What are some of the causes of vertigo?

Vertigo can be caused by a brain problem, or a problem with the balance apparatus of the inner ear called the vestibular system. Determining the cause of vertigo may require a suite of clinical tests carried out in the doctors office, brain imaging and by the use of vestibular technology carried out by a specialist physiotherapist or physician. These tests primarily involve studying abnormal eye movements during provoking head or body movements.

Some of the inner ear issues that need to be considered include Benign Positional Paroxysmal Vertigo (BPPV) and vestibular neuronitis. BPPV is a condition that is caused by within the balance detectors within the ear called semicircular canals. Balance and head movement is detected by fluid flow within these canals. In BPPV, calcium crystals on the walls of the canal may dislodge causing abnormal fluid movement and hence triggering vertigo. Patients often experience short lived bouts of vertigo with head movement, often improving with rest. Your neurologist and physiotherapist can help with repositioning techniques to move the dislodged crystals into position.

Vestibular neuronitis is a transient inflammatory condition of the nerves that transmit information from the vestibular system to the brain. Sufferers may develop an episode of unremitting vertigo for a few days that tends to improve over a few days to weeks. If the cochlear nerve is involved, hearing loss to the affected ear can occur and it is termed labyrinthitis.

Vestibular neuronitis typically resolves completely after 6 weeks, but in 15% of patients long standing vertigo can remain to various degrees, making ongoing vestibular physiotherapy essential.