It comes on suddenly. You feel like you're spinning—or maybe the world is spinning around you. Your stomach heaves, and you hold onto something so you don't fall. This is vertigo, a hallucination of motion—a mismatch between reality and the signals your eyes, inner ears, and sense of touch are sending your brain. Vertigo is a symptom, not a disease—an indication that something is wrong in the body—and it's surprisingly common. Here's what you need to know about the condition.
1. HAVING VERTIGO ISN'T THE SAME THING AS BEING DIZZY.
Dizziness is an umbrella term that describes the sensation of feeling lightheaded or faint. As kids, many of us experienced (and even enjoyed) that kind of garden-variety dizziness while spinning on a merry-go-round, but the sensation can also be caused by dehydration, motion sickness, or even a drop in blood pressure after standing up too fast.
While vertigo does make you dizzy, it also makes you feel like you’re spinning, swaying, or tilting. Some people with vertigo sense their bodies moving in space even though they’re standing still, while others sense their surroundings moving around them. A good way to tell you're experiencing vertigo and not just dizziness is that you feel like you're going to lose your lunch: “A person with vertigo can feel ill with nausea, vomiting, and other motion sickness-like symptoms,” says David Zee, a neurologist at Johns Hopkins University and a specialist in vertigo.
2. IT'S A VESTIBULAR DISORDER.
The name refers to the system located in parts of the inner ear and the brain that control balance and eye movements. The most common vestibular disorders often induce vertigo. Others include bilateral vestibular hypofunction (which causes balance problems), acoustic neuroma (a kind of benign tumor that can cause tinnitus or hearing loss), and a variety of autoimmune inner ear diseases.
3. MOST CASES OF VERTIGO ARE CAUSED BY TINY ROCKS IN YOUR HEAD …
Doctors split vertigo into two categories: peripheral or central. The former, which originates in the inner ear, is far more prevalent than the latter.
The most common form of peripheral vertigo is benign paroxymal positional vertigo (BPPV). BPPV comes on quickly, causing disorientation and stumbling; some even fall out of bed. (People can mistake it for a stroke, and not without reason—sudden vertigo and loss of balance experienced at the same time can be signs of one.) Most episodes last about a minute and recur over a period of a few days or weeks.
The majority of peripheral vertigo is caused by otoconia (also called canaliths), tiny limestone and protein crystals that reside deep inside your ear in the vestibule. You’d need a high-powered microscope to see a single otoconium—they’re roughly 10 microns across, or about 0.000393701 inches. Despite their small size, "otoconia create a lot of mischief,” Zee says. “These little stones can get dislodged and kind of float around, producing a powerful false sense of spinning.”
Most of us likely have a few renegade stones floating around in our inner ears, but it’s only when large clumps of more than three or four stones form and get loose that there’s a problem. Why they dislodge and relocate remains a mystery, but in some cases, the stones' movements can be triggered by external motion—a knock on the head or a ride on a bumpy road.
4. … BUT THERE ARE OTHER TRIGGERS.
Migraine headaches can bring on the dizzying sensation, as can lying in the magnetic field of an MRI machine. Other causes include labyrinthitis, an infection in the inner ear, and vestibular neuronitis, an infection of the vestibular nerve, which controls balance. Some people have a rare type of chronic peripheral vertigo called Meniere’s disease, which is caused by a buildup of fluid in the inner ear. Often doctors can’t pinpoint a specific cause for an episode of vertigo.
5. ONE TYPE OF VERTIGO CAN PERSIST FOR A LIFETIME—BUT IT'S RARE.
Far less common is central vertigo, which originates in the brain. Symptoms can vary, but a person with central vertigo is often unable to walk due to severe imbalance and may have nystagmus—strange, involuntary eye movements. This type of vertigo can be caused by diseases or injuries to the brain, such as multiple sclerosis, tumors, concussions, or strokes. In some cases, it lasts for weeks or even the rest of someone's life, especially if they have permanent brain damage.
6. VERTIGO AFFECTS MILLIONS OF PEOPLE OF ALL AGES.
Nearly one-third of people over the age of 40 in the U.S.—roughly 69 million people—will experience vertigo at least once in their lives. It’s much more common in older people, especially those over the age of 60. But anyone can get vertigo, including children (though it may be harder to spot in kids because they can have difficulty describing their symptoms). Professional golfer Jason Day was just 27 when he developed vertigo during the U.S. Open, and basketball player Pau Gasol was in his early thirties when the condition benched him. Some medical historians believe Charles Darwin suffered from vertigo later in life.
7. WOMEN ARE THREE TIMES MORE LIKELY TO DEVELOP VERTIGO THAN MEN—BUT SCIENTISTS DON'T KNOW WHY.
Recent research suggests the disparity might be related to bone loss caused by aging, vitamin D deficiency (which impairs how the body metabolizes calcium—a key component of the otoconia’s mineral composition), or the increased frequency of migraine among women.
8. VERTIGO CAN BE EXTREMELY DISTRESSFUL.
Because it's so disorienting and comes on so suddenly, vertigo can cause anxiety and panic attacks. Chronic vertigo can cause depression in some people because doing everyday tasks—like caring for themselves, their children, or their family—is often impossible. They might even lose their job because driving is out of the question.
9. IT'S POSSIBLE TO GET SOME RELIEF FROM CERTAIN MEDICATIONS …
Drug treatments vary, based on the type of vertigo a person has, and generally target the symptoms of vertigo, not the cause. Antiemetics such as meclizine may inhibit the nausea or vomiting that accompanies most types of vertigo. For migraine-associated vertigo, doctors may prescribe beta blockers, anticonvulsants, or antidepressants. People with Meniere's disease may benefit from steroids or non-pharmaceutical approaches, such as a low-salt diet, which reduces fluid retention, or surgical procedures that help drain the inner ear.
10. … BUT PHYSICAL THERAPY IS THE ONLY THING THAT REALLY HELPS MOST CASES OF VERTIGO.
The most commonly used therapy for BPPV is the Epley maneuver (also known as a canalith repositioning procedure). Essentially, the exercises are human versions of those ball-in-a-maze puzzles you played as a kid, where you rolled a bead around in a maze, trying to get the bead to go into a hole. The goal is to roll the renegade otoconia (the beads) through the maze of canals inside your ear and return them to the vestibule (the hole). These moves, which take 15 minutes or less, resolve symptoms in about two-thirds or more of people with vertigo—usually after just a few tries.
11. DANCING CAN MAKE IT BETTER.
As you get older, you lose neurons in your inner ears, your brain’s coordination center, and in your feet—a triple whammy of losses that sets up a perfect storm for balance problems, Zee tells Mental Floss. But activities that challenge your sense of balance—like tai chi, yoga, or dancing—help in the long run. You don't get have to be as nimble as Johnny Castle log dancing or blind Frank Slade doing the tango—just get moving to the beat when your favorite songs come on.
12. VERTIGO DOESN'T STOP A GUINNESS WORLD RECORD HOLDER FROM SCALING BUILDINGS.
In 1982, French climber Alain Robert sustained massive injuries when he took a header from a rocky cliff during one climb—and though he recovered from multiple broken bones, the severe head trauma he sustained left him with chronic vertigo. Despite his condition, Robert returned to climbing (almost always without safety equipment), tackling the Empire State Building, the Eiffel Tower, and a multitude of other tall structures, eventually scaling the Burj Khalifa—the world’s tallest building. He now holds the Guinness World Record for climbing the most buildings.
13. IN VERTIGO, HITCHCOCK GOT THE SPECIAL EFFECTS RIGHT BUT THE CONDITION WRONG.
Named the “greatest film of all time” by the British Film Institute’s Sight and Sound magazine, Vertigo, starring Jimmy Stewart and Kim Novak, is a twisted tale about the human psyche, full of mystery, romance, and suspense—classic Hitchcock. The film is famous for its pioneering use of the dolly zoom—a camera technique sometimes called "the Vertigo effect" that recreates the unsettling experience. Although Hitchcock got the special effects right, the condition that Jimmy Stewart’s character had is not vertigo—it's acrophobia, or fear of heights. When a person with acrophobia looks down from a great height, they might feel vertiginous—but they're not experiencing a vestibular disorder. The reaction may be rooted in humans’ natural fear of falling.