A Mayo Clinic expert explains the differences between the two conditions, while tiny crystals in the inner ear may be responsible for episodes of vertigo.
Some people may suddenly feel as though the room is spinning around them, or that they are moving despite standing still. Others describe a sensation of lightheadedness or feeling as though they are about to lose their balance and fall. Although these symptoms may seem similar, there is a medical distinction between vertigo and dizziness in terms of the nature of the sensation, its underlying causes, and available treatment options.
Neil Shepard, an audiologist with a doctoral degree at Mayo Clinic in Minnesota, USA, explains that vertigo is an illusion of movement. A person may feel that they are spinning or moving, or that the surrounding objects are spinning or moving, even though no actual movement is taking place.
Dizziness, on the other hand, is usually associated with lightheadedness, unsteadiness, or loss of balance, without the sensation that the person or the objects around them are moving. These symptoms may make it difficult to stand or walk steadily.
Inner Ear Crystals: A Common Cause of Vertigo
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo, particularly among adults. It occurs when tiny crystals in the inner ear become dislodged from their normal positions and move into other areas, making a person more sensitive to changes in head position and movement.
This condition causes brief episodes of vertigo when performing certain movements, such as getting out of bed, moving into a sitting position, tilting the head, or lying down. Symptoms may occur suddenly and can be alarming, especially for people experiencing them for the first time.
Shepard points out that these crystals normally help the body sense gravity and maintain balance. They remain in place thanks to a gelatinous membrane inside the ear. However, they may become displaced following an ear injury, such as a blow to the head. In some cases, particularly among older adults, no clear cause for their displacement can be identified.
How Is Vertigo Diagnosed?
The diagnosis of benign paroxysmal positional vertigo relies on a test known as the Dix-Hallpike test. During this test, the doctor places the patient in specific head and body positions to trigger symptoms and then observes their eye movements. The appearance of a characteristic pattern of involuntary eye movements associated with vertigo helps confirm the diagnosis.
If the test results are inconclusive, while the patient’s medical history suggests recurring episodes of vertigo, the doctor may recommend additional tests to assess eye movements and the patient’s ability to maintain balance. Further evaluations or referral to a specialized physical therapist may also be necessary.
Simple Maneuvers May Stop Vertigo Episodes
Unlike some other disorders affecting the inner ear, benign paroxysmal positional vertigo can often be treated through a series of specific head and body movements performed by a doctor to guide the displaced crystals back to their normal positions within the ear.
These maneuvers successfully relieve vertigo in many patients, and symptoms may disappear after a single treatment session. However, the condition may recur in approximately 50% of patients who initially respond to treatment within one year, making medical follow-up important if symptoms return.
Depending on the patient’s condition and diagnosis, the doctor may teach them how to perform these crystal-repositioning maneuvers at home. However, cases that do not respond to initial treatment may require follow-up sessions and further evaluation.
Other Causes of Vertigo
Vertigo is not caused solely by displaced crystals in the inner ear. It may also result from vestibular neuritis or labyrinthitis, two conditions associated with inflammation affecting the inner ear and often caused by an infection.
Ménière’s disease is another, less common disorder that may cause vertigo. It affects the inner ear, and its exact cause is not yet fully understood.
Treating these disorders may be more complex than treating benign paroxysmal positional vertigo. Nevertheless, symptoms can often be managed through appropriate treatment, helping patients maintain their daily activities.
The Mayo Clinic expert and the International Health Organization emphasize the importance of distinguishing between vertigo and dizziness and recommend seeking medical attention promptly after experiencing an episode of vertigo, even if the condition is not an emergency in itself. This helps identify the underlying cause and determine the appropriate treatment, particularly since recurring symptoms or those affecting mobility and balance warrant specialized medical evaluation.
