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Dizziness and Vertigo in MS

By Gay Falkowski

Though the words ‘dizziness’ and ‘vertigo’ are often used interchangeably to describe a sensation some people with MS experience, these symptoms are not one and the same. Dizziness is an umbrella term that describes an uncomfortable sensation best described as inner confusion. It includes lightheadedness, equilibrium imbalance, and feelings of being disoriented.
 
Vertigo is a special kind of dizziness marked by an intense spinning sensation. You may remember spinning like a top when you were a kid, then enjoying watching your surroundings whirl by after you stopped. (Involuntary vertigo is anything but fun.) The spinning sensation, whether clockwise or counter-clockwise, is the defining characteristic of vertigo.
 
Here’s some of what we know about dizziness and vertigo and what you might do to treat and prepare for destabilizing events:
 
1) Vertigo and dizziness in multiple sclerosis is usually caused by a growth of an existing lesion or the appearance of a new lesion on the brain stem or cerebellum, the area in the brain that controls balance.
 
2) Vertigo can also be a symptom of a problem with the inner ear. Other possible causes of dizziness or vertigo include certain medications, blood vessel disease, migraine, stroke, high and low blood pressure, cardiovascular disease, or even infections such as the flu.
 
3) A common cause of vertigo in all people is benign paroxysmal positioning vertigo, which is not a result of demyelination. BPPV occurs when crystals of calcium carbonate collect in specific parts of the ear canal that affect the vestibular system. When you move your head these crystal can dislodge from the tiny hairs in your ear and cause the hairs to move, sending false signals to the brain that results in vertigo.
 
4) Because dizziness and lightheadedness can be symptoms of other potentially serious conditions, always contact your physician to rule out other causes and determine whether or not these symptoms are related to your MS.
 
5) Once your doctor determines the cause of your vertigo, they can prescribe specific medications to treat vertigo. Over-the-counter anti-motion sickness medications available as oral tablets or as skin patches may resolve the problem.
 
6) If dizziness or vertigo becomes chronic, your doctor may prescribe more powerful anti-motion sickness or anti-nausea medications. In cases of severe vertigo, a short course of corticosteroids may be recommended.
 
7) Your first experience with vertigo can be very disturbing; some people have described it as frightening. It may be accompanied by nausea and vomiting. It can continue for hours, or even days. Sometimes, dizziness and vertigo are accompanied by vision problems, ringing in the ears, hearing loss, or trouble standing or walking.
 
8) When vertigo occurs, the following steps can help you stay safe and feel more comfortable:
 
  • Sit until it passes.
  • Avoid moving your head or body position.
  • Dim bright lights and don’t try to read.
  • Avoid stairs.
  • Don’t drive until you’re sure the vertigo has passed.
  • When you feel better begin moving slowly.
 
9) If vertigo strikes during the night, sit up straight, turn on soft lighting, and remain still until you feel better. If vertigo returns when you lie down, try sleeping in a comfortable recliner.
 
10) The balance issues caused by dizziness and vertigo increase the risk of injury due to falls, especially for people whose MS symptoms already include trouble walking, weakness, and fatigue. You can help reduce this risk by taking the following actions:
 
  • Clear your home of tripping hazards, especially throw rugs.
  • Use a cane or a walker.
  • Install handrails and grab bars.
  • Use a shower chair.
 
11) Vertigo is not permanent and may come and go. Test different strategies to better cope with your vertigo and minimize symptoms. Some tips to reduce vertigo in multiple sclerosis include:
 
  • Physical therapy may improve balance and coordination.
  • Try acupressure therapy, which targets specific points on the body.
  • Jot down the times when you experience vertigo and plan your day around times you’re likely to experience it.
  • Stay physically active, as exercising can help reduce symptoms of vertigo.
  • An occupational therapist may also teach you how to move safely around your home and office, especially during vertigo attacks.