Vertigo involves the illusion of movement, where someone either feels like they or the environment around them is moving-usually in a spinning manner. In this video I discuss the role of the vestibular system and related structures in producing vertigo.
TRANSCRIPT:
Vertigo involves the illusion of movement, where someone either feels like they, or the environment around them, is moving-usually in a spinning manner. Vertigo may range in severity from mild to so severe that it’s difficult to maintain one’s balance, and it frequently involves other symptoms as well, including sweating, nausea, and vomiting. While vertigo is often described as dizziness, dizziness is a more general term, and vertigo is considered a subtype of dizziness. There are many potential causes of vertigo, including conditions such as benign paroxysmal positional vertigo, migraine, or Meniere’s disease, as well as a number of other causes such as infections, head injuries, and tumors, among others.
Our sense of stability is maintained primarily by the activity of the vestibular system, which includes the semicircular canals and otolith organs of the inner ear as well as the vestibular nuclei in the brainstem. The inner ear structures receive information about head movement and communicate this information to other brain regions, including the brainstem, cerebellum, and cerebral cortex. Vertigo is typically associated with a disruption in function of either the vestibular system or one of the regions it communicates with to maintain our sense of balance and stability.
Vertigo can be classified as peripheral or central, with peripheral vertigo referring to vertigo typically caused by dysfunction in the vestibular structures of the inner ear or of the vestibular nerve, which carries information from those structures to the brain. Central vertigo involves disruption to regions of the central nervous system that handle vestibular information. The symptoms a patient is experiencing can help to determine if vertigo has a peripheral or central origin; for example, peripheral vertigo is more likely to result in short-lived episodes with more severe nausea and vomiting, while central vertigo may cause longer episodes that involve other neurological symptoms-but of course these commonalities may not hold true in every case.
REFERENCES:
Baloh RW. Vertigo. Lancet. 1998 Dec 5;352(9143):1841-6. doi: 10.1016/S0140-6736(98)05430-0. PMID: 9851400.
Labuguen RH. Initial evaluation of vertigo. Am Fam Physician. 2006 Jan 15;73(2):244-51. Erratum in: Am Fam Physician. 2006 May 15;73(10):1704. PMID: 16445269.
Noij KS, Shapiro SB, Samy RN, Naples JG. Vertigo: Streamlining the Evaluation through Symptom Localization. Med Clin North Am. 2021 Sep;105(5):901-916. doi: 10.1016/j.mcna.2021.05.011. Epub 2021 Jul 12. PMID: 34391542.
Stanton M, Freeman AM. Vertigo. 2023 Mar 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. PMID: 29493978.