In addition to a disease of the peripheral vestibular organ, vertigo can also be caused by damage to structures in the brain – this form of vertigo is called central vertigo. Possible causes may include stroke, multiple sclerosis, or premature aging of the cerebellum. Another common form is called vertigo migraine.
“Central vertigo is very often triggered by a stroke. This is an absolute emergency in which fast action is necessary,” emphasizes Strupp. “In addition to acute dizziness, stroke can cause other accompanying symptoms, such as swallowing and speech disorders and double vision.”
Phobic vertigo
Dizziness can have not only physical but also psychological causes, as is the case with phobic vertigo. In this case, in contrast to spinning vertigo, sufferers have the feeling that the ground is swaying beneath their feet. In addition to the vertigo, drowsiness and stance and gait disturbances may be accompanying symptoms.
“Phobic vertigo mainly affects extremely correct and dutiful people,” says Strupp. “Characteristically, the vertigo worsens in certain situations, for example in confined spaces or larger crowds. This leads sufferers to specifically avoid such situations. Exercise or small amounts of alcohol, on the other hand, improve the vertigo.”
Strupp emphasizes that in the case of phobic staggering vertigo, it is particularly important to explain to the affected patients how their vertigo develops and thereby also relieve their fear of a physical problem. Subsequently, those affected should regularly engage in light exercise and no longer avoid unpleasant situations. In individual patients who do not respond to these measures, vertigo can also be treated with medication.
Chronic vertigo – what are the causes?
Vertigo usually occurs in the form of acute attacks of dizziness, but for some sufferers it can become a constant companion. “Causes that may underlie chronic vertigo include bilateral failure of the vestibular organs and phobic vertigo,” Strupp explains. “In addition, chronic vertigo can also occur in diseases of the cerebellum.”
Damage to the cerebellum can have various causes, for example, it is caused by premature aging of cells of the cerebellum or by hereditary diseases. Depending on the cause, cerebellar damage may be accompanied by other symptoms besides dizziness, such as eye movement disorders.
A failure of the vestibular organs can also have different causes. Typical symptoms of such a failure are staggering vertigo and visual disturbances – those affected have the impression that fixed objects are moving. In addition, patients often state that staggering vertigo and gait disturbances increase in the dark. This is due to the fact that patients then lack the information that is perceived through the eyes in the light.
A failure of both organs of balance can sometimes be compensated somewhat by balance training. Under the guidance of a physiotherapist, patients practice using other senses to maintain their balance. Nevertheless, the symptoms cannot be completely resolved in all patients by this method.
