There are four major types of dizziness - vertigo, presyncope, disequilibrium, and lightheadedness.
Most patients with true vertigo have a peripheral vestibular disorder, such as benign positional vertigo. This is usually associated with tinnitus and hearing loss.
Central disorders, such as brain stem or cerebellar lesions, tend to be more chronic but less intense than peripheral disorders and are not associated with hearing loss. Central disorders account for only 15 percent of patients with vertigo.
Vertigo is the illusion that you - or your surroundings - are moving. You may feel that you are spinning, tilting, rocking, or falling through space. You may vomit or have ringing in the ears (tinnitus). Also, your eyes may uncontrollably jerk back and forth (a condition called nystagmus).
benign positional paroxysmal vertigo (BPPV) is a disorder of the inner ear. The cause usually is unknown, but an upper respiratory tract infection or a minor blow to the head may be responsible. This type of vertigo occurs abruptly when you move your head up and down, or when you turn over in bed. Symptoms can be distressing but they fade in a few seconds. Avoiding positions that bring this on may reduce its occurrence.
BPPV is the commonest form of vertigo, with attacks lasting 30 to 60 seconds, typically set off when rolling over in bed, moving the head to one side or reaching for something ("top-shelf vertigo"). Sufferers can usually describe specific head movements that trigger it.
Although BPPV often occurs for no apparent reason, it can follow an ear infection, head or ear injury, and is thought to result from the dislodgement of normal crystalline structures in the ear's balance detectors. People with BPPV are often relieved to hear that it is due to an inner ear condition and does not signify some serious disorder such as a stroke or tumor.
labyrinthitis refers to a variety of conditions within the inner ear. It may be associated with inflammation, an upper respiratory infection or nerve deterioration, but often occurs independently of other problems.
central nervous system disorders that can cause vertigo as a symptom include multiple sclerosis, epilepsy, neck injuries, certain forms of migraine, acoustic neuroma, cerebellar and brain stem tumors, and TIAS (transient ischemic attacks).
A patient may experience severe vertigo for days or weeks. Nausea, vomiting, and involuntary eye movements are common. The condition gradually improves, but symptoms can persist for weeks or months.