:

Peripheral vertigo is the most common type. It originates from problems in the inner ear, specifically the vestibular nerve, a sensory nerve responsible for balance and equilibrium.

Peripheral vertigo has four subtypes:

1. Benign Paroxysmal Positional Vertigo (BPPV)

It causes brief, repeated vertigo when you move your head. Though it is usually not a sign of a serious problem and resolves within a few weeks, it can cause you to fall, which may lead to injuries. If it doesn’t resolve within six weeks, a simple procedure with a neurologist can ease your symptoms. Patients above 65 years of age should be cautious about this type as its symptoms can be frightening for them.

Symptoms: Brief, intense spinning sensation triggered by specific head movements like sitting up in bed or tipping head backwards. You may also experience lightheadedness, balance problems, nausea, vomiting, and vision problems.

Causes: It happens when small calcium particles (otoconia) become dislodged from the utricle (a sensory organ) and move into the fluid-filled spaces of the inner ear. Head injury, degeneration of the vestibular system and inner ear disorder can also cause BPPV.

Treatment: Epley manoeuvre and vestibular rehabilitation therapy (VRT).

2. Labyrinthitis:

It is an inner ear infection wherein the labyrinth (the innermost of the ear responsible for hearing and sense of balance) gets inflamed. Labyrinthitis is usually not dangerous but it can cause persistent vertigo. If left untreated, it can cause permanent hearing loss and long-term balance problems. Though anyone can get it, people aged between 30 and 60 years are more prone.

Symptoms: Vertigo, balance issues, hearing loss, blurred vision, tinnitus (ringing in ears), difficulty concentrating, nausea, vomiting, dizziness, and involuntary eye movements.

Causes: Inner ear infection, usually viral. However, bacterial infection can also cause it. Some common causes of labyrinthitis include Epstein-Barr virus, herpes simplex, stomach flu, and upper respiratory infections. Rarely, head injuries can also cause it.

Treatment: Medicines, physical therapy, warm compression over the ear, gargling with warm salt water, and sometimes surgery.

3. Vestibular Neuritis:

This type inflames the vestibulocochlear nerve of the inner ear, which affects how your brain reads information like balancing and head positioning. It can affect anyone. However, it is less common among children. People with this type of vertigo experience balancing problems, dizziness and other symptoms.

Symptoms: Sudden, severe vertigo, nausea, vomiting, intense dizziness, lightheadedness, balance problems, difficulty concentrating, involuntary eye movements, severe motion sensitivity, fullness in ears and anxiety.

Causes: Viral infection.

Treatment: Medicines and vestibular neuritis exercises.

4. Ménière’s Disease:

Ménière’s disease is a rare chronic inner ear disorder that can cause a range of symptoms. It can affect one or both ears, and its symptoms can come on suddenly or after a period of tinnitus or muffled hearing. Its episodes can last from a few minutes to an entire day. If the symptoms are not managed properly, Ménière’s disease can cause permanent hearing loss and balance issues.

Symptoms: Recurring vertigo, trouble hearing/hearing loss, tinnitus, ear pressure/fullness.

Causes: Excessive buildup of fluid in the inner ear called endolymph is believed to be the primary cause of Ménière’s disease. Some possible causes of too much endolymph are allergies, an infection, a head injury and migraine headaches.

Treatment: Medications, dietary changes, lifestyle changes, therapies and sometimes surgery.

Central Vertigo:

Central vertigo is less common and stems from issues in the brain or central nervous system. People with this condition usually have more severe symptoms like walking and stability problems.

Symptoms: Prolonged vertigo episodes, difficulty swallowing, eye movement problems, slurred speech, weakness of the limbs, facial paralysis and double vision.

Causes: Blood vessel disease, certain drugs, multiple sclerosis, stroke, tumours, vestibular migraine, a type of migraine headache and rarely seizures.

Treatment: Medications, physical therapy, lifestyle modifications, stress management and sometimes surgery.

If you're experiencing vertigo symptoms, consult a healthcare professional for personalised guidance and treatment.