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Dizziness and Vertigo

Reviewed by: HU Medical Review Board | Last reviewed: March 2022.

Dizziness and vertigo are common experiences for many people. These can occur on their own or as a result of another underlying condition. Multiple sclerosis (MS) and its related damage can contribute to feelings of dizziness or being off-balance.

What is vertigo?

A person has vertigo when they feel like the room or environment around them is spinning. It is different from lightheadedness or dizziness. In these situations, the person feels off balance, but things around them seem relatively still.1,2

Vertigo may be described as a feeling like motion sickness. Other signs of vertigo include:1

  • Ringing in the ears
  • Headaches
  • Ear fullness
  • Uncontrollable eye movements

Vertigo is not dangerous, but it is uncomfortable. This can impact a person’s ability to carry out daily tasks and their quality of life.1,2

Vertigo can be caused by inner ear problems (peripheral vertigo) or brain issues (central vertigo). Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo. It is caused by calcium crystal buildup in the inner ear. Other ear-related causes of vertigo include:1

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  • Meniere’s disease
  • Infection of the inner ear
  • Non-cancerous inner ear growths (cholesteatoma)

Vertigo and dizziness can also be caused by certain drugs and health conditions, such as:1

  • Migraines
  • Diabetes
  • Low blood pressure
  • Heart conditions

Why do dizziness and vertigo happen in MS?

As many as 30 to 50 percent of people with MS report having vertigo. It can occur for several reasons.3

First, MS-related damage to certain nerves or pathways can impact our sense of balance. Our nervous system takes in a lot of information on what we see. It then tells our body how to respond. The connection between the world around us and our body’s response is what creates our sense of balance (equilibrium). When this process is impacted by MS-related lesions, it leads to feelings of dizziness or vertigo.1,3,4

It is also possible to develop vertigo separate from MS. For example, BPPV is very common and may occur along with MS rather than because of it. It can be hard to tell the 2 conditions apart.3

BPPV is usually triggered by changes in position and comes and goes. MS-related dizziness or vertigo tends to last for hours or days or longer. It occurs regardless of how a person is moving or what position they are in.3

How are dizziness and vertigo treated?

Vertigo caused by BPPV is treated with specific repositioning techniques called the Epley maneuver. In the Epley maneuver, a doctor teaches you how to move your head in specific motions to reposition the calcium crystals to prevent them from causing symptoms of vertigo. This maneuver may need to be repeated at home from time to time to help resolve symptoms.1,2

If vertigo is caused by another underlying health problem, it may improve by treating the original issue. For example, vertigo can be caused by viral infections that affect the nerve of the inner ear (vestibular nerve). Steroids may be used to reduce inner ear inflammation if this is the suspected cause.1,2

At this time, there is no single treatment for vertigo related to MS. However, there are options that may help reduce discomfort, including:1,2,4

Some people also find relief with behavioral changes, including:1,2,4

  • Propping up your head on multiple pillows at night
  • Sitting down when dizzy
  • Taking extra time when standing up

If you experience dizziness or vertigo with MS, talk to your doctor about what treatment options are right for you.