The Medical Minute: Why am I so dizzy?

Imagine suddenly feeling like the world is spinning violently around you.

For Chad Correll, a 47-year-old biomedical equipment technician, this wasn’t an isolated incident. It was the beginning of a seven-year nightmare.

“I sat up in bed, and everything was just spinning. I’d never had a sensation like that before,” Correll recalls.

He spent years visiting doctors who misdiagnosed him with everything from clogged eustachian tubes to anxiety. He suffered from debilitating dizzy spells and could hear his own heartbeat pounding inside his head, making concentration impossible.

It wasn’t until he saw Dr. Varun Patel, an otologist/neurotologist at Penn State Health Otolaryngology – Head and Neck Surgery, that he finally found an answer. He had Superior Semicircular Canal Dehiscence, a tiny hole in the bone that covers one of the balance canals in the inner ear.

While Correll’s condition was rare, sensations of vertigo and imbalance are incredibly common. Nearly 40% of U.S. adults will experience vertigo at least once in their lifetime.

Is it dizziness or vertigo?

While often used interchangeably, there is a medical difference between dizziness and vertigo.

“Vertigo is a room-spinning sensation, and it’s often ear-related,” explains Patel.

General dizziness, however, is often caused by blood pressure issues, medication side effects or cardiac and neurological issues rather than the inner ear. Patients with general dizziness may feel:

• Lightheaded or faint
• Off-balance or unsteady
• Like they need to hold onto a wall to walk

But when the room feels like it’s rotating while you’re standing still, the culprit is probably the vestibular system; i.e., the inner ear structure controlling balance.

Dr. Varun Patel, right, examines the inner ear of Theresa Barbieri of Reading to diagnose the cause of her vertigo.

Why is the room spinning?

Vertigo is often due to one of a few common conditions:

Benign paroxysmal positional vertigo (BPPV)

The most common cause, BPPV occurs when tiny calcium crystals in the inner ear break loose and drift into the semicircular canals.

“Think of it like a Jello mold that talks to your brain,” says Dr. Mark Whitaker, an otologist/neurotologist at Penn State Health Otolaryngology – Head and Neck Surgery. “The crystals can break off and sit in the part that governs rotations, giving you a false sense of spinning.”

Meniere’s Disease

Meniere’s disease involves fluid fluctuations in the inner ear, causing vertigo symptoms and hearing loss. Whitaker notes a significant overlap between Meniere’s and migraines, as both share triggers including:

• High salt intake
• Excessive caffeine
• Stress and poor sleep

Vestibular Neuritis

Often caused by a virus, such as COVID-19, attacking the inner ear nerve, vestibular neuritis results in severe dizziness that can last from days to weeks.

Stopping the spin

The good news is, most vertigo is treatable, and relief can be surprisingly fast.

For BPPV, doctors and physical therapists use maneuvers to guide the crystals back into place. The most common is the Epley maneuver.

Think of the inner ear as a winding tube with a marble lost inside. During the Epley maneuver, a clinician guides your head through specific positions, using gravity to shepherd the loose crystals (the marble) back to the chamber where they belong. The procedure has a success rate of nearly 90%.

For Meniere’s disease, Whitaker says treatment often begins with lifestyle changes, specifically a low-salt and low-caffeine diet to manage fluid pressure. If needed, doctors may use diuretics or administer steroid injections directly into the ear.

For patients with vestibular neuritis, care often begins with medications to suppress nausea and dizziness. As the acute symptoms fade, the body usually recovers naturally with time, though Patel says vestibular physical therapy is frequently used to assist patients with lingering balance issues.

In rare, complex cases like Correll’s, surgery is the only answer. Patel made an incision behind the ear to access the delicate mastoid bone, then used a tissue graft to plug the hole in the semicircular canal.

“I could actually sit somewhere quiet and realize, ‘That’s what silence is,’” Correll says of his recovery. “I hadn’t heard that in so long.”

Dr. Varun Patel checks Theresa Barbieri’s with a finger-to-nose test to tell if her vertigo is caused by the inner ear or brain.

When should you see a doctor?

Many people try to wait out dizziness, but specific signs require medical attention.

Whitaker warns that you should seek immediate, urgent care if vertigo is accompanied by:

• New, sudden hearing loss
• Severe headaches
• Numbness or weakness in the arms or legs

Correll’s advice to anyone seeking relief is simple: Don’t give up.

Dizziness and vertigo can feel overwhelming, but most causes are treatable. The right testing can pinpoint the underlying issue and finally stop the spin.

Find a Penn State Health vertigo expert near you.

Related Content:

• The Medical Minute: Why are my ears ringing? What to know about tinnitus and other hearing problems
• The Medical Minute: Why does my head hurt? What can I do about it?
• The Medical Minute: Ear infections and kids: top tips for parents

Learn more about treatments for dizziness.

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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