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==Overview==
==Overview==
Vertigo caused by problems with the inner ear or vestibular system, which is composed of the semicircular canals, the otolith (utricle andsaccule), and the vestibular nerve is called "peripheral", "otologic" or "vestibular" vertigo. The most common cause is benign paroxysmal positional vertigo (BPPV), which accounts for 32% of all peripheral vertigo. Other causes include Ménière's disease (12%),superior canal dehiscence syndrome, labyrinthitis and visual vertigo. Any cause of inflammation such as common cold, influenza, and bacterial infections may cause transient vertigo if it involves the inner ear, as may chemical insults (e.g., aminoglycosides) or physical trauma (e.g., skull fractures). Motion sickness is sometimes classified as a cause of peripheral vertigo.
Common causes of vertigo may include [[Ménière’s disease]], [[benign paroxysmal positional vertigo]], [[labyrinthitis]], [[vestibular neuritis]]. Less common causes of vertigo may include [[mood disorder]], [[anxiety]], and [[migraine]]. Life-threatening causes include [[brainstem]] [[ischemia]]/[[hemorrhage]], [[hypertension]] [[crisis]], [[drug]] [[overdose]], [[cyanide]] [[poisoning]].


==Causes==
==Causes==


===Common Causes===
===Common Causes===
*[[Alcohol]]
*[[Aminoglycosides]]
*[[Bacterial infection]]
*[[Benign paroxysmal positional vertigo]]
*[[Cerebrovascular accident]]
*[[Common cold]]
*[[Head injury]]
*[[Influenza]]
*[[Labyrinthitis]]
*[[Medicines]]
*[[Meniere's disease]]
*[[Migraine headaches]]


*[[Morning sickness]]
:*Common causes of vertigo may include:
 
:*
*[[Motion sickness]]
 
*[[Multiple sclerosis]]
 
*[[Otitis media]]
 
*[[Stroke]]
*[[Superior canal dehiscence syndrome]]
*[[Viral infection]]
*[[Visual vertigo]]
 
 
 
 
===Causes by Organ System===
 
{|style="width:80%; height:100px" border="1"
 
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
 
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | No underlying causes


{| class="wikitable"
|+
! colspan="2" |Peripheral Vertigo Causes<ref> name="Karatas2008">{{cite journal|last1=Karatas|first1=Mehmet|title=Central Vertigo and Dizziness|journal=The Neurologist|volume=14|issue=6|year=2008|pages=355–364|issn=1074-7931|doi=10.1097/NRL.0b013e31817533a3}}</ref>
|-
|-
 
![[Ménière’s disease]]
|-bgcolor="LightSteelBlue"
|
 
*Increased [[endolymph]] volume in [[semicircular canals]]. Recurrent vertigo, aural fullness, hearing loss and [[tinnitus]]
| '''Chemical / poisoning'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Acoustic neuroma]]
|-bgcolor="LightSteelBlue"
|
 
*[[tinnitus]], ear pain, [[aural fullness]], [[headache]], facial weakness.
| '''Dermatologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Benign paroxysmal positional vertigo]]
|-bgcolor="LightSteelBlue"
|
 
*Dislodged [[otoliths]] stimulate vestibular sense organ. Recurrent vertigo, nausea, vomiting, [[torsional]] [[nystagmus]]
| '''Drug Side Effect'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Acute]] [[labyrinthitis]]
|-bgcolor="LightSteelBlue"
|
 
*[[Inflammation]] of [[labyrinth]]/ [[viral]] or [[bacterial]]. Temporary hearing loss, vertigo, off balance, [[tinnitus]]
| '''Ear Nose Throat'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Endocrine'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Environmental'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Acute]] [[vestibular neuritis]]
|-bgcolor="LightSteelBlue"
|
 
*[[Inflammation]] of [[vestibular]] nerve caused by [[viral]] [[infection]]. Vertigo, hearing intact
| '''Gastroenterologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Herpes Zoster Oticus]]
|-bgcolor="LightSteelBlue"
|
 
*Ear pain, [[facial palsy]], hearing loss, [[tinnitus]] vertigo herpetic eruptions of the [[auricle]] and/or [[external auditory canal]].
| '''Genetic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Cholesteatoma]]
|-bgcolor="LightSteelBlue"
|
 
*[[Cyst]]/sac of [[keratin]] debris in middle ear. Fullness/pressure in the ear, vertigo, hearing loss, pain
| '''Hematologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
![[Otosclerosis]]
|
*Abnormal bone growth in the middle ear. Vertigo, [[tinnitus]] and, sensorineural hearing loss


|-bgcolor="LightSteelBlue"
|+
 
! colspan="2" |Central Vertigo Causes<ref name="Kerber2009">{{cite journal|last1=Kerber|first1=Kevin A.|title=Vertigo and Dizziness in the Emergency Department|journal=Emergency Medicine Clinics of North America|volume=27|issue=1|year=2009|pages=39–50|issn=07338627|doi=10.1016/j.emc.2008.09.002}}</ref>
| '''Iatrogenic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Brainstem]] [[Stroke]]
|-bgcolor="LightSteelBlue"
|
 
*Vertigo, imbalance, double vision, slurred speech, and altered [[consciousness]].
| '''Infectious Disease'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Vestibular]] [[Migraine]]
|-bgcolor="LightSteelBlue"
|
 
*Mostly unilateral severe throbbing [[headache]], vertigo lasting minutes to hours, sensitivity to motion/light/smell/noise, [[nausea]], [[vomiting]], imbalance.
| '''Musculoskeletal / Ortho'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Multiple Sclerosis]]
|-bgcolor="LightSteelBlue"
|
 
*Vertigo may accompany other symptoms like vision problem, fatigue, [[numbness]]/[[tingling]], limited mobility, bladder/bowel/speech/swallowing impairment.
| '''Neurologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Nutritional / Metabolic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Obstetric/Gynecologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Oncologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Opthalmologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Overdose / Toxicity'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Psychiatric'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Pulmonary'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Cerebellopontine angle]] [[tumors]]
|-bgcolor="LightSteelBlue"
|
 
*[[Meningioma]] or [[schwannoma]] in [[cerebellopontine]] angle can cause vertigo due to pressure on [[vestibular]] [[nerve]].
| '''Renal / Electrolyte'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Rheum / Immune / Allergy'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Sexual'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Lateral medullary syndrome]]
|-bgcolor="LightSteelBlue"
|
 
*Results from ischemia in the lateral part of the [[brainstem]]([[medulla oblongata]]). Associated with [[ataxia]], [[nystagmus]], vertigo, [[dysphagia]], [[dysarthria]].
| '''Trauma'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
![[Chiari malformation]]
|
*Extension of [[brainstem]] into [[spinal canal]]. Associated with [[numbness]]/[[tingling]] of hands and feet, [[dysphagia]], vertigo, unsteady [[gait]], hoarseness.


|-bgcolor="LightSteelBlue"
|+
 
! colspan="2" |Other Causes
| '''Urologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
!Medication induced
|-bgcolor="LightSteelBlue"
|
 
*[[Aminoglycosides]], [[anticonvulsants]]([[phenytoin]]), [[anti-depressants]]([[tricyclic antidepressants]], [[monoamine oxidase]]), [[antihypertensives]], [[diuretics]] ([[furosemide]]), [[barbiturates]], [[cocaine]], [[nitroglycerin]], [[salicylates]]
| '''Dental'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
![[Psychogenic]]
|
*Mood, [[anxiety]], or [[alcohol]] abuse disorders
|}<br />


|-bgcolor="LightSteelBlue"
===Less Common Causes===
 
| '''Miscellaneous'''
 
|bgcolor="Beige"| No underlying causes
 
|-


|}
*[[Mood disorder]]<ref name="BrantbergTrees2009">{{cite journal|last1=Brantberg|first1=Krister|last2=Trees|first2=Natalie|last3=Baloh|first3=Robert W.|title=Migraine-associated vertigo|journal=Acta Oto-Laryngologica|volume=125|issue=3|year=2009|pages=276–279|issn=0001-6489|doi=10.1080/00016480510003165}}</ref><ref name="BalabanJacob2001">{{cite journal|last1=Balaban|first1=Carey D.|last2=Jacob|first2=Rolf G.|title=Background and history of the interface between anxiety and vertigo|journal=Journal of Anxiety Disorders|volume=15|issue=1-2|year=2001|pages=27–51|issn=08876185|doi=10.1016/S0887-6185(00)00041-4}}</ref>
*[[Anxiety]]
*[[Migraine]]
*


<br />
==References==
==References==
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{{Reflist|2}}
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[[Category:Up-To-Date]]
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[[Category:Signs and symptoms]]
[[Category:Primary care]]
[[Category:Needs overview]]

Latest revision as of 20:02, 20 January 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

Common causes of vertigo may include Ménière’s disease, benign paroxysmal positional vertigo, labyrinthitis, vestibular neuritis. Less common causes of vertigo may include mood disorder, anxiety, and migraine. Life-threatening causes include brainstem ischemia/hemorrhage, hypertension crisis, drug overdose, cyanide poisoning.

Causes

Common Causes

  • Common causes of vertigo may include:
Peripheral Vertigo Causes[1]
Ménière’s disease
Acoustic neuroma
Benign paroxysmal positional vertigo
Acute labyrinthitis
Acute vestibular neuritis
Herpes Zoster Oticus
Cholesteatoma
  • Cyst/sac of keratin debris in middle ear. Fullness/pressure in the ear, vertigo, hearing loss, pain
Otosclerosis
  • Abnormal bone growth in the middle ear. Vertigo, tinnitus and, sensorineural hearing loss
Central Vertigo Causes[2]
Brainstem Stroke
  • Vertigo, imbalance, double vision, slurred speech, and altered consciousness.
Vestibular Migraine
  • Mostly unilateral severe throbbing headache, vertigo lasting minutes to hours, sensitivity to motion/light/smell/noise, nausea, vomiting, imbalance.
Multiple Sclerosis
  • Vertigo may accompany other symptoms like vision problem, fatigue, numbness/tingling, limited mobility, bladder/bowel/speech/swallowing impairment.
Cerebellopontine angle tumors
Lateral medullary syndrome
Chiari malformation
Other Causes
Medication induced
Psychogenic


Less Common Causes


References

  1. name="Karatas2008">Karatas, Mehmet (2008). "Central Vertigo and Dizziness". The Neurologist. 14 (6): 355–364. doi:10.1097/NRL.0b013e31817533a3. ISSN 1074-7931.
  2. Kerber, Kevin A. (2009). "Vertigo and Dizziness in the Emergency Department". Emergency Medicine Clinics of North America. 27 (1): 39–50. doi:10.1016/j.emc.2008.09.002. ISSN 0733-8627.
  3. Brantberg, Krister; Trees, Natalie; Baloh, Robert W. (2009). "Migraine-associated vertigo". Acta Oto-Laryngologica. 125 (3): 276–279. doi:10.1080/00016480510003165. ISSN 0001-6489.
  4. Balaban, Carey D.; Jacob, Rolf G. (2001). "Background and history of the interface between anxiety and vertigo". Journal of Anxiety Disorders. 15 (1–2): 27–51. doi:10.1016/S0887-6185(00)00041-4. ISSN 0887-6185.

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