Last updated
Optokinetic nystagmus.gif
Horizontal nystagmus,
a sign that may accompany vertigo
Specialty Otorhinolaryngology
Symptoms Feeling of spinning or swaying, vomiting, difficulty walking [1] [2]
Causes Benign paroxysmal positional vertigo (BPPV), Ménière's disease, vestibular neuritis, stroke, brain tumors, brain injury, multiple sclerosis, migraine [1] [2]
Differential diagnosis Presyncope, disequilibrium, non-specific dizziness [2]
Frequency20–40% at some point [3]

Vertigo is a condition in which a person has the sensation of movement or of surrounding objects moving when they are not. [1] Often it feels like a spinning or swaying movement. [1] [2] This may be associated with nausea, vomiting, sweating, or difficulties walking. [2] It is typically worse when the head is moved. [2] Vertigo is the most common type of dizziness. [2]


The most common disorders that result in vertigo are benign paroxysmal positional vertigo (BPPV), Ménière's disease, and vestibular neuritis. [1] [2] Less common causes include stroke, brain tumors, brain injury, multiple sclerosis, migraines, trauma, and uneven pressures between the middle ears. [2] [4] [5] Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed. [6] [7] Other causes may include toxin exposures such as to carbon monoxide, alcohol, or aspirin. [8] Vertigo typically indicates a problem in a part of the vestibular system. [2] Other causes of dizziness include presyncope, disequilibrium, and non-specific dizziness. [2]

Benign paroxysmal positional vertigo is more likely in someone who gets repeated episodes of vertigo with movement and is otherwise normal between these episodes. [9] Benign vertigo episodes generally last less than one minute. [2] The Dix-Hallpike test typically produces a period of rapid eye movements known as nystagmus in this condition. [1] In Ménière's disease there is often ringing in the ears, hearing loss, and the attacks of vertigo last more than twenty minutes. [9] In vestibular neuritis the onset of vertigo is sudden, and the nystagmus occurs even when the person has not been moving. [9] In this condition vertigo can last for days. [2] More severe causes should also be considered, [9] especially if other problems such as weakness, headache, double vision, or numbness occur. [2]

Dizziness affects approximately 20–40% of people at some point in time, while about 7.5–10% have vertigo. [3] About 5% have vertigo in a given year. [10] It becomes more common with age and affects women two to three times more often than men. [10] Vertigo accounts for about 2–3% of emergency department visits in the developed world. [10]


Vertigo is classified into either peripheral or central, depending on the location of the dysfunction of the vestibular pathway, [11] although it can also be caused by psychological factors. [12]

Vertigo can also be classified into objective, subjective, and pseudovertigo. Objective vertigo describes when the person has the sensation that stationary objects in the environment are moving. [13] Subjective vertigo refers to when the person feels as if they are moving. [13] The third type is known as pseudovertigo, an intensive sensation of rotation inside the person's head. While this classification appears in textbooks, it is unclear what relation it has to the pathophysiology or treatment of vertigo. [14]


Vertigo that is caused by problems with the inner ear or vestibular system, which is composed of the semicircular canals, the vestibule (utricle and saccule), and the vestibular nerve is called "peripheral", "otologic", or "vestibular" vertigo. [15] [16] The most common cause is benign paroxysmal positional vertigo (BPPV), which accounts for 32% of all peripheral vertigo. [16] Other causes include Ménière's disease (12%), superior canal dehiscence syndrome, vestibular neuritis, and visual vertigo. [16] [17] Any cause of inflammation such as common cold, influenza, and bacterial infections may cause transient vertigo if it involves the inner ear, as may chemical insults (e.g., aminoglycosides) [18] or physical trauma (e.g., skull fractures). Motion sickness is sometimes classified as a cause of peripheral vertigo.[ citation needed ]

People with peripheral vertigo typically present with mild to moderate imbalance, nausea, vomiting, hearing loss, tinnitus, fullness, and pain in the ear. [16] In addition, lesions of the internal auditory canal may be associated with facial weakness on the same side. [16] Due to a rapid compensation[ clarification needed ] process, acute vertigo as a result of a peripheral lesion tends to improve in a short period of time (days to weeks). [16]


Vertigo that arises from injury to the balance centers of the central nervous system (CNS), often from a lesion in the brainstem or cerebellum, [9] [15] [19] is called "central" vertigo and is generally associated with less prominent movement illusion and nausea than vertigo of peripheral origin. [20] Central vertigo may have accompanying neurologic deficits (such as slurred speech and double vision), and pathologic nystagmus (which is pure vertical/torsional). [16] [20] Central pathology can cause disequilibrium, which is the sensation of being off balance. The balance disorder associated with central lesions causing vertigo is often so severe that many people are unable to stand or walk. [16]

A number of conditions that involve the central nervous system may lead to vertigo including: lesions caused by infarctions or hemorrhage, tumors present in the cerebellopontine angle such as a vestibular schwannoma or cerebellar tumors, [9] [11] epilepsy, [21] cervical spine disorders such as cervical spondylosis, [11] degenerative ataxia disorders, [9] migraine headaches, [9] lateral medullary syndrome, Chiari malformation, [9] multiple sclerosis, [9] parkinsonism, as well as cerebral dysfunction. [16] Central vertigo may not improve or may do so more slowly than vertigo caused by disturbance to peripheral structures. [16] Alcohol can result in positional alcohol nystagmus (PAN).

Signs and symptoms

A drawing showing the sensation of vertigo 3D still showing Vertigo.jpg
A drawing showing the sensation of vertigo

Vertigo is a sensation of spinning while stationary. [22] It is commonly associated with nausea or vomiting, [21] unsteadiness (postural instability), [19] falls, [23] changes to a person's thoughts, and difficulties in walking. [24] Recurrent episodes in those with vertigo are common and frequently impair the quality of life. [10] Blurred vision, difficulty in speaking, a lowered level of consciousness, and hearing loss may also occur. The signs and symptoms of vertigo can present as a persistent (insidious) onset or an episodic (sudden) onset. [25]

Persistent onset vertigo is characterized by symptoms lasting for longer than one day [25] and is caused by degenerative changes that affect balance as people age. Naturally, the nerve conduction slows with aging and a decreased vibratory sensation is common. [26] Additionally, there is a degeneration of the ampulla and otolith organs with an increase in age. [27] Persistent onset is commonly paired with central vertigo signs and symptoms. [25]

The characteristics of an episodic onset vertigo are indicated by symptoms lasting for a smaller, more memorable amount of time, typically lasting for only seconds to minutes. [25]


The neurochemistry of vertigo includes six primary neurotransmitters that have been identified between the three-neuron arc [28] that drives the vestibulo-ocular reflex (VOR). Glutamate maintains the resting discharge of the central vestibular neurons and may modulate synaptic transmission in all three neurons of the VOR arc. Acetylcholine appears to function as an excitatory neurotransmitter in both the peripheral and central synapses. Gamma-Aminobutyric acid (GABA) is thought to be inhibitory for the commissures of the medial vestibular nucleus, the connections among the cerebellar Purkinje cells, the lateral vestibular nucleus, and the vertical VOR.

Three other neurotransmitters work centrally. Dopamine may accelerate vestibular compensation. Norepinephrine modulates the intensity of central reactions to vestibular stimulation and facilitates compensation. Histamine is present only centrally, but its role is unclear. Dopamine, histamine, serotonin, and acetylcholine are neurotransmitters thought to produce vomiting. [9] It is known that centrally acting antihistamines modulate the symptoms of acute symptomatic vertigo. [29]


Tests for vertigo often attempt to elicit nystagmus and to differentiate vertigo from other causes of dizziness such as presyncope, hyperventilation syndrome, disequilibrium, or psychiatric causes of lightheadedness. [1] Tests of vestibular system (balance) function include electronystagmography (ENG), [1] Dix-Hallpike maneuver, [1] rotation tests, head-thrust test, [9] caloric reflex test, [9] [30] and computerized dynamic posturography (CDP). [31]

The HINTS test, which is a combination of three physical examination tests that may be performed by physicians at the bedside, has been deemed helpful in differentiating between central and peripheral causes of vertigo. [32] The HINTS test involves the horizontal head impulse test, observation of nystagmus on primary gaze, and the test of skew. [33] CT scans or MRIs are sometimes used by physicians when diagnosing vertigo. [21]

Tests of auditory system (hearing) function include pure tone audiometry, speech audiometry, acoustic reflex, electrocochleography (ECoG), otoacoustic emissions (OAE), and the auditory brainstem response test. [31]

A number of specific conditions can cause vertigo. In the elderly, however, the condition is often multifactorial. [10]

A recent history of underwater diving can indicate a possibility of barotrauma or decompression sickness involvement, but does not exclude all other possibilities. The dive profile (which is frequently recorded by dive computer) can be useful to assess a probability for decompression sickness, which can be confirmed by therapeutic recompression. [34]

Benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder [3] and occurs when loose calcium carbonate debris has broken off of the otoconial membrane and enters a semicircular canal thereby creating the sensation of motion. [1] [9] People with BPPV may experience brief periods of vertigo, usually under a minute, [9] which occur with change in the position. [35]

This is the most common cause of vertigo. [10] It occurs in 0.6% of the population yearly with 10% having an attack during their lifetime. [10] It is believed to be due to a mechanical malfunction of the inner ear. [10] BPPV may be diagnosed with the Dix-Hallpike test and can be effectively treated with repositioning movements such as the Epley maneuver. [10] [35] [36] [37]

Ménière's disease

Ménière's disease is an inner ear disorder of unknown origin, but is thought to be caused by an increase in the amount of endolymphatic fluid present in the inner ear (endolymphatic hydrops). [1] However, this idea has not been directly confirmed with histopathologic studies, but electrophysiologic studies have been suggestive of this mechanism. [38] Ménière's disease frequently presents with recurrent, spontaneous attacks of severe vertigo in combination with ringing in the ears (tinnitus), a feeling of pressure or fullness in the ear (aural fullness), severe nausea or vomiting, imbalance, and hearing loss. [9] [25] [38] As the disease worsens, hearing loss will progress.

Vestibular neuritis

Vestibular neuritis presents with severe vertigo [10] with associated nausea, vomiting, and generalized imbalance and is believed to be caused by a viral infection of the inner ear, although several theories have been put forward and the cause remains uncertain. [9] [39] Individuals with vestibular neuritis do not typically have auditory symptoms, but may experience a sensation of aural fullness or tinnitus. [39] Persisting balance problems may remain in 30% of people affected. [10]

Vestibular migraine

Vestibular migraine is the association of vertigo and migraines and is one of the most common causes of recurrent, spontaneous episodes of vertigo. [3] [10] The cause of vestibular migraines is currently unclear; [3] [40] however, one hypothesized cause is that the stimulation of the trigeminal nerve leads to nystagmus in individuals with migraines. [1] Approximately 40% of all migraine patients will have an accompanying vestibular syndrome, such as vertigo, dizziness, or disruption of the balance system. [40]

Other suggested causes of vestibular migraines include the following: unilateral neuronal instability of the vestibular nerve, idiopathic asymmetric activation of the vestibular nuclei in the brainstem, and vasospasm of the blood vessels supplying the labyrinth or central vestibular pathways resulting in ischemia to these structures. [21] Vestibular migraines are estimated to affect 1–3% of the general population [1] [10] and may affect 10% of people with migraine . [1] Additionally, vestibular migraines tend to occur more often in women and rarely affect individuals after the sixth decade of life. [3]

Motion sickness

Motion sickness is common and is related to vestibular migraine. It is nausea and vomiting in response to motion and is typically worse if the journey is on a winding road or involves many stops and starts, or if the person is reading in a moving car. It is caused by a mismatch between visual input and vestibular sensation. For example, the person is reading a book that is stationary in relation to the body, but the vestibular system senses that the car, and thus the body, is moving.

Alternobaric vertigo

Alternobaric vertigo is caused by a pressure difference between the middle ear cavities, usually due to blockage or partial blockage of one eustachian tube, usually when flying or diving underwater. It is most pronounced when the diver is in the vertical position; the spinning is toward the ear with the higher pressure and tends to develop when the pressures differ by 60 cm of water or more. [41] [42]

Decompression sickness

Vertigo is recorded as a symptom of decompression sickness in 5.3% of cases by the U.S. Navy as reported by Powell, 2008 [41] including isobaric decompression sickness.

Decompression sickness can also be caused at a constant ambient pressure when switching between gas mixtures containing different proportions of different inert gases. This is known as isobaric counterdiffusion, and presents a problem for very deep dives. [43] For example, after using a very helium-rich trimix at the deepest part of the dive, a diver will switch to mixtures containing progressively less helium and more oxygen and nitrogen during the ascent. Nitrogen diffuses into tissues 2.65 times slower than helium, but is about 4.5 times more soluble. Switching between gas mixtures that have very different fractions of nitrogen and helium can result in "fast" tissues (those tissues that have a good blood supply) increasing their total inert gas loading. This is often found to provoke inner ear decompression sickness, as the ear seems particularly sensitive to this effect. [44]


A stroke (either ischemic or hemorrhagic) involving the posterior fossa is a cause of central vertigo. [33] Risk factors for a stroke as a cause of vertigo include increasing age and known vascular risk factors. Presentation may more often involve headache or neck pain, additionally, those who have had multiple episodes of dizziness in the months leading up to presentation are suggestive of stroke with prodromal TIAs. [33] The HINTS exam as well as imaging studies of the brain (CT, CT angiogram, MRI) are helpful in diagnosis of posterior fossa stroke. [33]

Vertebrobasilar insufficiency

Vertebrobasilar insufficiency, notably Bow Hunter's syndrome, is a rare cause of positional vertigo, especially when vertigo is triggered by rotation of the head. [45] [46]


Definitive treatment depends on the underlying cause of vertigo. [9] People with Ménière's disease have a variety of treatment options to consider when receiving treatment for vertigo and tinnitus including: a low-salt diet and intratympanic injections of the antibiotic gentamicin or surgical measures such as a shunt or ablation of the labyrinth in refractory cases. [47] Common drug treatment options for vertigo may include the following: [48]

All cases of decompression sickness should be treated initially with 100% oxygen until hyperbaric oxygen therapy (100% oxygen delivered in a high-pressure chamber) can be provided. [50] Several treatments may be necessary, and treatment will generally be repeated until either all symptoms resolve, or no further improvement is apparent.


Vertigo is from the Latin word, vertō , which means "a whirling or spinning movement". [51]

See also

Related Research Articles

<span class="mw-page-title-main">Ménière's disease</span> Disorder of the inner ear

Ménière's disease (MD) is a disease of the inner ear that is characterized by potentially severe and incapacitating episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. Typically, only one ear is affected initially, but over time, both ears may become involved. Episodes generally last from 20 minutes to a few hours. The time between episodes varies. The hearing loss and ringing in the ears can become constant over time.

A balance disorder is a disturbance that causes an individual to feel unsteady, for example when standing or walking. It may be accompanied by feelings of giddiness, or wooziness, or having a sensation of movement, spinning, or floating. Balance is the result of several body systems working together: the visual system (eyes), vestibular system (ears) and proprioception. Degeneration or loss of function in any of these systems can lead to balance deficits.

<span class="mw-page-title-main">Vestibular system</span> Sensory system that facilitates body balance

The vestibular system, in vertebrates, is a sensory system that creates the sense of balance and spatial orientation for the purpose of coordinating movement with balance. Together with the cochlea, a part of the auditory system, it constitutes the labyrinth of the inner ear in most mammals.

<span class="mw-page-title-main">Dizziness</span> Neurological condition causing impairment in spatial perception and stability

Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness. It can also refer to disequilibrium or a non-specific feeling, such as giddiness or foolishness.

<span class="mw-page-title-main">Labyrinthitis</span> Medical condition

Labyrinthitis is inflammation of the labyrinth, a maze of fluid-filled channels in the inner ear. Vestibular neuritis is inflammation of the vestibular nerve. Both conditions involve inflammation of the inner ear. Labyrinths that house the vestibular system sense changes in the head's position or the head's motion. Inflammation of these inner ear parts results in a sensation of the world spinning and also possible hearing loss or ringing in the ears. It can occur as a single attack, a series of attacks, or a persistent condition that diminishes over three to six weeks. It may be associated with nausea, vomiting, and eye nystagmus.

<span class="mw-page-title-main">Benign paroxysmal positional vertigo</span> Medical condition

Benign paroxysmal positional vertigo (BPPV) is a disorder arising from a problem in the inner ear. Symptoms are repeated, brief periods of vertigo with movement, characterized by a spinning sensation upon changes in the position of the head. This can occur with turning in bed or changing position. Each episode of vertigo typically lasts less than one minute. Nausea is commonly associated. BPPV is one of the most common causes of vertigo.

<span class="mw-page-title-main">Electronystagmography</span>

Electronystagmography (ENG) is a diagnostic test to record involuntary movements of the eye caused by a condition known as nystagmus. It can also be used to diagnose the cause of vertigo, dizziness or balance dysfunction by testing the vestibular system. Electronystagmography is used to assess voluntary and involuntary eye movements. It evaluates the cochlear nerve and the oculomotor nerve. The ENG can be used to determine the origin of various eye and ear disorders.

<span class="mw-page-title-main">Otolithic membrane</span>

The otolithic membrane is a fibrous structure located in the vestibular system of the inner ear. It plays a critical role in the brain's interpretation of equilibrium. The membrane serves to determine if the body or the head is tilted, in addition to the linear acceleration of the body. The linear acceleration could be in the horizontal direction as in a moving car or vertical acceleration such as that felt when an elevator moves up or down.

The Dix–Hallpike or Nylén–Bárány test is a diagnostic maneuver from the group of rotation tests used to identify benign paroxysmal positional vertigo (BPPV).

<span class="mw-page-title-main">DizzyFIX</span>

The DizzyFIX is a home medical device designed to assist in the treatment of benign paroxysmal positional vertigo (BPPV) and its associated vertigo. The device is a head-worn representation of semi-circular canals. The device is filled with fluid and a particle representing the otoconia associated with BPPV. The device works like a visual set of instructions and guides the user through the treatment maneuver for BPPV. This maneuver is called the particle repositioning maneuver or Epley maneuver.

The semicircular canal dehiscence (SCD) is a category of rare neurotological diseases/disorders affecting the inner ears, which gathers the superior SCD, lateral SCD and posterior SCD. These SCDs induce SCD syndromes (SCDSs), which define specific sets of hearing and balance symptoms. This entry mainly deals with the superior SCDS.

The Epley maneuver or repositioning maneuver is a maneuver used by medical professionals to treat one common cause of vertigo, benign paroxysmal positional vertigo (BPPV) of the posterior or anterior canals of the ear. The maneuver works by allowing free-floating particles, displaced otoconia, from the affected semicircular canal to be relocated by using gravity, back into the utricle, where they can no longer stimulate the cupula, therefore relieving the patient of bothersome vertigo. The maneuver was developed by the physician, John M. Epley, and was first described in 1980.

<span class="mw-page-title-main">Nystagmus</span> Dysfunction of eye movement

Nystagmus is a condition of involuntary eye movement, sometimes informally called "dancing eyes". People can be born with it but more commonly acquire it in infancy or later in life. In many cases it may result in reduced or limited vision.

<span class="mw-page-title-main">Nausea</span> Medical symptom or condition

Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat.

Vestibular migraine (VM) is vertigo with migraine, either as a symptom of migraine or as a related neurological disorder.

Videonystagmography (VNG) is a technology for testing inner ear and central motor functions, a process known as vestibular assessment. It involves the use of infrared goggles to trace eye movements during visual stimulation and positional changes. VNG can determine whether dizziness is caused by inner ear disease, particularly benign paroxysmal positional vertigo (BPPV), as opposed to some other cause such as low blood pressure or anxiety.

The righting reflex, also known as the labyrinthine righting reflex, is a reflex that corrects the orientation of the body when it is taken out of its normal upright position. It is initiated by the vestibular system, which detects that the body is not erect and causes the head to move back into position as the rest of the body follows. The perception of head movement involves the body sensing linear acceleration or the force of gravity through the otoliths, and angular acceleration through the semicircular canals. The reflex uses a combination of visual system inputs, vestibular inputs, and somatosensory inputs to make postural adjustments when the body becomes displaced from its normal vertical position. These inputs are used to create what is called an efference copy. This means that the brain makes comparisons in the cerebellum between expected posture and perceived posture, and corrects for the difference. The reflex takes 6 or 7 weeks to perfect, but can be affected by various types of balance disorders.

Subjective Visual Vertical (SVV) is a diagnostic test of the inner ear to assess a patient's perception of verticality and detect if there are signs of an abnormal tilt that can cause dizziness or vertigo. It investigates the function of the utricle, one of two otolith organs located in the vertebrate inner ear, to evaluate the perception of verticality. As its name suggests, the test is subjective and cannot directly diagnose Acute Vestibular Syndrome (AVS), Ménière’s disease, vestibular migraine, vestibular neuritis or other central nervous system pathologies.

<span class="mw-page-title-main">Vestibular rehabilitation</span> Form of physical therapy for vestibular disorders

Vestibular rehabilitation (VR), also known as vestibular rehabilitation therapy (VRT), is a specialized form of physical therapy used to treat vestibular disorders or symptoms, characterized by dizziness, vertigo, and trouble with balance, posture, and vision. These primary symptoms can result in secondary symptoms such as nausea, fatigue, and lack of concentration. All symptoms of vestibular dysfunction can significantly decrease quality of life, introducing mental-emotional issues such as anxiety and depression, and greatly impair an individual, causing them to become more sedentary. Decreased mobility results in weaker muscles, less flexible joints, and worsened stamina, as well as decreased social and occupational activity. Vestibular rehabilitation therapy can be used in conjunction with cognitive behavioral therapy in order to reduce anxiety and depression resulting from an individual's change in lifestyle.

Inner ear decompression sickness, (IEDCS) or audiovestibular decompression sickness is a medical condition of the inner ear caused by the formation of gas bubbles in the tissues or blood vessels of the inner ear. Generally referred to as a form of decompression sickness, it can also occur at constant pressure due to inert gas counterdiffusion effects.


  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Post, RE; Dickerson, LM (2010). "Dizziness: a diagnostic approach". American Family Physician. 82 (4): 361–369. PMID   20704166. Archived from the original on 2013-06-06.
  2. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Hogue, JD (June 2015). "Office Evaluation of Dizziness". Primary Care: Clinics in Office Practice. 42 (2): 249–258. doi:10.1016/j.pop.2015.01.004. PMID   25979586.
  3. 1 2 3 4 5 6 von Brevern, M; Neuhauser, H (2011). "Epidemiological evidence for a link between vertigo & migraine". Journal of Vestibular Research. 21 (6): 299–304. doi:10.3233/VES-2011-0423. PMID   22348934.
  4. Wicks, RE (January 1989). "Alternobaric vertigo: an aeromedical review". Aviation, Space, and Environmental Medicine. 60 (1): 67–72. PMID   2647073.
  5. Buttaro, Terry Mahan; Trybulski, JoAnn; Polgar-Bailey, Patricia; Sandberg-Cook, Joanne (2012). Primary Care – E-Book: A Collaborative Practice (4 ed.). Elsevier Health Sciences. p. 354. ISBN   978-0323075855. Archived from the original on 2017-09-08.
  6. Falvo, Donna R. (2014). Medical and psychosocial aspects of chronic illness and disability (5 ed.). Burlington, MA: Jones & Bartlett Learning. p. 273. ISBN   9781449694425. Archived from the original on 2015-07-02.
  7. Wardlaw, Joanna M. (2008). Clinical neurology. London: Manson. p. 107. ISBN   9781840765182. Archived from the original on 2015-07-02.
  8. Goebel, Joel A. (2008). Practical management of the dizzy patient (2nd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 97. ISBN   9780781765626. Archived from the original on 2015-07-02.
  9. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Kerber, KA (2009). "Vertigo and dizziness in the emergency department". Emergency Medicine Clinics of North America. 27 (1): 39–50. doi:10.1016/j.emc.2008.09.002. PMC   2676794 . PMID   19218018.
  10. 1 2 3 4 5 6 7 8 9 10 11 12 13 Neuhauser HK, Lempert T (November 2009). "Vertigo: epidemiologic aspects" (PDF). Seminars in Neurology. 29 (5): 473–81. doi:10.1055/s-0029-1241043. PMID   19834858.
  11. 1 2 3 Wippold 2nd, FJ; Turski, PA (2009). "Vertigo and hearing loss". American Journal of Neuroradiology. 30 (8): 1623–1625. PMC   7051589 . PMID   19749077. Archived from the original on 2013-02-05.
  12. "Chapter 14: Evaluation of the Dizzy Patient". Archived from the original on 2009-07-06. Retrieved 2009-08-06.
  13. 1 2 Berkow R., ed. (1992). The Merck manual of diagnostics and therapy. Rahway: Merck & Co Inc. p. 2844.
  14. Ropper, AH; Brown RH (2014). Adams and Victor's Principles of Neurology (tenth ed.). NY, Chicago, San Francisco. p. 303.
  15. 1 2 U.S. National Library of Medicine (2011). "Vertigo-associated disorders". National Institutes of Health. Archived from the original on 25 January 2013. Retrieved 2 January 2013.
  16. 1 2 3 4 5 6 7 8 9 10 Karatas, M (2008). "Central Vertigo and Dizziness". The Neurologist. 14 (6): 355–364. doi:10.1097/NRL.0b013e31817533a3. PMID   19008741. S2CID   21444226.
  17. Guerraz, M.; Yardley, L; Bertholon, P; Pollak, L; Rudge, P; Gresty, MA; Bronstein, AM (2001). "Visual vertigo: symptom assessment, spatial orientation and postural control". Brain. 124 (8): 1646–1656. doi: 10.1093/brain/124.8.1646 . PMID   11459755.
  18. Xie, J; Talaska, AE; Schacht, J (2011). "New developments in aminoglycoside therapy and ototoxicity". Hearing Research. 281 (1–2): 28–37. doi:10.1016/j.heares.2011.05.008. PMC   3169717 . PMID   21640178.
  19. 1 2 Jahn, K; Dieterich, M (December 2011). "Recent advances in the diagnosis and treatment of balance disorders". Journal of Neurology. 258 (12): 2305–2308. doi:10.1007/s00415-011-6286-4. PMID   22037955. S2CID   22123074.
  20. 1 2 Dieterich, Marianne (2007). "Central vestibular disorders". Journal of Neurology. 254 (5): 559–568. doi:10.1007/s00415-006-0340-7. PMID   17417688. S2CID   22647113.
  21. 1 2 3 4 Taylor, J; Goodkin, HP (2011). "Dizziness and vertigo in the adolescent". Otolaryngologic Clinics of North America. 44 (2): 309–321. doi:10.1016/j.otc.2011.01.004. PMID   21474006.
  22. "Vertigo: Dizziness and Vertigo: Merck Manual Home Edition". Archived from the original on 2010-02-13.
  23. Vieira, ER; Freund-Heritage, R; Da Costa, BR (September 2011). "Risk factors for geriatric patient falls in rehabilitation hospital settings: a systematic review". Clinical Rehabilitation. 25 (9): 788–799. doi:10.1177/0269215511400639. PMID   21504956. S2CID   22180203.
  24. Ricci, NA; Aratani, MC; Doná, F; MacEdo, C; Caovilla, HH; Ganança, FF (2010). "A systematic review about the effects of the vestibular rehabilitation of middle-age and older adults". Revista Brasileira de Fisioterapia. 14 (5): 361–371. doi: 10.1590/S1413-35552010000500003 . PMID   21180862.
  25. 1 2 3 4 5 Strupp, M; Thurtell, MJ; Shaikh, AG; Brandt, T; Zee, DS; Leigh, RJ (July 2011). "Pharmacotherapy of vestibular and ocular motor disorders, including nystagmus". Journal of Neurology. 258 (7): 1207–1222. doi:10.1007/s00415-011-5999-8. PMC   3132281 . PMID   21461686.
  26. Kaneko, A; Asai, N; Kanda, T (2005). "The influence of age on pressure perception of static and moving two-point discrimination in normal subjects". Journal of Hand Therapy. 18 (4): 421–424. doi:10.1197/j.jht.2005.09.010. PMID   16271689.
  27. Kutz, JW Jr. (September 2010). "The dizzy patient". Medical Clinics of North America. 94 (5): 989–1002. doi:10.1016/j.mcna.2010.05.011. PMID   20736108.
  28. Angelaki, DE (July 2004). "Eyes on target: what neurons must do for the vestibuloocular reflex during linear motion". Journal of Neurophysiology. 92 (1): 20–35. doi:10.1152/jn.00047.2004. PMID   15212435. S2CID   15755814.
  29. Kuo, CH; Pang, L; Chang, R (June 2008). "Vertigo-part 2-management in general practice" (PDF). Australian Family Physician. 37 (6): 409–413. PMID   18523693. Archived (PDF) from the original on 2013-10-19.
  30. "Core Curriculum: Inner Ear Disease —Vertigo". Baylor College of Medicine. 23 January 2006. Archived from the original on 2007-06-30. Retrieved 19 September 2007.
  31. 1 2 "Diagnosis: How are vestibular disorders diagnosed?". Vestibular Disorders Association. 2013. Archived from the original on 22 January 2013. Retrieved 9 January 2013.
  32. Gold, Daniel. "Demonstration of HINTS examination in a normal subject". Neuro-Ophthalmology Virtual Education Library (NOVEL): Daniel Gold Collection. Spencer S. Eccles Health Sciences Library. Retrieved 20 November 2019.
  33. 1 2 3 4 Tarnutzer, Alexander A.; Berkowitz, Aaron L.; Robinson, Karen A.; Hsieh, Yu-Hsiang; Newman-Toker, David E. (2011-06-14). "Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome". Canadian Medical Association Journal. 183 (9): E571–E592. doi:10.1503/cmaj.100174. ISSN   0820-3946. PMC   3114934 . PMID   21576300.
  34. Nachum, Z; Shupak, A; Spitzer, O; Sharoni, Z; Doweck, I; Gordon, C.R. (May 2001). "Inner ear decompression sickness in sport compressed-air diving". The Laryngoscope. 111 (5): 851–6. doi:10.1097/00005537-200105000-00018. PMID   11359165. S2CID   3143075.
  35. 1 2 MedlinePlus (2011). "Benign positional vertigo". U.S. National Institutes of Health. Archived from the original on 25 January 2013. Retrieved 2 January 2013.
  36. Alvarenga, GA; Barbosa, MA; Porto, CC (2011). "Benign paroxysmal positional vertigo without nystagmus: diagnosis and treatment". Brazilian Journal of Otorhinolaryngology. 77 (6): 799–804. doi: 10.1590/S1808-86942011000600018 . PMC   9443834 . PMID   22183288.
  37. Prim-Espada, MP; De Diego-Sastre, JI; Pérez-Fernández, E (June 2010). "[Meta-analysis on the efficacy of Epley's manoeuvre in benign paroxysmal positional vertigo]" (PDF). Neurologia. 25 (5): 295–299. doi: 10.1016/j.nrl.2010.01.004 . PMID   20643039. Archived (PDF) from the original on 2013-02-19.
  38. 1 2 Semaan, MT; Megerian, CA (April 2011). "Ménière's disease: a challenging and relentless disorder". Otolaryngologic Clinics of North America. 44 (2): 383–403. doi:10.1016/j.otc.2011.01.010. PMID   21474013.
  39. 1 2 Goddard, JC; Fayad, JN (2011). "Vestibular Neuritis". Otolaryngologic Clinics of North America. 44 (2): 361–365. doi:10.1016/j.otc.2011.01.007. PMID   21474010. S2CID   36332043.
  40. 1 2 Kramer, MD, Jeffrey. "Vestibular Migraine". Vestibular Disorders Association.
  41. 1 2 Powell, Mark (2008). Deco for Divers. Southend-on-Sea: Aquapress. p. 70. ISBN   978-1-905492-07-7.
  42. Ross, HE (December 1976). "The direction of apparent movement during transient pressure vertigo". Undersea Biomedical Research. 3 (4): 403–10. PMID   10897867. Archived from the original on 9 July 2010. Retrieved 2 June 2017.{{cite journal}}: CS1 maint: unfit URL (link)
  43. Hamilton, Robert W; Thalmann, Edward D (2003). "10.2: Decompression Practice". In Brubakk, Alf O; Neuman, Tom S (eds.). Bennett and Elliott's physiology and medicine of diving (5th Revised ed.). United States: Saunders. p. 477. ISBN   978-0-7020-2571-6. OCLC   51607923.
  44. Burton, Steve (December 2004). "Isobaric Counter Diffusion". ScubaEngineer. Archived from the original on 10 March 2009. Retrieved 10 January 2010.
  45. Zaidi HA, Albuquerque FC, Chowdhry SA, Zabramski JM, Ducruet AF, Spetzler RF (2014). "Diagnosis and management of bow hunter's syndrome: 15-year experience at barrow neurological institute". World Neurosurg. 82 (5): 733–8. doi:10.1016/j.wneu.2014.02.027. PMID   24549025.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  46. Go G, Hwang SH, Park IS, Park H (2013). "Rotational Vertebral Artery Compression : Bow Hunter's Syndrome". J Korean Neurosurg Soc. 54 (3): 243–5. doi:10.3340/jkns.2013.54.3.243. PMC   3836934 . PMID   24278656.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  47. Huon, LK; Fang, TY; Wang, PC (July 2012). "Outcomes of intratympanic gentamicin injection to treat Ménière's disease". Otology & Neurotology. 33 (5): 706–714. doi:10.1097/MAO.0b013e318259b3b1. PMID   22699980. S2CID   32209105.
  48. Huppert, D; Strupp, M; Mückter, H; Brandt, T (March 2011). "Which medication do I need to manage dizzy patients?". Acta Oto-Laryngologica. 131 (3): 228–241. doi:10.3109/00016489.2010.531052. PMID   21142898. S2CID   32591311.
  49. Fauci, Anthony S.; Daniel L. Kasper; Dan L. Longo; Eugene Braunwald; Stephen L. Hauser; J. Larry Jameson (2008). Chapter 22. Dizziness and Vertigo Harrison's Principles of Internal Medicine (17th ed.). New York: McGraw-Hill. ISBN   978-0-07-147691-1.
  50. Marx, John (2010). Rosen's emergency medicine: concepts and clinical practice (7th ed.). Philadelphia, PA: Mosby/Elsevier. p.  1813. ISBN   978-0-323-05472-0.
  51. "Definition of vertigo". Merriam-Webster Online Dictionary. Archived from the original on 2007-10-07. Retrieved 2007-09-19.
Listen to this article (16 minutes)
This audio file was created from a revision of this article dated 25 September 2019 (2019-09-25), and does not reflect subsequent edits.