Vertigo Isn’t a Diagnosis — It’s a Symptom
The condition has a dizzying number of causes
In the fall of 2017, Sara Morgan tried to get out of bed, and the whole room spun around her. “I collapsed and was totally unable to get up,” she says. “I freaked out and called an ambulance and had to be carried out on a stretcher.”
Morgan was experiencing an extreme bout of vertigo, a condition that nearly 40% of adults will have at some point in their lives at varying degrees of severity. It’s slightly more common in women than men and most prevalent in people over 50, but vertigo can happen at any age: Morgan was only 24.
For two weeks, Morgan, who lives in New York City, experienced constant whirling every time she moved her head or eyes. “I couldn’t drive, couldn’t look at a screen,” she says. “I couldn’t exercise and could barely work. The basic acts of taking care of myself, like going to the grocery store, were almost impossible. My mom and my roommate at the time would have to practically feed me. I couldn’t move my head to look down at a plate.”
It took about a month for Morgan’s symptoms to fade completely, during which time she saw a number of specialists who ran test after test. Eventually, doctors told her they believed a virus had affected her inner ear, causing her vertigo symptoms, and they expected it wouldn’t happen again.
What exactly is vertigo?
For most people, vertigo feels like a sudden spinning sensation, and the symptoms only last a few seconds or only happen when they move their heads or bodies a certain way.
“Vertigo is not a diagnosis; it is a symptom,” explains Sherrie Davis, director of audiology and the Dizziness and Balance Center at Penn Medicine. “It means experiencing a false sense of motion. For some, that could mean a true whirling or spinning sensation. For others, it could be rocking and sliding. It’s a sense of moving when one is not.”
It can be a symptom of a long list of diseases and conditions, including Parkinson’s disease, migraines, diabetes, and even pregnancy. There are both neurological causes and physiological ones. In rarer cases like Morgan’s, vertigo symptoms can be constant and prolonged.
What does it feel like?
“Movement causes the sensation of your body moving in space or the world moving around you in an unpredictable way,” Morgan says. “If I was sitting in a chair, it would feel like the chair was rocking back and forth or floating.”
Some people experience true spinning or whirling. Other people with vertigo describe a more lightheaded feeling. Davis says the feelings of vertigo vary widely, as do peoples’ definitions of “dizziness,” but in short, it can be described as a “false sense of motion.”
What causes it?
The list of possible causes is long, but vertigo is most commonly related to an inner ear issue. Each inner ear contains three tiny, fluid-filled tubes called semicircular canals that we rely on for balance and stability.
“The fluid moves when we move our bodies, which elicits an eye movement response called the vestibular-ocular reflex,” says Davis. “Our inner ears cause an eye movement that is equal or opposite to the head and body movement.”
The brain is calibrated to use information from both inner ears to maintain balance, and if something like a virus or disease affects one side, suddenly the brain only gets half the information. “The body thinks it’s moving, and it gives a person a false sense of motion,” says Davis.
One of the most common spin-inducing disorders is called benign paroxysmal positioning vertigo, or BPPV. There are more than 200,000 cases diagnosed each year. “Basically, these crystals fall from one part of the inner ear to another and lay in those canals like sludge,” Davis says. “Those crystals move and stimulate the inner ear to produce spinning or vertigo. It’s a common cause for dizziness, and it’s the absolute easiest thing to treat.”
“In 2019, I was at my desk and I stood up and my head spun all the way around — or at least it felt that way.”
How is vertigo treated?
For vertigo caused by BPPV, a specialist will perform what’s called a “particle repositioning maneuver.” It’s essentially a specific series of head movements that move the crystals in the inner ear. It’s not always a permanent fix — the vertigo symptoms of BPPV do recur fairly frequently — but it can be done over and over and only takes a couple of seconds.
Unfortunately, for vertigo with other root causes, the treatment isn’t always as simple. “If one [inner ear] is attacked by a virus or something, the brain and other side can learn to compensate,” Davis says. “Some people need help with that, and that’s done through a kind of physical therapy called vestibular rehab.”
Morgan’s doctors had told her the vertigo she experienced in 2017 was a one-time thing, but “in 2019,” she explains, “I was at my desk and I stood up and my head spun all the way around — or at least it felt that way — and I knew it was back.”
This time, Morgan says, her extreme symptoms took longer to dissipate, and she still hasn’t completely returned to normal. “Eventually, I was given a diagnosis of something called persistent postural perceptual dizziness,” she says. “It’s a neurological diagnosis. They think an original virus affected my inner ear, and when it healed, my brain didn’t properly readapt to the signals it processes about balance through sight and touch. They’ve given me some medication that’s supposed to help train my brain to readapt.”
Morgan has returned to work, and she’s now able to do most of the things she could do prior to the start of her symptoms. “I am so grateful for the functionality I do have,” she says. “If this is the best it gets, I’ll be fine.”
Physical therapy is often an important part of vertigo treatment, Davis says, especially for older people who are at risk of falling when they feel dizzy. “A specialist can help make people more reliant on visual cues and help them with exercises to strengthen certain reflexes.”
If you’re experiencing any symptoms of vertigo, even if they’re mild, Davis says it’s a good idea to mention it to your primary care doctor. “There’s such a plethora of causes, it’s really a good idea to have a medical professional weed through those.”
Sudden bouts of dizziness or instability can be disconcerting or even scary, but the good news is the sooner you see a professional, the sooner it’s likely to go away.