vertigo
Meaning of vertigo: Not the same thing as dizziness or faintness, and the distinction narrows the list of possible causes faster than any test.
Definition of vertigo
Vertigo is a false sense of movement, most often that the room is spinning or that the body is turning while it is still. It arises when the balance organs of the inner ear, the nerve carrying their signals, or the parts of the brain reading them send conflicting information. Nausea, vomiting, unsteadiness and rhythmic flicking of the eyes commonly come with it.
How is it different from dizziness?
Dizziness is an umbrella word covering at least four separate sensations, and telling them apart narrows the possible causes quickly. Feeling faint or close to blacking out points toward the circulation. Feeling unsteady on the feet points toward the legs, the joints and the nerves supplying them. A vague woolly-headedness often accompanies low mood or a medicine. Vertigo differs from all three because it is a positive illusion of movement, a sense that the room is turning or that the body is rotating, and it is usually accompanied by the eyes flicking rhythmically in one direction, a sign called nystagmus.
What causes it?
The balance organs sit in the inner ear right beside the hearing organ, which is why so many causes of vertigo also disturb hearing and produce ringing described as tinnitus. The nerve carrying their signals runs into the brainstem, and the cerebellum behind it compares those signals against what the eyes and joints report. Trouble anywhere along that chain produces the same sensation, so the pattern of the attacks does most of the sorting.
| Cause | Pattern |
|---|---|
| Benign positional vertigo | Seconds of spinning triggered by rolling over or looking up |
| Vestibular neuritis | Days of constant spinning after a viral illness, hearing unaffected |
| Labyrinthitis | The same picture, with hearing loss added |
| Meniere disease | Attacks lasting hours with ringing, ear fullness and changing hearing |
| Stroke in the back of the brain | Sudden onset with double vision, slurred speech or inability to stand |
How are inner ear and brain causes told apart?
An attack beginning in the inner ear and a stroke at the back of the brain can look identical in the first hours, and that overlap is why sudden vertigo is taken seriously rather than dismissed. Double vision, slurred speech, numbness, weakness, a severe new headache or an inability to stand and walk unaided all point away from the ear. Vertigo appearing in a young adult with other neurological symptoms can instead reflect multiple sclerosis, where a patch of damage sits on the balance pathways. Medicines that damp the sensation, including antihistamine preparations, relieve the spinning and the sickness without touching the cause, and prolonged use slows the brain's own reweighting of the signals reaching it.
Used in a sentence
Vertigo lasting less than a minute was provoked by turning over in bed.
Good to know
Vertigo arising in the inner ear and vertigo caused by a stroke at the back of the brain can present identically at onset, and accompanying double vision, slurred speech, weakness, numbness or an inability to stand distinguishes the second, which is time-critical.
Word origin
Where “vertigo” comes from
Vertigo is the Latin word for a whirling or spinning, from vertere, meaning to turn.