Vertigo, dizziness and balance-related conditions are among the most common health problems in adults. Nearly 40 percent of U.S. adults experience vertigo at least once in their lifetime, with women slightly more likely to get it than men. It can occur because of a problem with the body's vestibular system, which includes structures of the inner ear, vestibular nerve, brain stem and cerebellum, a region of the brain that integrates sensory perception, coordination and motor control. This system regulates balance, posture and the body's orientation in space.

At the UCSF Medical Center Audiology Clinic, our experts assess patients to determine what's causing the vertigo and to recommend treatments.

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Although the cause is unknown in many cases, a number of disorders can cause vertigo, dizziness and imbalance. Those conditions include:

Benign Paroxysmal Positional Vertigo(BPPV)

In people with BPPV, head or body movements — particularly when lying in bed or leaning over — can cause a brief vertigo attack that lasts less than one minute. BPPV occurs when microscopic calcium deposits called otoliths are trapped in one of the three semicircular canals that make up the vestibular system. BPPV is the most common cause of vertigo and can be treated effectively.

Meniere's Disease

Meniere's Disease results from an imbalance of fluids in the inner ear, which can cause periods of vertigo lasting from minutes to hours. It's frequently accompanied by fluctuating, low-frequency hearing loss, tinnitus and a feeling of fullness or pressure in the ears, known as aural fullness.

Viral and Bacterial Labyrinthitis

Labyrinthitis results from inflammation within the inner ear, and may cause vertigo attacks lasting from hours to days.

Other Causes

Various neurological conditions can also cause vertigo. These include:

Other, non-neurological causes include:

  • Diabetes
  • Heart arrhythmias
  • Hyperventilation
  • Orthostatic hypotension, a sudden decrease in blood pressure when you stand up
  • Psychiatric or emotional problems such as panic attacks and anxiety
  • Use of multiple prescription and non-prescription medications
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By definition, vertigo is a false sensation that you or your surroundings are moving. The sensation is best described as spinning, whirling or moving vertically or horizontally. Vertigo attacks may be constant or sporadic and can last from seconds to days.

Other symptoms may include, but are not limited to:

  • Abnormal or involuntary eye movements, called nystagmus
  • Blurred vision, known as diplopia
  • Difficulty speaking or slurred speech, called dysarthria
  • Difficulty walking, known as ataxic gait
  • Feeling faint
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To assess what's causing your vertigo, the Balance Center at UCSF will give you a number of subtests that examine the effectiveness and interaction of the vestibular system, or inner ear, the somatosensory system, or flex and pressure sensors in your feet, and the vision system — as well as how these systems contribute to your overall stability and balance. The assessment helps determine which system or systems may be contributing to your symptoms and gives direction for treatment.

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Treatment will vary depending on the diagnosis and may include medications, surgery, vestibular rehabilitation training, balance training or canalith repositioning maneuvers.

Vestibular rehabilitation is the primary treatment for many disorders and is also used along with surgery or medications. Vestibular rehabilitation includes exercises that are designed to retrain the brain to compensate for, and adapt to, loss of function in the vestibular system.

Canalith repositioning maneuvers are very effective for treating BPPV. These maneuvers consist of a series of head movements designed to move the calcium deposits out of the canal in the vestibular system in which they're trapped, and back to their normal position.

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Reviewed by health care specialists at UCSF Medical Center.

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UCSF Clinics & Centers


Balance and Falls Center
2380 Sutter St., First Floor
San Francisco, CA 94115-0340
Phone: (415) 353-2101
Fax: (415) 353-2883
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