{"id":1759,"date":"2026-01-11T04:00:00","date_gmt":"2026-01-11T00:00:00","guid":{"rendered":"http:\/\/vitamed.test\/vertigo-causes-diagnosis-threatment\/"},"modified":"2026-09-14T13:56:19","modified_gmt":"2026-09-14T09:56:19","slug":"vertigo-causes-diagnosis-threatment","status":"publish","type":"post","link":"https:\/\/vitamed.production.am\/en\/vertigo-causes-diagnosis-threatment\/","title":{"rendered":"VERTIGO &#8211; CAUSES, DIAGNOSIS, THREATMENT"},"content":{"rendered":"<p><!-- vitamed:content-featured-image:start --><\/p>\n<figure class=\"article-content-thumbnail-wrap\"><img decoding=\"async\" width=\"1920\" height=\"1080\" src=\"https:\/\/vitamed.production.am\/wp-content\/uploads\/2026\/05\/vertigo.jpg\" class=\"article-content-thumbnail\" alt=\"VERTIGO - CAUSES, DIAGNOSIS, THREATMENT\" loading=\"lazy\" \/><\/figure>\n<p><!-- vitamed:content-featured-image:end --><\/p>\n<h2>What is Vertigo?<\/h2>\n<p><strong>Vertigo <\/strong>is the sensation of false rotation of the body or surrounding objects, associated with dysfunction of the vestibular system. It is a type of systemic dizziness, distinct from nonspecific complaints such as &quot;fog in the head&quot;, &quot;unsteadiness&quot;, or &quot;near-fainting&quot;.<\/p>\n<p><strong>Vertigo <\/strong>is not a diagnosis, but a symptom that occurs in disorders of both peripheral and central origin. Accurate diagnosis and differentiation are key to effective treatment.<\/p>\n<h2>Causes and Risk Factors<\/h2>\n<p>Vertigo arises from dysfunction of the vestibular system, which includes the inner ear, vestibular nerve, brainstem, and cerebellum.<\/p>\n<p><strong>Main causes:<\/strong><\/p>\n<p>Peripheral vertigo (up to 80% of cases):<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Benign paroxysmal positional vertigo (BPPV) &mdash; most common cause<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Vestibular neuritis<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Meniere&rsquo;s disease<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Labyrinthitis<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Ear trauma and surgical interventions<\/p>\n<p><strong>Central vertigo:<\/strong><\/p>\n<p>&bull;&nbsp;&nbsp; &nbsp;Cerebellar or brainstem stroke<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Multiple sclerosis<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Tumors of the posterior cranial fossa<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Migraine-associated vertigo<\/p>\n<p><strong>Risk factors:<\/strong><\/p>\n<p>&bull;&nbsp;&nbsp; &nbsp;Age &gt;60 years<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Arterial hypertension<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Atherosclerosis<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Hearing impairment<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Head trauma<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Viral infections<\/p>\n<h2>Classification and Types<\/h2>\n<p>By location:<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Peripheral (inner ear, vestibular nerve)<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Central (brainstem, cerebellum)<\/p>\n<p>By duration of episodes:<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Seconds: benign positional vertigo<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Minutes &ndash; hours: Meniere&rsquo;s disease<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Hours &ndash; days: vestibular neuritis, stroke<\/p>\n<p>By provoking factors:<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Positional &mdash; triggered by head movement (typical for BPPV)<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Spontaneous &mdash; without apparent cause<\/p>\n<p>Main Symptoms<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Sudden sensation of spinning (of body or surroundings)<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Balance disturbance<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Nausea, vomiting<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Sweating, pallor<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Worsening of symptoms with head movement<br \/>\n&bull;&nbsp;&nbsp; &nbsp;In peripheral vertigo: often nystagmus (rhythmic eye movements)<br \/>\n&bull;&nbsp;&nbsp; &nbsp;In central forms: neurological symptoms (dysarthria, diplopia, ataxia)<\/p>\n<h2>Diagnosis<\/h2>\n<p>Diagnosis is based on history, clinical examination, and vestibular testing.<\/p>\n<p><strong>Main methods:<\/strong><br \/>\n&bull;&nbsp;&nbsp; &nbsp;Clinical assessment &mdash; identification of nystagmus type, balance, and head-movement-induced symptoms<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Dix-Hallpike maneuver &mdash; gold standard for diagnosing BPPV<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Vestibular tests: Head Impulse Test, Romberg, Unterberger<\/p>\n<p><strong>Instrumental diagnostics:<\/strong><br \/>\n&bull;&nbsp;&nbsp; &nbsp;Audiogram &mdash; in suspected Meniere&rsquo;s disease<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Brain MRI &mdash; in suspected central origin<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Videonystagmography &mdash; evaluation of eye movements<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Vestibular EMG, posturography &mdash; in complex cases<\/p>\n<h2>Modern Treatment Approaches<\/h2>\n<p>Treatment depends on the underlying cause of vertigo and aims to relieve symptoms and restore vestibular function.<\/p>\n<p>1. Benign paroxysmal positional vertigo (BPPV):<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Positional maneuvers (Epley, Semont) &mdash; highly effective, 1&ndash;2 sessions often sufficient<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Medications are ineffective in BPPV<\/p>\n<p>2. Vestibular neuritis:<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Glucocorticoids &mdash; within the first 72 hours<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Symptomatic therapy: betahistine, metoclopramide, dimenhydrinate<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Early vestibular rehabilitation (physical exercises)<\/p>\n<p>3. Meniere&rsquo;s disease:<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Salt-restricted diet<br \/>\n&bull;&nbsp;&nbsp; &nbsp;In severe cases &mdash; intratympanic steroid or gentamicin injection<\/p>\n<p>4. Central vertigo:<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Treatment of the underlying condition (stroke, tumor, demyelination)<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Often requires hospitalization and neurological supervision<\/p>\n<h2>When to See a Doctor<\/h2>\n<p>Seek immediate medical attention if:<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Vertigo is accompanied by limb weakness, speech disturbances, or double vision<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Onset is sudden, especially in the presence of stroke risk factors<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Hearing loss or tinnitus is observed<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Symptoms persist for more than 3 days or worsen<br \/>\n&bull;&nbsp;&nbsp; &nbsp;Quality of life, work capacity, or mobility is impaired<br \/>\n&nbsp;<\/p>\n<h2 style=\"text-align: justify\">Neurological Services in Armenia, at &laquo;VitaMed&raquo; MC (Yerevan, Charentsavan, Stepanavan)<\/h2>\n<table border=\"1\" cellpadding=\"1\" cellspacing=\"1\" style=\"width:500px\">\n<tbody>\n<tr>\n<td>Initial consultation with a neurologist, including repeated consultation within 10 days<\/td>\n<td>12.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Initial online consultation with a neurologist, including repeated consultation within 10 days<\/td>\n<td>10.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Repeated consultation with a neurologist (3rd visit)<\/td>\n<td>6.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>EMG (electromyography) &#8211; upper extremities<\/td>\n<td>15.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>ENMG (electromyography) &#8211; lower extremities<\/td>\n<td>15.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>ENMG (electromyography) &#8211; lower and upper extremities<\/td>\n<td>25.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Doctor home visit<\/td>\n<td>20.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Diagnostics + therapeutic massage 60 minutes<\/td>\n<td>30.000 AMD<\/td>\n<\/tr>\n<tr>\n<td>Diagnostics + therapeutic massage 30 minutes<\/td>\n<td>20.000 AMD<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"<p>Vertigo is the sensation of false rotation of the body or surrounding objects, associated with dysfunction of the vestibular system.<\/p>\n","protected":false},"author":1,"featured_media":1754,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[173,171],"tags":[],"class_list":["post-1759","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en","category-blog"],"acf":[],"_links":{"self":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1759","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/comments?post=1759"}],"version-history":[{"count":3,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1759\/revisions"}],"predecessor-version":[{"id":6460,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/posts\/1759\/revisions\/6460"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/media\/1754"}],"wp:attachment":[{"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/media?parent=1759"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/categories?post=1759"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vitamed.production.am\/en\/wp-json\/wp\/v2\/tags?post=1759"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}