What factors can trigger vertigo?

Vertigo is not an independent disease. There are several disease and drug related side-effects that can cause vertigo1. This is why it is so important to consult a specialist in time: only a doctor can diagnose the true cause of vertigo and prescribe treatment.

Conditions in the inner ear

Most of the time, vertigo is triggered by conditions in the inner ear, such as:

  • Benign paroxysmal positional vertigo (BPPV), which is strongly associated with the feeling of positional vertigo. BBPV is defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo2.
  • Vestibular neuronitis can trigger vertigo and is characterized by inflammation of the inner ear3.
  • Ménière’s disease, also a condition of the inner ear, can cause severe vertigo. Ménière’s disease is characterized by recurrent episodes of vertigo4.
  • Vestibular migraine is the term used for all forms of the relationship between migraine and vertigo5

Other triggers

Other triggers for vertigo include the following:

  • Pregnancy: Women can experience episodes of vertigo during pregnancy due to hormonal changes. Pregnancy can also cause nasal stuffiness6 , which can lead to ear pressure.
  • Multiple sclerosis7 : This condition affects the brain and spinal cord, which can provoke problems with balance.
  • Dehydration8 : Characterized by not enough water in the body and can result into lightheadedness.
  • Hypoglycemia9 : Low levels of sugar in the blood can provoke sweating, fatigue, and headaches.
  • Parkinson’s disease10 : A neurodegenerative disorder affecting the brain. Patients with Parkinson’s disease can experience episodes of vertigo.
  • Head and neck injuries11 : These injuries can damage the inner ear and provoke vertigo, often defined as “post-traumatic vertigo.”
  • Stroke: It happens when the blood supply to a part of your brain is reduced or completely altered12. A stroke can affect the areas of your brain that affect balance and cause vertigo13.
  • Hypertension: Condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels14. Hypertension can affect vestibular system (peripheral and/or central) and cause Vertigo15.
  • Diabetes9Patients with diabetes can experience hypoglycemic episodes that can trigger vertigo. The brain does not function properly when the blood sugar level is low.

Risk factors / conditions that put people at a higher risk of experiencing vertigo

In addition to these conditions, there are risk factors / conditions that put people at a higher risk of experiencing vertigo. These include:

  • Age16: As the years go by, the number of vestibular nerves decrease, which degrades balance and vision.

Did you know?
30% of people over 60 y.o and 50% beyond 85 y.o have vertigo

  • Women have a greater risk than men of experiencing vertigo due to hormonal changes. Menopause or menstrual disorders can compromise blood flow to the inner ear, causing migraine and balance problems6.
  • Unhealthy diets17can provoke vertigo or aggravate the course of diseases of which it is a symptom. There are certain foods that can affect the concentration of substances inside your ear and provoke symptoms such as tinnitus (ringing in the ear), migraine and imbalance. For instance, excessive consumption of alcohol increases the severity of many symptoms and can be toxic to the inner ear.
  • Stress and anxiety are common triggers for vertigo. High levels of stress or anxiety may leave to nervous exhaustiveness and fatigue, and are linked with lightheadedness, sweating, and nausea18.
  • Head movements, such as turning in bed or looking up, can trigger vertigo. This can indicate BPPV19.
  • Genetics20Several conditions, such as Ménière’s disease and migraine that run in families increase the chances of experiencing vertigo.

This list is not exhaustive and represents only some causes among many others. In case of vertigo experience, do not hesitate to consult the doctor as soon as possible for a diagnosis and to get a good understanding of your condition.

References

  1. Medscape. Vertigo: Identifying the Hidden Cause. https://reference.medscape.com/slideshow/vertigo-6001144#7. Published 2020. Accessed October 29, 2020.
  2. Bhattacharyya N, Gubbels S, Schwartz S et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update) Executive Summary. Otolaryngol Head Neck Surg. 2017;156(3):403-416.
  3. NHS. Labyrinthitis and vestibular neuritis. nhs.uk. https://www.nhs.uk/conditions/labyrinthitis/. Published 2020. Accessed October 14, 2020.
  4. Smith T, Rider J, Cen S. Vestibular Neuronitis (Labyrinthis). https://www.ncbi.nlm.nih.gov/books/NBK549866/. Published 2010.  Accessed October 14, 2020.
  5. Vestibular Disorders Association. Vestibular Migraine. https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/vestibular-migraine/. Published 2020. Accessed October 28, 2020.
  6. Vestibular Disorders Association. Hormones and Vestibular Disorders. https://vestibular.org/sites/default/files/page_files/Documents/Hormones%20and%20Vestibular%20Disorders.pdf. Published 2016. Accessed October 28, 2020.
  7. NHS. Multiple Sclerosis. nhs.uk. https://www.nhs.uk/conditions/multiple-sclerosis/#:~:text=Multiple%20sclerosis%20(MS)%20is%20a,it%20can%20occasionally%20be%20mild. Published 2020. Accessed October 14, 2020
  8. Vestibular Disorders Association. Causes of Dizziness. https://vestibular.org/article/what-is-vestibular/causes-of-dizziness/. Published 2020. Accessed October 29, 2020.
  9. The global diabetes community. Dizziness. https://www.diabetes.co.uk/symptoms/dizziness.html. Published 2020. Accessed October 14, 2020.
  10. Parkinson’s Foundation. What Is Parkinson’s?. https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons. Published 2020. Accessed October 14, 2020.
  11. Marks J, Sanjai Sinha M. What Causes Vertigo and Who Is at Risk for It? | Everyday Health. EverydayHealth.com. https://www.everydayhealth.com/vertigo/causes-risk-factors/. Published 2020. Accessed October 14, 2020.
  12. Stroke Association. What is stroke? https://www.stroke.org.uk/what-is-stroke. Published 2020. Accessed October 29, 2020.
  13. Stroke Association. Balance problems after stroke. https://www.stroke.org.uk/sites/default/files/balance_problems_after_stroke.pdf. Published 2020. Accessed October 29, 2020.
  14. WHO. Hypertension. https://www.who.int/health-topics/hypertension/#tab=tab_1. Published 2020. Accessed October 29, 2020.
  15. Moreira M, Trelha C, Marchiori L, Lopes A. Association between complaints of dizziness and hypertension in non-institutionalized elders. Int Arch Otorhinolaryngol. 2014;17(02):157-162.
  16. Fernández L, Breinbauer H, Delano P. Vertigo and Dizziness in the Elderly. Front Neurol. 2015;6:44
  17. Vestibular Disorders Association. Dietary Considerations. https://vestibular.org/article/coping-support/dietary-considerations/. Published 2020. Accessed October 29, 2020.
  18. Morris L. Why does anxiety and stress cause me to be dizzy? Vestibular rehabilitation. https://www.neuropt.org/docs/default-source/vsig-english-pt-fact-sheets/anxiety-and-stress-dizziness4ca035a5390366a68a96ff00001fc240.pdf?sfvrsn=80a35343_0. Accessed October 29, 2020.
  19. Betterhealth.vic.gov.au. Benign paroxysmal positional vertigo (BPPV). https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/benign-paroxysmal-positional-vertigo-bppv#:~:text=Symptoms%20of%20BPPV,-Activities%20that%20bring&text=Getting%20out%20of%20bed%20or,called%20’top%20shelf%20vertigo’. Published 2020. Accessed October 30, 2020.
  20. Cha Y, Kane M, Baloh R. Familial Clustering of Migraine, Episodic Vertigo, and Ménière’s Disease. Otol. Neurotol. 2008;29(1):93-96.
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