“Vertigo is defined as a hallucination of motion of the body or the environment and may be rotatory or linear… it is a cardinal symptom of vestibular system disease” (Smouha, 2013, pp. 456). The most common causes of vertigo include benign paroxysmal positional vertigo (BPPV), Meniere’s disease, inner ear infections and/or vestibular neuritis. When treating vertigo, the provider will focus on the cause rather than the symptoms. For example, if a patient has Meniere’s disease, then the provider may prescribe them a diuretic or recommend a low sodium diet to help reduce the amount of fluid pressure on the inner ear. If the patient is experiencing BPPV, then they are usually treated with exercises, physical therapy and slow-positioning maneuvers.
“Lightheadedness (syncope or near-syncope) is cardiovascular or cerebrovascular in origin, or occasionally metabolic (e.g., hypoglycemia), but almost never vestibular” (Smouha, 2013, pp. 456). The most common causes of lightheadedness include orthostatic hypotension (sudden drop in blood pressure when a patient stands up), illnesses (cold, flu, allergies, etc.), certain medications, arrhythmia, anxiety stroke, anemia and/or neurological conditions. Treating lightheadedness is like treating vertigo even though it is not the same causes – you would treat a patient that is lightheaded with potential medications, head position maneuvers, balance therapy or psychotherapy for something caused by an anxiety disorder.
With treating an individual with either vertigo or lightheadedness, a referral to Ear, Nose and Throat (ENT) should be recommended when the patient is experiencing reoccurring episodes – regardless of the cause because there may be an underlying condition that should be further evaluated by a specialist.
Smouha, E. (2013). Inner ear disorders. NeuroRehabilitation, 32(3), 455–462.