Vertigo
Vertigo is the feeling that you or the world around you is spinning when there is no actual movement. It is not a fear of heights but a genuine disturbance of balance, most commonly traced to the inner ear. Episodes can last seconds or persist for hours, and are often accompanied by nausea, vomiting, and difficulty walking steadily.
Key points
- Displaced calcium crystals within the inner ear, a condition called BPPV, are the most common trigger of spinning episodes.
- Meniere’s disease along with inflammation of the vestibular nerve or the inner ear are other common causes of spinning episodes.
- Betahistine helps regulate inner-ear fluid to reduce how often and how severely Meniere’s-related attacks occur.
- Prochlorperazine targets the nausea and vomiting that often accompany an acute spinning episode.
What triggers it
The commonest cause is benign paroxysmal positional vertigo (BPPV), where tiny calcium crystals in the inner ear shift out of place. Meniere’s disease, vestibular neuritis, and labyrinthitis are other frequent culprits. Inner-ear infections following upper respiratory illness are a notable trigger, partly because high humidity favours the viral and bacterial conditions that precede them.
Managing spinning episodes
Treatment targets both the underlying balance disorder and the accompanying nausea. Betahistine works on the histamine receptors of the inner ear to improve fluid regulation and reduce the frequency and severity of attacks, making it the mainstay for Meniere’s disease. For acute episodes with significant nausea, prochlorperazine helps suppress the vomiting reflex and eases the sense of spinning. Both sit within the broader neurology range.
Seek medical attention promptly if vertigo comes on suddenly with headache, double vision, difficulty speaking, or weakness on one side, as these may indicate a more serious cause requiring urgent assessment.