From the Guidelines
Vertigo is primarily caused by inner ear problems, with the most common being benign paroxysmal positional vertigo (BPPV), where calcium crystals in the inner ear become dislodged and send false signals about head movement to the brain. Other significant causes include Meniere's disease (characterized by fluid buildup in the inner ear), vestibular neuritis or labyrinthitis (inflammation of the inner ear nerves), migraines, and certain medications like anticonvulsants and antihypertensives. Head trauma, strokes affecting the brainstem or cerebellum, multiple sclerosis, and acoustic neuromas (benign tumors on the vestibular nerve) can also trigger vertigo. Less commonly, anxiety disorders may manifest with vertigo-like symptoms. Treatment depends on the underlying cause, ranging from repositioning maneuvers for BPPV (like the Epley maneuver), medications such as meclizine (25-50mg every 4-6 hours) or diazepam for acute symptoms, to vestibular rehabilitation therapy for long-term management. If experiencing vertigo, it's essential to move slowly, avoid sudden head movements, sit or lie down when symptoms occur, and seek medical attention if vertigo is severe, persistent, or accompanied by other neurological symptoms like weakness, slurred speech, or vision changes, as suggested by 1.
The causes of vertigo can be categorized into:
- Inner ear problems: BPPV, Meniere's disease, vestibular neuritis or labyrinthitis
- Neurological disorders: migraines, multiple sclerosis, strokes affecting the brainstem or cerebellum
- Other causes: head trauma, acoustic neuromas, anxiety disorders, certain medications It is crucial to determine the underlying cause of vertigo to provide appropriate treatment and management, as the treatment approach varies significantly depending on the cause, and some causes may require immediate medical attention to prevent further complications.
In clinical practice, it is essential to consider the patient's symptoms, medical history, and physical examination findings to determine the underlying cause of vertigo and develop an effective treatment plan, as emphasized by 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Causes of Vertigo
The causes of vertigo can be categorized into several broad groups, including:
- Otological vertigo, which includes disorders of the inner ear such as Ménière's disease, vestibular neuritis, benign paroxysmal positional vertigo (BPPB), and bilateral vestibular paresis 2
- Central vertigo, which includes entities such as vertigo associated with migraine and certain strokes 2
- Psychogenic vertigo, which occurs in association with disorders such as panic disorder, anxiety disorder, and agoraphobia 2
- Undetermined and ill-defined causes of vertigo, which make up a large remainder of diagnoses 2
Inner Ear Disorders
Inner ear disorders can cause vertigo, and common causes include:
- Vestibular neuritis (sudden, unilateral vestibular loss) 3, 4
- Meniere's disease (episodic vertigo) 3, 5, 6
- Benign paroxysmal positional vertigo (BPPB) 3, 5, 6
- Bilateral vestibular loss 3
Central Nervous System Causes
Central nervous system causes of vertigo include:
- Post concussion syndrome 3
- Cervical vertigo 3
- Vestibular migraine 3, 5, 6
- Cerebrovascular disease 3
- Acoustic neuroma 3
Other Causes
Other causes of vertigo include: