Most children love to roll or spin until they feel dizzy. But though adults may also enjoy amusement rides, unwanted dizziness is no fun. There are many potential causes, and diagnosis can be difficult.

What Are the Causes of Vertigo?

A leading expert on balance disorders helps us sort out the various types of vertigo and how they can be treated.

This Week’s Guest:

David M. Kaylie, MD, FACS, is Associate Professor and Medical Director of the Vestibular Lab in the Department of Otolaryngology – Head and Neck Surgery at Duke University Medical Center.
Dr. Kaylie suggests that if your physician cannot solve your balance disorder, you may need to look for a specialist. One place to look is:

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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Air Date:April 7, 2012

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  1. smb

    The best source for information and referrals is the Vestibular Disorders Association of America (VEDA). They have and excellent website, a publication and list of practitioners nationwide who are skilled in the treatment of dizziness and vertigo and other vestibular disorders.
    I have had BPPV ( twice), neuritis and another unknown balance problem. Also had 6 months of vestibular therapy (it literally saved my life). the information is invaluable.

  2. D.McB.

    Wonderful interview. My husband has been suffering for 12 yrs. with vertigo. We have been to doctors from N.Y.City to Tampa, Fl. and every kind. Most have been understanding but not helpful and others not interested in getting to the answers. All expected him to live with it. Needless to say, our lives have forever been changed. He has had the tests Dr. Kaylie spoke of numerous times and brain scans. An ENT doc. has him on Meclazine twice a day. (he is now going to be off of it ) Same doc. put him on a tranquilizer and he took a bad fall hurting his ribs.
    People do not believe he is so ill because other than too many red blood cells that he takes meds. for he has had numerous xrays, ct.scans, etc. and is o.k. physically. Tried to go to Mayo but they do not accept HMO’S or CASH. Two wks. ago we started with an new Neurologist who sent for his reports from said tests and we are waiting to hear from him. We recently went to a Vestibular Therapist but after 2 wks. suggested we do the therapy at home. Will look up physicians. Thank you for the Dr. Kaylie interview. We can hope again. Mrs. McB.

  3. Robinlee

    We need a cure of treatment that really works, this is a terrible disease!!

  4. susan

    Susan- again sorry. I meant that the Sea-bands are elastic wrist band that have a plastic ball that rests on a acupressure point. I wear them for about 3/4 of a day when I get “wavy” and the dizziness goes away and stays away. I thought they were crazy but I bought them when I was desperate. They can be used by children who get car sick and are used for people during chemo too.

  5. Pam

    I am that person Dr. Kaylie described. I walk with a constant “floaty” feeling waiting for my surroundings to catch up with me. I try to function like a normal person, but it’s challenging to sit in a meeting or focus on one person for conversation w/out feeling like I’m going to fall backwards. Forget shopping-it immediately puts me in overstimulation mode and I have to hang on to the grocery cart for dear life.
    And I can’t sit on a bar stool in my own kitchen without fear of falling off. IF I didn’t have a dog to walk me, I wouldn’t be able to take daily walks on my own. The anxiety is something I never experienced until all of this started 5 years ago. My ENT & I have gone down a list of possible triggers and we’ve tried everything, from Epley maneuver to various drugs to chiropractic care and thinking it may be hypothyroid problem.
    The ONLY thing that has worked somewhat is the birth control pill, even though I’m 53 yrs old and still getting periods. It took 3 months for any effects to show up but now after being on the pill for 6 months, my female internist & I have come to the conclusion that perhaps the 25 mg dose is too strong and now trying lower dosage. Still can’t tell if this is migraineous vertigo as the roller coaster of estrogen/progesterone levels tend to cause migraines which do trigger fullness in my ears/head, difficulty working on the computer for long periods of time w/out feeling very “floaty”, severe nausea and horrible anxiety. I will be calling Dr. Kaylie to schedule appt w the lab. I am fortunate enough to live in Raleigh NC.
    I only noticed one comment refer to hormones. Has anyone else had success with hormone therapy as a solution to this chronic challenging feeling?

  6. susan

    You might want to try “seabands”. You can find them at the drugstore next to the dramadine. These are two elastic bands worn on the wrists. The bands have a plastic ball that rests on an acupuncture point for dizziness. I have found this to be the most helpful thing for BPPV.

  7. Karen

    This program was so informative. My mother has been diagnosed with vertigo just recently. For the past few months we have had an awful time with it. She is 76, and we have been in the emergency room once because of it. I fear that she will fall and that could be catastrophic in an elderly person. But her present doctor (and I have been telling her to change doctors) has told her to LIVE WITH IT… when I heard your show last night and you said that you do NOT HAVE TO LIVE WITH IT, I was ecstatic.
    It is so scary for me to see my Mom walking along the wall to get around. I just happened to turn to the station WBGO in NJ, and was like they are talking about VERTIGO. I arrived home and didn’t get out of the car until the broadcast was over. I then immediately called my Mom and told her about the show, and that I was going to get her the CD. Because I am not certain the type of vertigo she has has been diagnosed.

  8. Julie

    Hi all! First off, I would like to thank the People’s Pharmacy for posting this thread! I am a pharmacist and a yoga teacher. I started with the “symptoms” almost a year ago, mostly when switching lanes while driving. I was misdiagnosed w BPPV based on the nystagmus, and, although I did have a brief resolution, it came back with a vengeance this past fall.
    I had the constant brain fog, could not go in stores, hold a conversation, even look at someone face to face… my eyes were always shifting and I had a constant shakiness inside, causing horrendous anxiety. I didn’t really “spin” was more like an overall disequilibrium. I was so depressed all the time and teaching yoga was quite the challenge. My neurologist had basically dismissed me and, finally, I went to an ENT who told me it was first migraine associated vertigo, then, when the Topamax failed to help, he sent me to a new neurologist, who told me he believed it was an inner ear thing.
    Lo and behold, after rotatory testing and confirmed by caloric testing, I was found to have 62% vestibular loss on my left side and diagnosed with vestibular neuritis. Even though there is no cure, I think having a diagnosis that fits and finally makes sense has helped me start to overcome, along with the VRT that I go to weekly. I can now focus, the fog and depression and anxiety are gone, and I have found myself again. My joy is back! So, for anyone else out there who may be going through similar, be persistent, as you are the best advocate for your own healthcare. And, know that life as normal can come back!!

  9. Whw

    I was diagnosed two years ago with oscilopsia cased by bilateral vestibulopathy. Has anyone heard of this?

  10. Bloomergal

    Thank you for the information provided in this program. I used to experience a temporary roaring sound in my ears if I got up quickly and started walking after having sat for an extended period of time. This certainly alleviated my concern in that regard.
    On the subject of hearing in general, several years ago I undertook an extensive project; audio transcribing interviews of holocaust survivors, elderly people with weak voices and very strong European accents. This required a level of very focused listening for extended periods of time. The result was very strong improvement in my hearing ability, as if that concentrated listening had somehow exercised my ears! It’s been over a year since that project was completed and my hearing is much more acute today than when I started the project.

  11. Erin

    Rita, P.S. Check out an ear, nose, and throat specialist if there is one in your area…there must be?

  12. Erin

    Have you looked into Meniere’s Disease at all? I was diagnosed about a year ago, and the diagnosis itself made all the difference in the world. Nice to have a name put to how you’re feeling and something to start treating.
    Here are some of the basic symptoms of Meniere’s: 1) Recurring episodes of vertigo (lasting from 20 minutes to a few hours to a day or so. In severe cases, nausea or vomiting can occur as well), 2) Hearing loss and fluctuation (particularly in low tones), 3) Tinnitus (ringing, buzzing, hissing, roaring in the ear), and 4) Feeling of fullness or pressure in the ear. It is mainly associated with one ear only, though I’m pretty sure I have it in both.
    The problem, in simple terms, is that the fluid sacs in the ear have trouble regulating sodium content, or don’t do something right with the chemical balance, which causes the organ to swell, which puts pressure on the other small organs in your ear- cochlea (causing the hearing loss) and the balance canals (where the real fun happens! …the vertigo).
    The main “treatment” is to go on a severely reduced sodium diet…I’m talking around 1000 mg a day. (Start reading labels!) The important thing about sodium intake is to keep it low AND consistent throughout the day. I go for about 100-120 mg every 2 hours or so. I also take a “water pill” (hydrochlorothyazide). With those changes, I haven’t had an attack in about a year. A God-send as I’m sure you can imagine. It’s really difficult to get used to the diet, but there are a number of good low sodium products out there…and I cook from scratch a lot. One great cookbook is “500 Low Sodium Recipes” by Dick Louge. It makes life so much easier.
    Give the low sodium diet a try….if you feel better, I bet you’re on the right track. Good luck! It will get better. :o)

  13. George S.

    I was so glad to hear this episode today. I have suffered for years now with vertigo and I’m so tired of hearing my doctor say there’s nothing they can do. I must sleep on 3 pillows at night. I can’t lay flat. I have trouble flying. At the dentist and doctor I can’t go all the way back in the chair which makes it difficult. If I turn my head back quickly or to the side I have bad dizziness and nausea for hours. It has has gotten particularly bad when driving and I must be careful not to turn my head quickly. I almost had an accident due a spell I had recently on the highway. I have had to stop doing so many activities I have so enjoyed for so many years like whitewater rafting, backpacking, mountain climbing, etc. due to this condition. I’m at wits end. What can I do???

  14. Linda C

    I am fortunate that Dr. Kaylie is my Neurotologist. He has been a godsend to me.
    For the others who seek a Physician with similar training as Dr. Kaylie, I would recommend checking for a Neurotologist through their membership list.

  15. AJCY

    You have been most helpful–I was very fortunate to have the Physicians
    Assistant in Ear, nose and throat Specialist office to realize that I needed to have the Epley Manuver. One treatment has been effective. Feel that in a small town –and being 80 years old –my cost was just the office visit. Hope more people learn about this!!

  16. Rita C

    As your Saturday 4/7 program came on my NPR station (KERA-FM Dallas TX), I was in the throes of a 4-day “dizzy” spell, which I have always called “vertigo” from the first day I started having them – about 10 years ago. It’s just hell!!
    I’ve had 4-6 a year – never know when they’re coming – lots of severe nausea, banging into walls, headaches, lethargy and at least two days getting back to normal. Have been given Meclizine (25mg)of course, and it seemed to help in the beginning, at least to allay the grinding nausea.
    Then I discovered Original Dramamine; have even tried something labeled “Prometh gel” 25mg which you rub into a large muscle. Each one of these drugs has “seemed” to help from time to time BUT I think they all delay “feeling better.” I try to avoid them.
    I’ve used organic, strong, bottled ginger ale (helps the nausea), brewed ginger tea, (helps a little), sleep propped up on at least four pillows and try not to move my head AT ALL. Ringing in ears is minor (to me) compared to the hideous bouts of “vertigo.”
    Have seen four physicians….they had no solutions, diagnoses, or insights. Also was evaluated by the Dallas Ear Institute docs and an Occupational Therapist who came recommended as “the only vertigo expert in Dallas, TX.” Former said I had a slight hearing loss in left ear and to “come back in 6 months.” Latter said I “don’t have a brain tumor” and gave me a “Dizzy Diary” to keep – for what purpose I’m not sure. No help with the dizziness from either one. I checked the website to find a specialist in my area but there is not one listed – I’m in Dallas, TX.
    I would be so extremely grateful to have someone’s advice about what I could do next.
    Thank you, Rita C

  17. Darold Smith: PE, CSEP

    Need to check hormone balances (primarily female) for vertigo.
    About 20 years ago, when I first met my to-wife who was in her mid 50’s at the time, she would be stricken with severe vertigo and would be disabled for several days.
    After some months, we determined that it was occurring on a periodic basis that correlated with her schedule of hormone replacement therapy dosages. The physician had put her on a schedule that tried to mimic the normal hormonal cycle. I had heard of estrogen dominance and that one of the symptoms was vertigo. What was happening was that stopping progesterone for a few days while maintaining the same estrogen dosage.
    When the progesterone was changed to be continuous, the symptoms stopped.
    We switched doctors in order to switch from the conjugated hormones (pharmaceutical) to bio-identical ones. Several times over the years, she has experienced minor bouts of vertigo (primarily when rising from bed in the morning) and in each case, decreasing the estrogen (to change the estrogen/progesterone ratio) cleared the symptoms.
    IMPORTANT: We discovered the cure to this problem on our own – the medical profession was of no help and tried all kinds of prescriptions.
    We listen to the show on KERA in Dallas, TX.

  18. mc

    My friend who recently was dizzy went to her chiropractor and was able to do a manuver to correct the problem.
    My mother who was also having problems being dizzy one day fell bacwards and hit her head which corrected the problem. Seems crazy, but I think it probably corrected the problem by “accident.”
    The People’s Pharmacy has brought so much information to people. Thank you Joe and Terry!!!!!!!
    Thanks for sharing these stories. We would, however, not advise that anyone have an accident and hit their heads to overcome dizziness. We’re glad it help your mother, but we do not want anyone else trying this at home.
    Appreciate your kind words.

  19. JAD

    On listening to your program this morning (4/07/12) about vertigo, Méniére’s disease and other conditions involving balance with, or without, nausea my initial reaction was how these conditions are treated in quackery. When Joe mentioned experienced problems turning over in bed, a common case easily treatable by quacks (homeopaths), I thought of the remedy that would have brought quick relief.
    As the program progressed into the discussion on vertigo, a subject that was prominent in my misspent youth as an AF pilot. Many student pilots experienced the condition during early training when learning to recover from spins and later in aerobatics. I unintentionally exposed a flight surgeon friend to vertigo when I gave him a ride for him to obtain flying time. As I recall it was during a few aileron rolls that many of used add variety to simply boring holes in air, i.e., flying without a specific goal beyond obtaining flying time for pay purposes.
    Treating vertigo is a little more difficult to treat as it involves more different remedies and specific indications for their uses to obtain the simillimum (best possible remedy) for the evident symptoms. At my age, eighty plus, it is beneficial to be able to differentiate between vertigo, instability, and other problems causing staggering, falling, etc. when walking which I do for five, or more miles per day. The Epley maneuver that was mentioned as described in Wikipedia sounds a bit difficult to picture for the uninitiated. Your guest was appreciated for his approach to treatment with out excessive reliance on drugs – I enjoyed the program and feel that I benefited from it.
    My advice to both Joe and Terry: growing old isn’t for sissies.

  20. LM

    Excellent show. Referring this to a friend who Dr. Kaylie could have been talking about.

  21. Linda

    I’ve adjusted to the constant ringing in my ears…it’s been present for 40years or more.
    When I experienced light headedness that persisted, I recalled a friend who went to her family doc. She had no insurance; he did the Epley maneuver and she was fine shortly after…no further tests were needed.
    So, I googled Epley and found a nice description. I did both sides a few times. And then, it was gone!!
    I’m a nurse and felt comfortable with the neck/head movements; this may not be a self help treatment for anyone, though

  22. Evelyn

    After being hospitalized several times for dizziness, my husband was prescribed 16 mg. of betahistine and to stay away from salt and caffeine. He has Mennieres disease (spelled it right?) and takes a cortizone type drug and antinausea pill when he gets an attack. He has stayed out of the hospital for months now and I am very grateful. His attacks are minimal when he gets them and under control.
    Before he was diagnosed, his head was spinning so much that the emergency personnel had to be called to take him to the hospital. He couldn’t even walk by himself. The disease has caused hearing loss in one ear and he has to drink more fluids.

  23. A. Ward

    I am a 45 year old woman and I too have been suffering from chronic vertigo/dizziness for 19 years. I was involved in a car accident in 1994 and bumped my head but not unconscious. I was examined and results were normal. I suffered from minor stiffness in my neck and received treatment from a chiropractor. About 6 months later at my daughters birthday party the imbalance started and to this day I continue to suffer.
    Since then I was diagnosed with breast cancer in 2009 and the chemotherapy has heightened the dizziness. I use to think I was alone with my symptoms until I received my diagnoses today from the ENT. I will begin rehabilitation exercise and attempt to stay mobile, and with prayer “I know GOD will strengthen me”!! WE must remain strong in this fight for a cure.

  24. MJ

    My husband has had dizzy, nauseous spells for weeks. A cat scan has revealed brain bleeds over the balance part of the brain. We are currently doctoring for the bleeds. Only anti nausea meds help at this time. Possible surgery if bleeds continue in that area.

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