Why is the Room Spinning? Understanding Vertigo and Balance Disorders
By Dr. Ritwiz Bihari
Feeling dizzy or like the world is spinning around you? Learn the difference between dizziness and vertigo, common causes like BPPV, and when to see a neurologist. We have all felt a little unsteady or "lightheaded" at some point. But Vertigo is different. It is the distinct, often scary sensation that you—or the world around you—are spinning, rocking, or tilting when you are actually standing still.
We have all felt a little unsteady or "lightheaded" at some point. But Vertigo is different. It is the distinct, often scary sensation that you—or the world around you—are spinning, rocking, or tilting when you are actually standing still.
Dizziness vs. Vertigo: What is the difference?
Patients often use the word "dizzy" to describe many feelings. To a neurologist, the distinction is important:
- Lightheadedness: Feeling like you might faint (often due to blood pressure or dehydration).
- Vertigo: An illusion of movement. You feel like you are on a spinning ride. This usually points to a problem in the inner ear or the brain.
Common Causes of Vertigo
Most cases of vertigo are treatable and not life-threatening. Common causes include:
- BPPV (Benign Paroxysmal Positional Vertigo): This is the most common cause. It happens when tiny calcium crystals in your inner ear get dislodged. You might feel a violent spin when you turn over in bed or look up.
- Vestibular Migraine: A type of migraine where dizziness is the main symptom, sometimes even without a headache.
- Meniere's Disease: A condition involving fluid buildup in the ear, causing hearing loss, ringing (tinnitus), and vertigo.
- Labyrinthitis: An infection of the inner ear nerve.
When is Vertigo an Emergency?
[Image of brain showing vestibular system]While ear problems are the most common cause, vertigo can sometimes be a sign of a stroke or a brain issue. Seek immediate medical help if vertigo is accompanied by:
- Sudden, severe headache ("Thunderclap" headache)
- Double vision or trouble seeing
- Weakness or numbness in an arm or leg
- Slurred speech
- Difficulty walking or falling repeatedly
How is it Treated?
The treatment depends entirely on the cause. For BPPV, a simple physical maneuver called the Epley Maneuver can often cure it in one session by moving the crystals back into place. For other conditions, medication to suppress dizziness or treat the underlying migraine may be prescribed.
If you suffer from recurrent dizziness, do not ignore it. A proper neurological evaluation can identify the root cause and restore your balance.
Dr. Ritwiz Bihari
Head and Chairperson, Neurology
Chandan Hospital, Lucknow