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{{SI}}
{{Vertigo}}
{{CMG}}{{AE}} {{Hilda}}
{{CMG}}; {{AE}} {{ZMalik}}  


==Overview==
==Overview==
Vertigo caused by problems with the inner ear or vestibular system, which is composed of the semicircular canals, the otolith (utricle and saccule), 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==
===Life threatening Causes===
*[[Brainstem stroke]]
*[[Intracranial hemorrhage|Cerebellar hemorrhage]]
*[[Cerebellar infarction]]
*[[Cerebrovascular accident]]
*[[Cyanide]]
*[[Drug overdose]]
*[[Head injury]]
*[[Stroke]]


===Common Causes===
===Common Causes===
*[[Alcohol]]
*[[Aminoglycosides]]
*[[Bacterial infection]]
*[[Benign paroxysmal positional vertigo]]
*[[Stroke|Cerebellar Stroke]]
*[[Cerebrovascular accident]]
*[[Common cold]]
*[[Head injury]]
*[[Influenza]]
*[[Labyrinthitis]]
*[[Medications]]
*[[Meniere's disease]]
*[[Migraine headaches]]
*[[Morning sickness]]
*[[Motion sickness]]
*[[Multiple sclerosis]]
*[[Otitis media]]
*[[Superior canal dehiscence syndrome]]
*[[Viral infection]]


===Causes by Organ System===
:*Common causes of vertigo may include:
 
:*
{|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
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Chemical / poisoning'''
 
|bgcolor="Beige"| [[Amanita muscaria]], [[arsine]], [[cyanide]], [[multiple chemical sensitivity]],  [[nitrogen narcosis]], [[snakebites ]], [[tsetse fly]]
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Dermatologic'''
 
|bgcolor="Beige"| [[Neurofibromatosis]]
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Drug Side Effect'''
 
|bgcolor="Beige"| [[3-Quinuclidinyl benzilate]], [[4-HO-MPT]], [[ACE inhibitors]], [[aminoglycosides]], [[anti-obesity drug]], [[antibiotics]], [[anticonvulsants]], [[antiretroviral drug]], [[biperiden]], [[buspirone]], [[cabergoline]], [[daptomycin]], [[flucytosine]], [[gamma-hydroxybutyric acid]], [[gentamicin]], [[histamine agonist]], [[ibotenic acid]], [[isosorbide mononitrate]], [[ketorolac]], [[loop diuretic]], [[loprazolam]], [[lorazepam]], [[lormetazepam]], [[malaria prophylaxis]],[[minocycline]], [[moclobemide]], [[modafinil]], [[nialamide]], [[nitrazepam]], [[oprelvekin]], [[papaverine]], [[paroxetine]], [[perphenazine]], [[praziquantel]], [[sedatives]], [[SSRI discontinuation syndrome]], [[streptomycin]], [[sultiame]], [[temazepam]], [[trazodone]], [[tuberculosis treatment]], [[valaciclovir]], [[venlafaxine]], [[vigabatrin]], [[viloxazine]], [[zimelidine]], [[zolmitriptan]]
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Ear Nose Throat'''
 
|bgcolor="Beige"|
[[Acoustic neuroma]], [[cogan syndrome]], [[earwax]], [[herpes zoster oticus]], [[Vertebrobasilar insufficiency|labyrinth infarction]], [[Concussion|labyrinthine concussion]], [[labyrinthitis]], [[meniere's disease]], [[otitis externa]], [[otitis media]], [[ototoxicity]], [[perilymphatic fistula]], [[Superior canal dehiscence syndrome|semicircular canal dehiscence syndrome]], [[superior canal dehiscence syndrome]]
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Endocrine'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Environmental'''
 
|bgcolor="Beige"| [[Microwave auditory effect]], [[noise health effects]]
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Gastroenterologic'''
 
|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]]
| '''Genetic'''
 
|bgcolor="Beige"| [[Fabry's disease]], [[neurofibromatosis]]
 
|-
|-
 
![[Acoustic neuroma]]
|-bgcolor="LightSteelBlue"
|
 
*[[tinnitus]], ear pain, [[aural fullness]], [[headache]], facial weakness.
| '''Hematologic'''
 
|bgcolor="Beige"| [[Polycythemia vera]]
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Iatrogenic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Infectious Disease'''
 
|bgcolor="Beige"| [[Bacterial infection]], [[common cold]], [[herpes zoster oticus]], [[influenza]], [[labyrinthitis]], [[lyme disease]], [[mastoiditis]], [[syphillis]], [[viral infection]]
 
|-
 
|-bgcolor="LightSteelBlue"
 
| '''Musculoskeletal / Ortho'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Benign paroxysmal positional vertigo]]
|-bgcolor="LightSteelBlue"
|
 
*Dislodged [[otoliths]] stimulate vestibular sense organ. Recurrent vertigo, nausea, vomiting, [[torsional]] [[nystagmus]]
| '''Neurologic'''
 
|bgcolor="Beige"|
[[Acoustic neuroma]], [[arachnoid cyst]], [[Arnold-Chiari malformation]], [[balance disorder]], [[benign paroxysmal positional vertigo]], [[brain zaps]], [[Lateral medullary syndrome|brainstem infarction]], [[Lateral medullary syndrome|brainstem ischemia]], [[brainstem stroke]], [[Ludwig Bruns|bruns' syndrome]], [[Intracranial hemorrhage|cerebellar hemorrhage]], [[cerebellar infarction]], [[cerebral shunt]], [[cerebrovascular accident]], [[colloid cyst]], [[episodic ataxia]], [[facial nerve paralysis]], [[hydrocephalus]], [[Intracranial hemorrhage|inferior cerebellar bleeding]], [[Cerebellar infarction|inferior cerebellar infarction]], [[lateral medullary syndrome]], [[migraine headaches]], [[Migraine|migrainous vertigo]], [[multiple sclerosis]], [[neurofibromatosis]], [[non-epileptic seizure]], [[oculogyric crisis]], [[opsoclonus myoclonus syndrome]], [[ramsay hunt syndrome ]], recurrent vestibulopathy, [[sensorineural hearing loss]], [[spinocerebellar ataxia]], [[stroke]], [[stroke recovery]], [[tolosa-hunt syndrome]], vasovagal episode, [[vasovagal syncope]], vertebrobasilar inschemia, vertebrobasilar transient ischemic attack, [[vestibular neuritis]]
|-
|-
 
![[Acute]] [[labyrinthitis]]
|-bgcolor="LightSteelBlue"
|
 
*[[Inflammation]] of [[labyrinth]]/ [[viral]] or [[bacterial]]. Temporary hearing loss, vertigo, off balance, [[tinnitus]]
| '''Nutritional / Metabolic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
 
![[Acute]] [[vestibular neuritis]]
|-bgcolor="LightSteelBlue"
|
 
*[[Inflammation]] of [[vestibular]] nerve caused by [[viral]] [[infection]]. Vertigo, hearing intact
| '''Obstetric/Gynecologic'''
 
|bgcolor="Beige"| [[Hyperemesis gravidarum]]
 
|-
|-
 
![[Herpes Zoster Oticus]]
|-bgcolor="LightSteelBlue"
|
 
*Ear pain, [[facial palsy]], hearing loss, [[tinnitus]] vertigo herpetic eruptions of the [[auricle]] and/or [[external auditory canal]].
| '''Oncologic'''
 
|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
| '''Opthalmologic'''
 
|bgcolor="Beige"| Cogan's syndrome
 
|-
|-
![[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>
| '''Overdose / Toxicity'''
 
|bgcolor="Beige"| [[Alcohol]], [[aminoglycosides]], [[atenolol]], [[cinchonism]], [[drug overdose]], [[gentamicin]], [[hellebore]]
|-
|-
 
![[Brainstem]] [[Stroke]]
|-bgcolor="LightSteelBlue"
|
 
*Vertigo, imbalance, double vision, slurred speech, and altered [[consciousness]].
| '''Psychiatric'''
 
|bgcolor="Beige"| [[Panic attack]]
 
|-
|-
 
![[Vestibular]] [[Migraine]]
|-bgcolor="LightSteelBlue"
|
 
*Mostly unilateral severe throbbing [[headache]], vertigo lasting minutes to hours, sensitivity to motion/light/smell/noise, [[nausea]], [[vomiting]], imbalance.
| '''Pulmonary'''
 
|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.
| '''Renal / Electrolyte'''
 
|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]].
| '''Rheum / Immune / Allergy'''
 
|bgcolor="Beige"| Cogan's syndrome
 
|-
|-
 
![[Lateral medullary syndrome]]
|-bgcolor="LightSteelBlue"
|
 
*Results from ischemia in the lateral part of the [[brainstem]]([[medulla oblongata]]). Associated with [[ataxia]], [[nystagmus]], vertigo, [[dysphagia]], [[dysarthria]].
| '''Sexual'''
 
|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
| '''Trauma'''
 
|bgcolor="Beige"| [[Head injury]], labyrinthine concussion, [[skull fractures]]
 
|-
|-
 
!Medication induced
|-bgcolor="LightSteelBlue"
|
 
*[[Aminoglycosides]], [[anticonvulsants]]([[phenytoin]]), [[anti-depressants]]([[tricyclic antidepressants]], [[monoamine oxidase]]), [[antihypertensives]], [[diuretics]] ([[furosemide]]), [[barbiturates]], [[cocaine]], [[nitroglycerin]], [[salicylates]]
| '''Urologic'''
 
|bgcolor="Beige"| No underlying causes
 
|-
|-
![[Psychogenic]]
|
*Mood, [[anxiety]], or [[alcohol]] abuse disorders
|}<br />


|-bgcolor="LightSteelBlue"
===Less Common Causes===
 
| '''Dental'''


|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]]
 
*
|-bgcolor="LightSteelBlue"
 
| '''Miscellaneous'''
 
|bgcolor="Beige"| [[Airsickness]], [[chronic fatigue syndrome]], [[decompression sickness]], [[deep water blackout]], [[morning sickness]], [[motion sickness]], [[sea-sickness]], [[sound pressure]], [[taravana]], [[tobacco smoking]], [[visceroptosis]]
 
|-
 
|}
 
===Causes in Alphabetical Order===
{{col-begin|width=80%}}
{{col-break|width=33%}}
*[[3-Quinuclidinyl benzilate]]
 
*[[4-HO-MPT]]
 
*[[ACE inhibitors]]
 
*[[Acoustic neuroma]]
 
*[[Airsickness]]
 
*[[Alcohol]]
 
*[[Amanita muscaria]]
 
*[[Aminoglycosides]]
 
*[[Anti-obesity drug]]
 
*[[Antibiotics]]
 
*[[Anticonvulsants]]
 
*[[Antiretroviral drug]]
 
*[[Arachnoid cyst]]
 
*[[Arnold-Chiari malformation]]
 
*[[Arsine]]
 
*[[Atenolol]]
 
*[[Bacterial infection]]
 
*[[Balance disorder]]
 
*[[Benign paroxysmal positional vertigo]]
 
*[[Biperiden]]
 
*[[Brain zaps]]
 
*[[Lateral medullary syndrome|Brainstem infarction]]
 
*[[Lateral medullary syndrome|Brainstem ischemia]]
 
*[[Brainstem stroke]]
 
*[[Ludwig Bruns|Bruns' syndrome]]
 
*[[Buspirone]]
 
*[[Cabergoline]]
 
*[[Intracranial hemorrhage|Cerebellar hemorrhage]]
 
*[[Cerebellar infarction]]
 
*[[Cerebral shunt]]
 
*[[Cerebrovascular accident]]
 
*[[Chronic fatigue syndrome]]
 
*[[Cinchonism]]
 
*[[Cogan syndrome]]
 
*[[Colloid cyst]]
 
*[[Common cold]]
 
*[[Cyanide]]
 
*[[Daptomycin]]
 
*[[Decompression sickness]]
 
*[[Deep water blackout]]
 
*[[Drug overdose]]
 
*[[Earwax]]
 
*[[Episodic ataxia ]]
 
*[[Fabry's disease]]
 
*[[Facial nerve paralysis]]
 
*[[Flucytosine]]
 
*[[Gamma-Hydroxybutyric acid]]
{{col-break|width=33%}}
 
*[[Gentamicin]]
 
*[[Head injury]]
 
*[[Hellebore]]
 
*[[Herpes zoster oticus]]
 
*[[Histamine agonist]]
*[[Hydrocephalus]]
*[[Hyperemesis gravidarum]]
*[[Ibotenic acid]]
*[[Intracranial hemorrhage|Inferior cerebellar bleeding]]
*[[Cerebellar infarction|Inferior cerebellar infarction]]
*[[Influenza]]
*[[Isosorbide mononitrate]]
*[[Ketorolac]]
*[[Vertebrobasilar insufficiency|Labyrinth infarction]]
*[[Concussion|Labyrinthine concussion]]
*[[Labyrinthitis]]
*[[Lateral medullary syndrome]]
*[[Loop diuretic]]
*[[Loprazolam]]
*[[Lorazepam]]
*[[Lormetazepam]]
*[[Lyme disease]]
 
*[[Malaria prophylaxis]]
 
*[[Mastoiditis]]
 
*Medicines
 
*[[Meniere's disease]]
 
*[[Microwave auditory effect]]
 
*[[Migraine headaches]]
 
*[[Migraine|Migrainous vertigo]]
*[[Minocycline]]
*[[Moclobemide]]
*[[Modafinil]]
*[[Morning sickness]]
*[[Motion sickness]]
*[[Multiple chemical sensitivity]]
*[[Multiple sclerosis]]
*[[Neurofibromatosis]]
*[[Nialamide]]
*[[Nitrazepam]]
*[[Nitrogen narcosis]]
*[[Noise health effects]]
*[[Non-epileptic seizure]]
*[[Oculogyric crisis]]
*[[Oprelvekin]]
*[[Opsoclonus myoclonus syndrome]]
*[[Otitis externa]]
*[[Otitis media]]
{{col-break|width=33%}}
*[[Ototoxicity]]
 
*[[Panic attack]]
 
*[[Papaverine]]
 
*[[Paroxetine]]
 
*[[Perilymphatic fistula]]
 
*[[Perphenazine]]
 
*[[Polycythemia vera]]
 
*[[Praziquantel]]
 
*[[Ramsay Hunt syndrome ]]
 
*Recurrent vestibulopathy
 
*[[Sea-sickness]]
 
*[[Sedatives]]
 
*Semicircular canal dehiscence syndrome
 
*[[Sensorineural hearing loss]]
 
*[[Skull fractures]]
 
*[[Snakebites ]]
 
*[[Sound pressure]]
 
*[[Spinocerebellar ataxia]]
 
*[[SSRI discontinuation syndrome]]
 
*[[Streptomycin]]
 
*[[Stroke]]
 
*[[Stroke recovery]]
 
*[[Sultiame]]
 
*[[Superior canal dehiscence syndrome|Superior canal dehiscence syndrome]]
 
*[[Syphillis]]
 
*[[Taravana]]
 
*[[Temazepam]]
 
*[[Tobacco smoking]]
 
*[[Tolosa-Hunt syndrome]]
 
*[[Trazodone]]
 
*[[Tsetse fly]]
 
*[[Tuberculosis treatment]]
 
*[[Valaciclovir]]
 
*[[Vasovagal episode]]
 
*[[Vasovagal syncope]]
 
*[[Venlafaxine]]
 
*[[Vertebrobasilar inschemia]]
 
*[[Vertebrobasilar transient ischemic attack]]
 
*[[Vestibular neuritis]]
 
*[[Vigabatrin]]
*[[Viloxazine]]
*[[Viral infection]]
*[[Visceroptosis]]
*[[Zimelidine]]
 
*[[Zolmitriptan]]
{{col-end}}


<br />
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Crowdiagnosis]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Otolaryngology]]
[[Category:Signs and symptoms]]
[[Category:Up-To-Date]]
[[Category:Primary care]]

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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