Vertigo

1. Balance Disorders Slideshow
2. Take the Vertigo Quiz
3. Tinnitus Slideshow: Why Are My Ears Ringing?

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Balance is defined as a state of equilibrium. It takes significant amount of work for this to occur in the body. The brain uses inputs from many sources to understand where the body is located in relationship to the world and to allow it to function. Sensory information from the eyes, ears, and position receptors in the rest of the body help keep the body upright and allow it to move in a coordinated fashion.

Information comes to cerebellar lobes located in the base of the brain from the vestibular system in the inner ear, vision from the eyes, and proprioception (position) receptors located throughout the body that send signals through the spinal cord. The cerebellum uses that information to maintain posture, coordinate body motions like walking and also coordinate fine motor skills like using a pen to write.

Vertigo, a feeling of spinning movement and sometimes accompanied by nausea and vomiting, occurs when any part of the system breaks down. However, people tend not to use that word to describe their symptoms but instead use the word dizziness or lightheadedness. It is up to the health care practitioner to understand the person's symptoms and define vertigo as the cause of the their situation.

Dizziness is a difficult word to understand and needs to be divided into two categories, either lightheadedness or vertigo. Lightheadedness is the feeling that a person might faint while vertigo is most often described as a spinning sensation with loss of balance. The direction of care is markedly different since lightheadedness may suggest to the health care practitioner to investigate decreased oxygen or nutrient supply to the brain due a variety of causes including heart rhythm disturbances or dehydration, while vertigo sends the health care practitioner looking for a neurologic or inner ear cause.

The most important initial step in helping a person with vertigo is to take a history and understand that the person is complaining of spinning symptoms that may be associated with nausea and vomiting and loss of balance among other symptoms.