Symptoms
A person's specific symptoms will indicate if the vertigo originates in the inner ear or brain, or if it is caused by another problem Table 02.
Hearing loss, ringing in the ear (tinnitus), nausea, and vomiting all indicate that an inner ear problem is causing vertigo. With Meniere's disease, for example, vertigo comes on suddenly, and is accompanied by tinnitus and hearing impairment. Bouts last for a few minutes to a few hours, and often include nausea and vomiting. Vertigo strikes suddenly in labyrinthitis as well, and gets progressively worse as the hours go by. Stomach upset is common, and the vertigo typically worsens with head movement. BPPV is triggered by changes in head position. For example, getting out of bed or bending over may trigger it.
Headaches, loss of coordination, slurred speech, impaired vision, and weakness in an arm or leg suggest that vertigo is brain–based.
Faintness or light–headedness might indicate a circulation problem. If circulation problems are the cause, the vertigo will worsen with standing, and will improve with reclining.
Confusion and panic — or a general "foggy" feeling — may indicate that the cause is psychiatric in nature.
Table 2. What Symptoms Reveal
Symptom Source Possible cause(s) Spinning Inner ear Infection, nerve inflammation, benign paroxysmal positional vertigo, Meniere's disease, motion sickness Faintness Cardiovascular system Transient disturbance in brain function caused by lack of blood flow and oxygen to the brain due to low blood pressure Confusion Psychiatric disorder Depression, anxiety disorders, psychosis Off balance Central nervous system Mini?stroke effecting the balance centers in the brain,head injury, multiple sclerosis, infection causing nerve compression, brain tumors 
Figure 01. The Inner Ear
Risk Factors
Although dizziness affects people of all ages, it tends to be most problematic for older adults. About 20% of sufferers over the age of 60 report that dizziness interferes with their daily lives. BPPV is a frequent complaint among the elderly, while labyrinthitis and motion sickness plague people in every age group.
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I'm Shereen A. Gharbia, PharmD. Welcome to PDR Health!
