What is it? Vertigo is a condition in which you feel off-balance and dizzy, as if you or your surroundings are moving, spinning, or swaying. It can lead to nausea and disability. Vertigo is most common in elderly people, but it can affect both sexes at any age. It may be a temporary or permanent condition.

Statistics: Dizziness affects 30% of people over the age of 65. From 2001 – 2004 35.4% of U.S. adults aged 40 years or older (69 million Americans) had vestibular dysfunction. Patient care costs for falls are more than $8 billion per year. Almost eight million American adults report a chronic problem with balance, while an additional 2.4 million Americans report a chronic problem with dizziness alone.

Important Facts: The organ of balance is the vestibular system in the ear, a tiny grid of fluid-filled tubes and sacs. There are two identical vestibular systems, located in the labyrinth of each inner ear. As you move, the liquid in the tubes also moves about, and its levels are read by nerve cells. The information is sent to the brain, which uses it to calculate which way is down and what should be the horizontal level.

Any problems with balance originate in the vestibular system, so people who suffer from frequent vertigo are said to have a vestibular disorder. Balance problems may be associated with a ringing in the ears or loss of hearing. Vertigo can also be caused by changes in the parts of the brain (cerebellum and brain stem) that are also involved in controlling balance.

Treatment Duration: Your doctor may begin treatment by prescribing bed rest; medications that suppress the activity of the inner ear, such as meclizine (Antivert, Bonine and other brand names), dimenhydrinate (Dramamine) or promethazine (Phenergan); anticholinergic medication such as scopolamine (Transderm-Sco); or a tranquilizer, such as diazepam (Valium). Depending on the cause and duration of the vertigo, additional advice will be offered. For persistent benign positional vertigo, you may be given specific exercises to help reduce the symptoms.

Do’s/Don’ts: Get up slowly from your bed or chair. Sit on the edge of the bed for a few minutes before standing. Sit up or stand up slowly to avoid sudden changes in blood flow to your head that can make you feel lightheaded.

Common Myths: Myth: I’m so dizzy; I must have had a stroke. Truth: There are many causes of dizziness, and not all are life-threatening. Benign positional vertigo (BPV) is the most common cause of dizziness. It is caused when the tiny crystals in your inner ear – those responsible for balance – break free and float around in the inner ear fluids. When the head moves in certain positions, these floaters tickle the balance cells, causing transient vertigo.

Vertigo is all in your head because you have an overactive imagination. In fact, vertigo is all in your head; however, probably not because of your imagination. The symptoms of dizziness and unsteady movement are quite real. Whether it is BPPV (brain) or Meniere’s (inner ear), the vertigo is spiraling from the area above the neck.