Peripheral Vertigo: General Symptoms, Common Causes, Types, Differences and Treatment

It is the more common of the two types of vertigo disease categories.

The other, central vertigo, refers to episodes arising from sources in the central nervous system .

Peripheral vertigo focuses on the vestibular system, which includes the inner ear and the vestibular nerve that sends information between the ear and the brain regarding balance and spatial orientation.

We are going to analyze the most common types of peripheral vertigo diseases. By comparing the symptoms that accompany vertigo, it makes it easier to determine the underlying cause of vertigo.

Once that cause of vertigo is identified, medical professionals are in a better position to provide relief.

General symptoms of peripheral vertigo

A patient with peripheral vertigo presents with an intense vertiginous or spinning sensation. Associated presenting symptoms include nausea, vomiting, sweating, diarrhea, changes in blood pressure and pulse, and paleness.

These symptoms are usually abrupt in the beginning and the sensation of propulsion is very intense. In peripheral vertigo, vertigo is influenced by changes in position and is worsened by certain positions more than others.

Tinnitus is often present and nystagmus is fatigued. With peripheral vertigo, nystagmus is inhibited by ocular fixation.

Common causes of peripheral vertigo

Common causes of peripheral vertigo are vestibular neuronitis, labyrinthitis, and medications. Patients with vestibular neuronitis present with positional nystagmus and fullness in the affected ear or tinnitus.

  • Calcium deposits in the inner ear.
  • Inflammation from nerve damage.
  • Cinetosis.
  • Post viral infection.
  • Minocycline.

There is no hearing loss present. The caloric vestibular test is usually present in the affected ear. The exact site of the injury is unknown, but it is suspected of viral origin.

The symptoms are acute onset and the vertigo is worsened by certain movements of the head. Vestibular neuronitis can last for days or weeks.

Types of peripheral vertigo

Benign Paroxysmal Positional Vertigo (BPPV)

This is the most common form of vertigo. It tends to be a trap when a doctor doesn’t understand the underlying cause of vertigo. In fact, there are really only two things that qualify vertigo as a symptom of benign paroxysmal positional vertigo, these are:

Episode Trigger : Keyword is positional. With benign paroxysmal positional vertigo, the vertigo is triggered by the position of the head. Certain positions or sudden movements provoke the attack.

Getting up too fast or bending over are common examples of what can trigger an episode of benign paroxysmal positional vertigo.

Duration of attack : attacks of benign paroxysmal positional vertigo are very short. They often only last a few minutes. Of course, that is enough to hurt if someone falls as a result of the sudden false sensation of movement.

Meniere’s disease

This is a comparatively rare vestibular condition that causes flare-ups of symptoms followed by long periods of absence of symptoms. There are four main symptoms of Meniere’s disease:

Vertigo : Meniere’s disease makes our list because vertigo is the main symptom. The attacks can be severe and can last between 20 minutes and 24 hours.

Tinnitus – You’ve probably heard this commonly called ringing in the ears. This is also severe when a person suffers from Meniere’s disease. The sound can resemble a ringing, buzzing, or even whistling.

Hearing loss : Fortunately, Meniere’s function rarely affects more than one ear. However, in the affected ear, hearing loss can occur, especially in low tones.

As the disease progresses, the high tones can also be lost, leaving the patient with a small band of mid-tone hearing in the affected ear. As a result, a hearing test is part of a diagnosis.

Feeling of fullness in the ear: The affected ear can also feel full at times. This could be due to an overabundance of fluid called endolymph . This fluid normally must drain through the Eustachian tubes that connect the ears and throat.

Neuritis vestibular

This severe form of vertigo occurs when the vestibular nerve becomes inflamed. Sometimes this happens at the end of a virus like the flu. The following symptoms can occur:

Severe vertigo for several days : When the inflammation is at its peak, the vertigo can be intense and last for several days.

Persistent positional vertigo: Unlike benign paroxysmal positional vertigo that occurs for short periods of time, positional vertigo that occurs during vestibular neuritis is persistent.

Absence of auditory symptoms : Auditory symptoms, such as hearing loss or tinnitus, do not accompany vestibular neuritis.

Acoustic neuroma

This refers to a tumor that affects the ear. It is not cancerous, but it can affect the brain’s ability to receive signals from the ear correctly.

As a result, this condition begins as a form of peripheral vertigo, but can cross over to central vertigo. The main symptoms of an acoustic neuroma include:

  • Vertigo.
  • Hearing loss.
  • Tinnitus.

As a result of similar symptoms, a doctor may choose to run tests to rule out an acoustic neuroma before diagnosing a patient with Meniere’s disease.


Labyrinthitis is similar to vestibular neuritis in that inflammation is involved. However, in this case, the inflammation is in the labyrinth or inner ear. Again, the cause may be a viral infection such as a cold or the flu. Symptoms include:

  • Vertigo.
  • Tinnitus.
  • Hearing loss.

Labyrinthitis is often easy to distinguish from an acoustic neuroma because the patient is currently ill or recently ill. Vertigo and other symptoms should go away within a week or two after the underlying cause.

How To Find Natural Relief From Vertigo Disease

There is a form of natural care that is bringing hope to many patients suffering from recurrent vertigo that has been unexplained or is related to Meniere’s disease or positional vertigo.

It is no coincidence that vertigo and other symptoms often begin in the months or even years after an accident or injury. The neck plays a vital role in how the body perceives balance and spatial orientation. In what ways?

Protects the Brainstem : The C1 vertebra houses the area where the brainstem meets the spinal cord. Misalignment can inhibit proper operation.

Facilitates blood flow : The cervical vertebra facilitates blood flow to the brain through the vertebral foramen. Misalignments can affect this proper blood flow.

Proximity to the ear : The C1 vertebra, in particular, is close to the ears. A misalignment can affect the function of the Eustachian tube, gradually leading to conditions where vertigo can become a recurring problem.

If you suffer from vertigo, especially if you have a history of head or neck trauma, contact an upper cervical chiropractor today. You may find that this common problem improves significantly with upper cervical chiropractic care.

Peripheral Vertigo vs Central Vertigo – What’s the Difference?

In short, the difference between peripheral and central vertigo is the source of the symptom. Peripheral vertigo is usually caused by problems in the inner ear. Central vertigo is related to a problem in the central nervous system (CNS) that leads to vertigo.

A patient with central vertigo presents very differently than a patient with peripheral vertigo. Central vertigo symptoms are slow onset and are not aggravated by movement or specific position changes.

There is no nausea, vomiting, sweating or paleness. The sensation of vertigo is less intense than in peripheral vertigo. Central vertigo is caused by disease of the cerebellum and brainstem.

Peripheral vertigo is usually associated with lateralized nystagmus (either spontaneous or caused by head movement in a horizontal or rotational direction) and the absence of other brain or brainstem findings.

Central vertigo is often accompanied by other brainstem findings (cranial nerve deficits, sensory or crossover motor findings) or cerebellar findings. Vertical nystagmus is suggestive of a central etiology.

Who suffers from peripheral vertigo?

Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo.

One third of patients with vertigo were diagnosed as benign paroxysmal positional vertigo in a multinational population study and benign paroxysmal positional vertigo accounts for half of the patients with peripheral vertigo.

A German national study shows that its prevalence and incidence were 1.6% and 0.6%, respectively. The prevalence of benign paroxysmal positional vertigo increases with age.

Benign paroxysmal positional vertigo is twice as common in women as in men in all age groups, and patients with a family history are five times more likely to have benign paroxysmal positional vertigo than people without a family history.

Migraine, hypertension , hyperlipidemia, and stroke were independently associated with benign paroxysmal positional vertigo.

Treatment for peripheral vertigo

How can I treat benign paroxysmal positional vertigo?

In many cases, the condition will clear up on its own after a few weeks, but there are also some established best practices to minimize discomfort caused by the condition. Are:

Limit symptoms by getting out of bed slowly in the morning. Using repositioning techniques like the Epley Maneuver. Reduce sudden head movements as much as possible to avoid triggering the condition.

By practicing Brandt-Daroff exercises that have been shown to help alleviate the condition.

How to treat labyrinthitis?

Like benign paroxysmal positional vertigo, the symptoms of labyrinthitis pass in a few weeks in most cases, but of course, sufferers of this uncomfortable condition will want to learn how to better manage and treat their symptoms.

The best ways to manage this condition are:

Bed rest : Research has shown that bed rest allows the body’s immune system to repair itself more effectively, and regular and adequate rest will certainly help sufferers to better cope with their labyrinthitis.

Vestibular Rehabilitation Treatment (VRT) : This treatment works by attempting to rewire the brain to more effectively cope with the altered signals it receives from the vestibular system as a result of labyrinthitis.

Drink plenty of water – Making sure the body receives enough fluids will prevent patients from becoming dehydrated, which can make symptoms worse.

When staying still, during a labyrinthitis attack, it is best to remain as still as possible until the most severe symptoms pass. Research has shown that lying on one side is the most beneficial position for relieving symptoms.

Also, patients should avoid bright lights, tobacco, chocolate, and alcohol, as these can all trigger an attack. It is also strongly recommended to avoid stressful situations and eliminate intrusive noises.

How to treat vestibular neuronitis?

Vestibular rehabilitation exercises have been found to be effective in treating the symptoms of this condition with the patient referred to a vestibular rehabilitation therapist who will assess the severity of the disorder.

Following this evaluation, a comprehensive treatment plan will be developed consisting of specialized balance exercises designed to correct and strengthen balance. Other treatments include:

Treating the underlying virus that caused the infection with medication. Ensuring that the patient drinks plenty of water to stay hydrated. Medications to reduce dizziness may be prescribed to lessen symptoms. Medications to suppress nausea can also be prescribed in severe cases.

How should I treat menieres disease?

There are several ways this form of vertigo can be treated, depending on the severity and depth of the symptoms experienced.

  • Antihistamines .
  • Antibiotics (used if there is also an ear infection).
  • Benzodiazepine (anxiety medications that can also relieve vertigo symptoms).
  • Prochlorperazine (used to relieve symptoms of nausea).
  • Pressure pulse treatment such as the Meniett device, a machine used to generate a pulse of pressurized air in the ear canal.
  • Internal ear surgery (used in extreme cases of the disorder where other treatments do not relieve repeated attacks of the disease).

People with Menieres disease also often prescribe a drug called betahistine, which helps reduce the pressure caused by fluid levels in the inner ear, relieving the uncomfortable symptoms of the disease.

Helpful tips

Other things you can do to avoid symptoms include:

  • Avoid bright lights.
  • Stand up slowly.
  • Avoid rapid head movement and stooping.
  • Staying hydrated.
  • Avoid stress.
  • Sleep with your head supported.
  • Avoid smoking, alcohol, and caffeine.
  • Avoid looking up.

What to do next?

If you suspect a diagnosis of peripheral vertigo, the first thing to do is visit a qualified physician to confirm the diagnosis. If you’ve already been diagnosed, following the advice in this guide will help you better manage your individual form of the condition.

Peripheral vertigo is generally not treated with conventional medications, but if its form is particularly severe, your doctor may prescribe a short course of prescription medications, such as benzodiazepines or antiemetics, to suppress nausea and vomiting.

Always be sure to see your doctor if you experience worsening symptoms or experience additional symptoms such as mental confusion or weakness or numbness in a part of your body, as this could indicate a more serious medical condition.