Vertigo causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.^[2]; Vendhan Ramanujam M.B.B.S [3]

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.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular	Abdominal aortic aneurysm, coronary heart disease, malignant hypertension
Chemical / poisoning	Amanita muscaria, arsine, cyanide, multiple chemical sensitivity, nitrogen narcosis, snakebites, tsetse fly
Dermatologic	Neurofibromatosis
Drug Side Effect	3-Quinuclidinyl benzilate, 4-HO-MPT, ACE inhibitors, aminoglycosides, anti-obesity drug, antibiotics, anticonvulsants, antiretroviral drug, biperiden, buspirone, cabergoline, daptomycin, febuxostat, 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, Primidone, rizatriptan, ropinirole, sedatives, Sertraline, SSRI discontinuation syndrome, streptomycin, sultiame, tamsulosin, temazepam, trazodone, tuberculosis treatment, valaciclovir, venlafaxine, vigabatrin, viloxazine, zimelidine, zonisamide, zolmitriptan
Ear Nose Throat	Acoustic neuroma, cholesteatoma, Cogan syndrome, earwax, glomus tumor, herpes zoster oticus, labyrinth infarction, labyrinthine concussion, labyrinthitis, Ménière's disease, osteoma of the external ear canal, otitis externa, otitis media, ototoxicity, perilymphatic fistula, semicircular canal dehiscence syndrome, superior canal dehiscence syndrome
Endocrine	No underlying causes
Environmental	Microwave auditory effect, noise health effects
Gastroenterologic	No underlying causes
Genetic	Fabry's disease, neurofibromatosis
Hematologic	Polycythemia vera
Iatrogenic	No underlying causes
Infectious Disease	Bacterial infection, common cold, herpes zoster oticus, influenza, labyrinthitis, lyme disease, mastoiditis, syphillis, viral infection
Musculoskeletal / Ortho	No underlying causes
Neurologic	Acoustic neuroma, arachnoid cyst, Arnold-Chiari malformation, astrocytoma, balance disorder, benign paroxysmal positional vertigo, brain zaps, brainstem infarction, brainstem ischemia, brainstem stroke, Bruns' syndrome, cerebellar hemorrhage, cerebellar infarction, cerebral shunt, cerebrovascular accident, colloid cyst, ependymoma, episodic ataxia, facial nerve paralysis, hydrocephalus, inferior cerebellar bleeding, inferior cerebellar infarction, lateral medullary syndrome, medulloblastoma, meningioma, migraine headaches, 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 syncope, vertebrobasilar insufficiency, vertebrobasilar transient ischemic attack, vestibular neuritis
Nutritional / Metabolic	Metabolic acidosis
Obstetric/Gynecologic	Hyperemesis gravidarum
Oncologic	Acoustic neuroma, astrocytoma, ependymoma, medulloblastoma, meningioma, osteoma of the external ear
Opthalmologic	Cogan syndrome
Overdose / Toxicity	Alcohol, aminoglycosides, atenolol, cinchonism, drug overdose, gentamicin, hellebore
Psychiatric	Panic attack
Pulmonary	No underlying causes
Renal / Electrolyte	Chronic renal failure
Rheum / Immune / Allergy	Cogan syndrome
Sexual	No underlying causes
Trauma	Head injury, labyrinthine concussion, skull fractures
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	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

References

↑ Gauss, I.; Delank, KW.; Esser, M.; Grau, A. (2008). "[Life-threatening differential diagnoses of vertigo and sudden hearing loss]". HNO. 56 (7): 733–40, quiz 741. doi:10.1007/s00106-008-1771-5. PMID 18566785. Unknown parameter |month= ignored (help)
↑ Kroenke, K.; Hoffman, RM.; Einstadter, D. (2000). "How common are various causes of dizziness? A critical review". South Med J. 93 (2): 160–7, quiz 168. PMID 10701780. Unknown parameter |month= ignored (help)

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[Gauss-2008-1] Gauss, I.; Delank, KW.; Esser, M.; Grau, A. (2008). "[Life-threatening differential diagnoses of vertigo and sudden hearing loss]". HNO. 56 (7): 733–40, quiz 741. doi:10.1007/s00106-008-1771-5. PMID 18566785. Unknown parameter |month= ignored (help)

[Kroenke-2000-2] Kroenke, K.; Hoffman, RM.; Einstadter, D. (2000). "How common are various causes of dizziness? A critical review". South Med J. 93 (2): 160–7, quiz 168. PMID 10701780. Unknown parameter |month= ignored (help)

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