Dizziness (vertigo)

blurred trees indicating dizziness

What is vertigo?

Dizziness or lightheadedness is a common symptom of multiple sclerosis. If the sensation is more severe and gives the feeling that your surroundings are spinning, it is referred to as vertigo. Vertigo is the sensation that you or your surroundings are moving.  It can cause you to feel unsteady, more likely to fall and make you feel nauseous. 

There are a number of approaches to managing dizziness and vertigo, including physiotherapy, medication and exercise programmes.

What causes vertigo?

Our ability to feel orientated while stationary or moving, relies on a complex interaction of a variety of sensory systems; our eyes, the balance systems in our inner ears, and the information from movement, touch and joint sensors throughout our body. When we turn our head, our eyes, neck muscle sensors and two inner ears all give matching information to the brain.

If something causes a mismatch in the information, it affects our sense of orientation and causes vertigo. In MS, these symptoms are caused by damage to the areas that coordinate perception and response to visual and spatial information. There are other non MS causes of vertigo. 

How many people experience vertigo?

Research suggests that one in three people with MS will be affected by vertigo at some time. 

What treatments are there for vertigo?

Although vertigo is a common symptom in MS, there are other unrelated causes of vertigo and dizziness.  Your symptoms should be fully assessed by a health professional before starting treatment.

Treatment can involve physiotherapy, in which a therapist will determine if certain positions of the head make the symptom worse and then work to build up a tolerance to the head being in those positions.

Antihistamine and anti-nausea drugs such as Arlevert (cinnarizine, dimenhydrinate) or betahistine can sometimes help. If the symptom is more severe, steroids can sometimes help.

Di Stadio A, et al.
The role of vestibular evoked myogenic potentials in multiple sclerosis-related vertigo. A systematic review of the literature.
Mult Scler Relat Disord. 2019 Feb;28:159-164.
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