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| __NOTOC__ | | __NOTOC__ |
| {{SI}} | | {{Vertigo}} |
| {{CMG}}; {{AE}} {{Hilda}}; {{VR}} | | {{CMG}}; {{AE}} {{ZMalik}} |
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| ==Overview== | | ==Overview== |
| Vertigo can result from problems of the [[inner ear]] or the vestibular system which is composed of the semicircular canals, the otolith (utricle and saccule) and the vestibular [[nerve]]. Hence, depending on the cause of the vertigo, it can be referred to as "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]]. |
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| ==Causes== | | ==Causes== |
| ===Life Threatening Causes===
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| Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
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| *[[Brainstem stroke]]
| | ===Common Causes=== |
| *[[Intracranial hemorrhage|Cerebellar hemorrhage]]
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| *[[Cerebellar infarction]]
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| *[[Cyanide]]
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| *[[Drug overdose]]
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| *[[Head injury]]
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| *[[Stroke]]<ref name="Gauss-2008">{{Cite journal | last1 = Gauss | first1 = I. | last2 = Delank | first2 = KW. | last3 = Esser | first3 = M. | last4 = Grau | first4 = A. | title = [Life-threatening differential diagnoses of vertigo and sudden hearing loss]. | journal = HNO | volume = 56 | issue = 7 | pages = 733-40; quiz 741 | month = Jul | year = 2008 | doi = 10.1007/s00106-008-1771-5 | PMID = 18566785 }}</ref>
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| ===Common Causes===
| | :*Common causes of vertigo may include: |
| *[[Acoustic neuroma]]
| | :* |
| *[[Aminoglycosides]]
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| *[[Benign paroxysmal positional vertigo]]
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| *[[Lateral medullary syndrome|Brainstem ischemia]]
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| *[[Intracranial hemorrhage|Cerebellar hemorrhage]]
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| *[[Cerebellar infarction]]
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| *[[Labyrinthitis]]
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| *[[Medications]]
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| *[[Meniere's disease]]
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| *[[Migraine|Migrainous vertigo]]
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| *[[Otitis media]]
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| *[[Superior canal dehiscence syndrome]] | |
| *[[Vestibular neuritis]]<ref name="Kroenke-2000">{{Cite journal | last1 = Kroenke | first1 = K. | last2 = Hoffman | first2 = RM. | last3 = Einstadter | first3 = D. | title = How common are various causes of dizziness? A critical review. | journal = South Med J | volume = 93 | issue = 2 | pages = 160-7; quiz 168 | month = Feb | year = 2000 | doi = | PMID = 10701780 }}</ref>
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| ===Causes by Organ System===
| | {| class="wikitable" |
| {|style="width:80%; height:100px" border="1" | | |+ |
| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | | ! 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> |
| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Abdominal aortic aneurysm]], [[coronary heart disease]], [[malignant hypertension]] | |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Ménière’s disease]] |
| | '''Chemical / poisoning'''
| | | |
| |bgcolor="Beige"| [[Amanita muscaria]], [[arsine]], [[cyanide]], [[multiple chemical sensitivity]], [[nitrogen narcosis]], [[snakebites]], [[tsetse fly]]
| | *Increased [[endolymph]] volume in [[semicircular canals]]. Recurrent vertigo, aural fullness, hearing loss and [[tinnitus]] |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Acoustic neuroma]] |
| | '''Dermatologic''' | | | |
| |bgcolor="Beige"| [[Neurofibromatosis]]
| | *[[tinnitus]], ear pain, [[aural fullness]], [[headache]], facial weakness. |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Benign paroxysmal positional vertigo]] |
| | '''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]], [[hydroxychloroquine]], [[ibotenic acid]], [[indomethacin]], [[isosorbide mononitrate]], [[ketorolac]], [[leflunomide]], [[loop diuretic]], [[loprazolam]], [[lorazepam]], [[lormetazepam]], [[malaria prophylaxis]], [[methimazole]], [[methocarbamol]], [[methylprednisolone]], [[minocycline hydrochloride]], [[moclobemide]], [[modafinil]], [[nabumetone]], [[nialamide]], [[nitrazepam]], [[oprelvekin]], [[papaverine]], [[paroxetine]], [[Pentamidine Isethionate]], [[perphenazine]], [[praziquantel]], [[rizatriptan]], [[sedatives]], [[SSRI discontinuation syndrome]], [[streptomycin]], [[sultiame]], [[temazepam]], [[trazodone]], [[tuberculosis treatment]], [[valaciclovir]], [[venlafaxine]], [[vigabatrin]], [[viloxazine]], [[zimelidine]], [[Zonisamide]], [[zolmitriptan]]
| | *Dislodged [[otoliths]] stimulate vestibular sense organ. Recurrent vertigo, nausea, vomiting, [[torsional]] [[nystagmus]] |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Acute]] [[labyrinthitis]] |
| | '''Ear Nose Throat'''
| | | |
| |bgcolor="Beige"| [[Acoustic neuroma]], [[cholesteatoma]], [[Cogan syndrome]], [[earwax]], [[glomus tumor]], [[herpes zoster oticus]], [[Vertebrobasilar insufficiency|labyrinth infarction]], [[Concussion|labyrinthine concussion]], [[labyrinthitis]], [[Ménière's disease]], [[Osteoma|osteoma of the external ear canal]], [[otitis externa]], [[otitis media]], [[ototoxicity]], [[perilymphatic fistula]], [[Superior canal dehiscence syndrome|semicircular canal dehiscence syndrome]], [[superior canal dehiscence syndrome]]
| | *[[Inflammation]] of [[labyrinth]]/ [[viral]] or [[bacterial]]. Temporary hearing loss, vertigo, off balance, [[tinnitus]] |
| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| [[Microwave auditory effect]], [[noise health effects]]
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| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Acute]] [[vestibular neuritis]] |
| | '''Gastroenterologic''' | | | |
| |bgcolor="Beige"| No underlying causes
| | *[[Inflammation]] of [[vestibular]] nerve caused by [[viral]] [[infection]]. Vertigo, hearing intact |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Herpes Zoster Oticus]] |
| | '''Genetic''' | | | |
| |bgcolor="Beige"| [[Fabry's disease]], [[neurofibromatosis]]
| | *Ear pain, [[facial palsy]], hearing loss, [[tinnitus]] vertigo herpetic eruptions of the [[auricle]] and/or [[external auditory canal]]. |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Cholesteatoma]] |
| | '''Hematologic''' | | | |
| |bgcolor="Beige"| [[Polycythemia vera]]
| | *[[Cyst]]/sac of [[keratin]] debris in middle ear. Fullness/pressure in the ear, vertigo, hearing loss, pain |
| |- | | |- |
| |-bgcolor="LightSteelBlue" | | ![[Otosclerosis]] |
| | '''Iatrogenic'''
| | | |
| |bgcolor="Beige"| No underlying causes | | *Abnormal bone growth in the middle ear. Vertigo, [[tinnitus]] and, sensorineural hearing loss |
| | |
| | |+ |
| | ! 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> |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Brainstem]] [[Stroke]] |
| | '''Infectious Disease'''
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| |bgcolor="Beige"| [[Bacterial infection]], [[common cold]], [[herpes zoster oticus]], [[influenza]], [[labyrinthitis]], [[lyme disease]], [[mastoiditis]], [[syphillis]], [[viral infection]]
| | *Vertigo, imbalance, double vision, slurred speech, and altered [[consciousness]]. |
| |- | | |- |
| |-bgcolor="LightSteelBlue" | | ![[Vestibular]] [[Migraine]] |
| | '''Musculoskeletal / Ortho'''
| | | |
| |bgcolor="Beige"| No underlying causes
| | *Mostly unilateral severe throbbing [[headache]], vertigo lasting minutes to hours, sensitivity to motion/light/smell/noise, [[nausea]], [[vomiting]], imbalance. |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Multiple Sclerosis]] |
| | '''Neurologic'''
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| |bgcolor="Beige"| [[Acoustic neuroma]], [[arachnoid cyst]], [[Arnold-Chiari malformation]], [[astrocytoma]], [[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]], [[ependymoma]], [[episodic ataxia]], [[facial nerve paralysis]], [[hydrocephalus]], [[Intracranial hemorrhage|inferior cerebellar bleeding]], [[Cerebellar infarction|inferior cerebellar infarction]], [[lateral medullary syndrome]], [[medulloblastoma]], [[meningioma]], [[migraine headaches]], [[Migraine|migrainous vertigo]], [[multiple sclerosis]], [[neurofibromatosis]], [[non-epileptic seizure]], [[oculogyric crisis]], [[opsoclonus myoclonus syndrome]], [[Ramsay Hunt syndrome]], [[Migraine|recurrent vestibulopathy]], [[sensorineural hearing loss]], [[spinocerebellar ataxia]], [[stroke]], [[stroke recovery]], [[Tolosa-Hunt syndrome]], [[vasovagal syncope]], [[vertebrobasilar insufficiency]], [[Transient ischemic attack|vertebrobasilar transient ischemic attack]], [[vestibular neuritis]]
| | *Vertigo may accompany other symptoms like vision problem, fatigue, [[numbness]]/[[tingling]], limited mobility, bladder/bowel/speech/swallowing impairment. |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Cerebellopontine angle]] [[tumors]] |
| | '''Nutritional / Metabolic''' | | | |
| |bgcolor="Beige"| [[Metabolic acidosis]]
| | *[[Meningioma]] or [[schwannoma]] in [[cerebellopontine]] angle can cause vertigo due to pressure on [[vestibular]] [[nerve]]. |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Lateral medullary syndrome]] |
| | '''Obstetric/Gynecologic''' | | | |
| |bgcolor="Beige"| [[Hyperemesis gravidarum]]
| | *Results from ischemia in the lateral part of the [[brainstem]]([[medulla oblongata]]). Associated with [[ataxia]], [[nystagmus]], vertigo, [[dysphagia]], [[dysarthria]]. |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Chiari malformation]] |
| | '''Oncologic''' | | | |
| |bgcolor="Beige"| [[Acoustic neuroma]], [[astrocytoma]], [[ependymoma]], [[medulloblastoma]], [[meningioma]], [[Osteoma|osteoma of the external ear]]
| | *Extension of [[brainstem]] into [[spinal canal]]. Associated with [[numbness]]/[[tingling]] of hands and feet, [[dysphagia]], vertigo, unsteady [[gait]], hoarseness. |
| | |
| | |+ |
| | ! colspan="2" |Other Causes |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | !Medication induced |
| | '''Opthalmologic''' | | | |
| |bgcolor="Beige"| [[Cogan syndrome]]
| | *[[Aminoglycosides]], [[anticonvulsants]]([[phenytoin]]), [[anti-depressants]]([[tricyclic antidepressants]], [[monoamine oxidase]]), [[antihypertensives]], [[diuretics]] ([[furosemide]]), [[barbiturates]], [[cocaine]], [[nitroglycerin]], [[salicylates]] |
| |- | | |- |
| |-bgcolor="LightSteelBlue"
| | ![[Psychogenic]] |
| | '''Overdose / Toxicity'''
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| |bgcolor="Beige"| [[Alcohol]], [[aminoglycosides]], [[atenolol]], [[cinchonism]], [[drug overdose]], [[gentamicin]], [[hellebore]]
| | *Mood, [[anxiety]], or [[alcohol]] abuse disorders |
| |- | | |}<br /> |
| |-bgcolor="LightSteelBlue"
| | |
| | '''Psychiatric'''
| | ===Less Common Causes=== |
| |bgcolor="Beige"| [[Panic attack]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Renal / Electrolyte'''
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| |bgcolor="Beige"| [[Chronic renal failure]]
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| |- | |
| |-bgcolor="LightSteelBlue"
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| | '''Rheum / Immune / Allergy'''
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| |bgcolor="Beige"| [[Cogan syndrome]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| [[Head injury]], [[Concussion|labyrinthine concussion]], [[skull fractures]]
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Dental'''
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| |bgcolor="Beige"| No underlying causes
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| |-
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"| [[Airsickness]], [[chronic fatigue syndrome]], [[decompression sickness]], [[deep water blackout]], [[morning sickness]], [[motion sickness]], [[sea-sickness]], [[sound pressure]], [[taravana]], [[tobacco smoking]], [[visceroptosis]]
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| |-
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| |}
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| ===Causes in Alphabetical Order=== | | *[[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> |
| {{col-begin|width=80%}}
| | *[[Anxiety]] |
| {{col-break|width=33%}}
| | *[[Migraine]] |
| *[[3-Quinuclidinyl benzilate]]
| | * |
| *[[4-HO-MPT]]
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| *[[Abdominal aortic aneurysm]]
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| *[[Acoustic neuroma]]
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| *[[Airsickness]]
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| *[[Alcohol]]
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| *[[Amanita muscaria]]
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| *[[Aminoglycosides]]
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| *[[Anti-obesity drug]]
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| *[[Antibiotics]]
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| *[[Anticonvulsants]]
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| *[[Antiretroviral drug]]
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| *[[Arachnoid cyst]]
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| *[[Arnold-Chiari malformation]]
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| *[[Arsine]]
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| *[[Astrocytoma]]
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| *[[Atenolol]]
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| *[[Bacterial infection]]
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| *[[Balance disorder]]
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| *[[Benign paroxysmal positional vertigo]]
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| *[[Biperiden]]
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| *[[Brain zaps]]
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| *[[Lateral medullary syndrome|Brainstem infarction]]
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| *[[Lateral medullary syndrome|Brainstem ischemia]]
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| *[[Brainstem stroke]]
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| *[[Ludwig Bruns|Bruns' syndrome]]
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| *[[Buspirone]]
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| *[[Cabergoline]]
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| *[[Intracranial hemorrhage|Cerebellar hemorrhage]]
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| *[[Cerebellar infarction]]
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| *[[Cerebral shunt]]
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| *[[Cerebrovascular accident]]
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| *[[Cholesteatoma]]
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| *[[Chronic fatigue syndrome]]
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| *[[Chronic renal failure]]
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| *[[Cinchonism]]
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| *[[Cogan syndrome]]
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| *[[Colloid cyst]]
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| *[[Common cold]]
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| *[[Coronary heart disease]]
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| *[[ACE inhibitors]]
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| *[[Cyanide]]
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| *[[Daptomycin]]
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| *[[Decompression sickness]]
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| *[[Deep water blackout]]
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| *[[Drug overdose]]
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| *[[Earwax]]
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| *[[Efavirenz]]
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| *[[Ependymoma]]
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| *[[Episodic ataxia ]]
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| *[[Fabry's disease]]
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| {{col-break|width=33%}}
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| *[[Facial nerve paralysis]]
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| *[[Flucytosine]]
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| *[[Gamma-hydroxybutyric acid]]
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| *[[Gentamicin]]
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| *[[Glomus tumor]]
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| *[[Head injury]]
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| *[[Hellebore]]
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| *[[Herpes zoster oticus]]
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| *[[Histamine agonist]]
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| *[[Hydrocephalus]]
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| *[[Hyperemesis gravidarum]]
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| *[[Ibotenic acid]]
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| *[[Intracranial hemorrhage|Inferior cerebellar bleeding]]
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| *[[Cerebellar infarction|Inferior cerebellar infarction]]
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| *[[Influenza]]
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| *[[Isosorbide mononitrate]]
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| *[[Ketorolac]]
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| *[[Vertebrobasilar insufficiency|Labyrinth infarction]]
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| *[[Concussion|Labyrinthine concussion]]
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| *[[Labyrinthitis]]
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| *[[Lateral medullary syndrome]]
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| *[[Loop diuretic]]
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| *[[Loprazolam]]
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| *[[Lorazepam]]
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| *[[Lormetazepam]]
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| *[[Lyme disease]]
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| *[[Malaria prophylaxis]]
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| *[[Malignant hypertension]]
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| *[[Mastoiditis]]
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| *[[Medulloblastoma]]
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| *[[Meniere's disease]]
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| *[[Meningioma]]
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| *[[Metabolic acidosis]]
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| *[[Microwave auditory effect]]
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| *[[Migraine headaches]]
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| *[[Migraine|Migrainous vertigo]]
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| *[[Minocycline]]
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| *[[Moclobemide]]
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| *[[Modafinil]]
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| *[[Morning sickness]]
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| *[[Motion sickness]]
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| *[[Multiple chemical sensitivity]]
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| *[[Multiple sclerosis]]
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| *[[Neurofibromatosis]]
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| *[[Nialamide]]
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| *[[Nitrazepam]]
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| *[[Nitrogen narcosis]]
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| *[[Noise health effects]]
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| *[[Non-epileptic seizure]]
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| *[[Oculogyric crisis]]
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| {{col-break|width=33%}}
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| *[[Oprelvekin]]
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| *[[Opsoclonus myoclonus syndrome]]
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| *[[Osteoma|Osteoma of the external ear canal]]
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| *[[Otitis externa]]
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| *[[Otitis media]]
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| *[[Ototoxicity]]
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| *[[Panic attack]]
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| *[[Papaverine]]
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| *[[Paroxetine]]
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| *[[Perilymphatic fistula]]
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| *[[Perphenazine]]
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| *[[Polycythemia vera]]
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| *[[Praziquantel]]
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| *[[Ramsay Hunt syndrome ]]
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| *[[Migraine|Recurrent vestibulopathy]]
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| *[[Sea-sickness]]
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| *[[Sedatives]]
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| *[[Superior canal dehiscence syndrome|Semicircular canal dehiscence syndrome]]
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| *[[Superior canal dehiscence syndrome]]
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| *[[Sensorineural hearing loss]]
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| *[[Skull fractures]]
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| *[[Snakebites ]]
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| *[[Sound pressure]]
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| *[[Spinocerebellar ataxia]]
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| *[[SSRI discontinuation syndrome]]
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| *[[Streptomycin]]
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| *[[Stroke]]
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| *[[Stroke recovery]]
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| *[[Sultiame]]
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| *[[Superior canal dehiscence syndrome|Superior canal dehiscence syndrome]]
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| *[[Syphillis]]
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| *[[Taravana]]
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| *[[Temazepam]]
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| *[[Tobacco smoking]]
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| *[[Tolosa-Hunt syndrome]]
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| *[[Trazodone]] | |
| *[[Tsetse fly]] | |
| *[[Tuberculosis treatment]]
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| *[[Valaciclovir]]
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| *[[Vasovagal syncope]]
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| *[[Venlafaxine]]
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| *[[Vertebrobasilar insufficiency]]
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| *[[Transient ischemic attack|Vertebrobasilar transient ischemic attack]]
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| *[[Vestibular neuritis]] | |
| *[[Vigabatrin]]
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| *[[Viloxazine]]
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| *[[Viral infection]]
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| *[[Visceroptosis]]
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| *[[Zimelidine]]
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| *[[Zolmitriptan]]
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| {{col-end}}
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| | <br /> |
| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
| | {{WH}} |
| | {{WS}} |
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| [[Category:Crowdiagnosis]] | | [[Category:Crowdiagnosis]] |
| [[Category:Neurology]] | | [[Category:Neurology]] |
| [[Category:Otolaryngology]] | | [[Category:Otolaryngology]] |
| [[Category:Primary care]]
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| [[Category:Signs and symptoms]]
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| [[Category:Up-To-Date]] | | [[Category:Up-To-Date]] |
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| {{WH}}
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| {{WS}}
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