From the Guidelines
Stress can exacerbate peripheral vertigo, particularly in conditions like Ménière's disease, by triggering the body's fight-or-flight response and affecting the vestibular system in the inner ear. According to the clinical practice guideline on Ménière's disease 1, stress can play a role in making symptoms worse, and managing stress is essential to control symptoms. The guideline suggests that patients with Ménière's disease should consider keeping a food and activity diary to identify triggers, including stress, and develop coping mechanisms to manage stress, such as getting adequate sleep and exercise, meditation, and support groups.
Some key points to consider in managing stress-related peripheral vertigo include:
- Identifying and managing triggers, including stress, through techniques like journaling and support groups 1
- Developing a healthy lifestyle, including a balanced diet, regular exercise, and adequate sleep 1
- Using stress reduction techniques, such as deep breathing exercises, progressive muscle relaxation, and meditation, to manage stress levels
- Considering vestibular rehabilitation therapy for persistent symptoms
- Consulting a healthcare provider to rule out other potential causes and develop a comprehensive treatment plan
It's also important to note that other conditions, like benign paroxysmal positional vertigo (BPPV), can cause vertigo, and stress may not be a direct trigger for these conditions 1. However, managing stress can still be beneficial for overall health and well-being. By addressing both vertigo symptoms and stress levels, patients can better manage their condition and improve their quality of life.
From the Research
Relationship Between Stress and Peripheral Vertigo
- There is evidence to suggest that stress may play a role in the development of peripheral vertigo, particularly in the case of benign paroxysmal positional vertigo (BPPV) 2.
- A study found that patients with BPPV reported significantly more life events than control subjects in the year preceding the onset of vertigo, and also had higher levels of anxiety, depression, and somatization 2.
- Another study noted that emotional stress connected to adverse life events may be a trigger of otoconial dysfunction, which can lead to peripheral vestibular disorders such as BPPV 2.
- However, it is worth noting that the exact relationship between stress and peripheral vertigo is not fully understood and may require further research.
Treatment of Peripheral Vertigo
- Treatment for peripheral vertigo often focuses on relieving symptoms and may include medications such as meclizine and diazepam 3, 4, 5.
- Vestibular rehabilitation programs, including patient education and home-based exercises, may also be effective in managing peripheral vertigo 4, 6.
- In some cases, procedures such as the Epley maneuver may be used to treat BPPV 6.
Diagnosis and Evaluation of Peripheral Vertigo
- Diagnosis of peripheral vertigo typically involves a physical examination, including orthostatic blood pressure measurement, a full cardiac and neurologic examination, assessment for nystagmus, and the Dix-Hallpike maneuver 6.
- The HINTS (head-impulse, nystagmus, test of skew) examination may also be used to help distinguish peripheral from central etiologies of vertigo 6.