Peripheral vertigo refers to a sensation of dizziness or a feeling of the surroundings spinning. It might also be mistaken it for motion sickness if people lean over to one side.  Peripheral vertigo is a type of vertigo that is caused by a problem with the body’s vestibular system, which is the body’s balance system that lies inside the inner ear.


It helps maintain the body’s balance with respect to the body’s position in space, by sending appropriate signals to the brain which then instructs the other organ systems to move accordingly. The other type of vertigo is called central vertigo. It is caused by an issue with the brain or the brainstem, & the way it processes the information sent by the vestibular system, the eyes, & the movement organs like the legs & the limbs.


The most common type of vertigo that comes under the peripheral vertigo category is BPPV, also known as Benign Paroxysmal Positional Vertigo.


Other common peripheral vertigo symptoms include:


  • Loss of hearing, usually in one ear
  • Ringing in the ears, also known as tinnitus
  • Difficulty in focusing your eyes at one place
  • Some amount of loss of balance


Peripheral Vertigo is usually the more severe type of vertigo as compared to central vertigo, & also comes on more suddenly. Peripheral vertigo is also the more common type of vertigo as compared to central vertigo, & affects more people than central vertigo.


What are all the various types of peripheral vertigo?


Four different types of peripheral vertigo exist. All of them are caused by issues with the inner ear.

These are mentioned below:


  • Benign paroxysmal positional vertigo(BPPV):

Most people consider BPPV to be the most common type of vertigo. This type of vertigo causes short, frequent, & sudden bouts of vertigo to the patients.
BPPV is also triggered by certain head movements, or when you tip your head to one side.
BPPV is caused by tiny calcium crystals that normally reside in your middle ear, breaking loose from their original position & depositing in the semicircular canal of the inner ear. There, they activate the tiny hair on the surface of the canal, causing the inner ear to send conflicting signals about the body’s balance & position in space to the brain. This misfire in brain signals is what causes the patient to feel dizzy, nauseous, & disoriented during an attack.


  • Labyrinthitis:

Labyrinthitis is an inner ear disorder that is caused by swelling or inflammation in the labyrinth of the inner ear. The swelling or inflammation is often caused by an infection by a viral agent, such as the cold or the flu. Less commonly, it is caused by a bacterial agent, &/or an autoimmune reaction. The swelling in the region causes problems with the way the inner ear sends balance-related signals to the brain, which leads to problems with the way the body balances itself.


  • Vestibular Neuronitis:

Vestibular Neuritis, also known as vestibular neuronitis, is a viral or bacterial illness of the vestibular nerve. When the vestibular nerve gets swelled up or inflamed due to a viral or bacterial infection, the resulting condition is called vestibular neuritis. It causes sudden bouts of dizziness, nausea, vomiting, & headaches It sometimes also causes a ringing or buzzing sound in the ears, known as tinnitus, along with earache. Common viral illnesses like the cold or the flu can cause vestibular neuritis.


  • Meniere’s Disease:

Meniere’s Disease is an inner ear disorder caused by an excessive amount of fluid inside the ears. The fluid causes the patient to feel pressure inside the ears, along with a ringing, buzzing, roaring, or hissing sound in the ears known as tinnitus.
Meniere’s Disease also causes sudden bouts of dizziness, loss of balance, disorientation, nausea, vomiting, headaches, & motion sickness.
People with Meniere’s Disease might also experience a loss of hearing in the affected ear.



Diagnosis of Peripheral vertigo


Your doctor can find out if you’re suffering from Peripheral Vertigo through a variety of tests. These consist of ear exams that check for signs of infection, along with balance, walking, & posture tests to check your ability to walk in a straight line.


They might also utilize hearing tests called audiometry to check if your ears are functioning properly, along with vision tests & other tests to look for nystagmus & disarray in the balance signals received from the other organ systems, & the commands that the brain gives.


A test called the Dix-Hallpike maneuver tests for signs of BPPV in individuals affected by vertigo & dizziness, the origins of which appear to be peripheral.


This test involves your doctor moving you from a sitting position to a lying down position, while your head is at the lowest position of your body. They will perform the movement rather quickly to induce BPPV symptoms if you suffer from the condition.


If you experience vertigo symptoms during this test, your doctor will conclude that you suffer from Benign Paroxysmal Positional Vertigo. If your symptoms are particularly severe, your doctor might also order MRI scans or CT scans of your head & neck to rule out any potentially serious causes for your peripheral vertigo.



What are Peripheral Vertigo treatment options?


A lot of options are used for peripheral vertigo treatment. These include vertigo medicines, vertigo exercises, & vertigo home remedies.


Some popular & well-known vertigo medicines used for peripheral vertigo treatment include:


  • Antibiotics to treat any bacterial infections
  • Antihistamines like Antivert(meclizine) to reduce excessive histamine production in the body
  • Prochlorperazine, to help provide relief from nausea
  • Benzodiazepines, also known as anti-anxiety medications to relieve anxiety & excessive stress that might sometimes cause dizziness & nausea in people
  • Betahistine, also known as betaserc or serc to reduce the amount of pressure inside the ears. This medicine is used to provide relief to sufferers of Meniere’s Disease


If patients with Meniere’s Disease experience hearing loss, their doctor might suggest that they use hearing aids to help them hear better.



Vertigo exercises:


If you have BPPV, your doctor might also recommend certain exercises to help relieve your symptoms & treat your condition. These exercises include:


The Epley Maneuver:


The Epley maneuver is a well-known vertigo exercise used for peripheral vertigo treatment. It helps relieve a patient’s condition by displacing the calcium crystals from the semicircular canal of the inner ear back to their original position in the middle ear, where they can’t cause problems with the way the inner ear sends balance signals to the brain.


Your doctor can either perform the maneuver in their office or give you some tips & advice to perform those yourself.


To perform the Epley Maneuver by yourself at home, follow the steps below.


  • Sit up on the bed, with your legs laying out in front of you. Now, turn your head 45 degrees in the left direction.
  • Next, quickly lie down, keeping your head turned to the left. Wait for 30 seconds.
  • Turn your head 90 degrees towards the right until it’s facing 45 degrees in that direction.
  • Next, roll over onto your right side before sitting back up.


Perform these exercises at least thrice every day in a set of 5, for about a week until you go 24 hours without any vertigo symptoms.  Always remember to wait 15 minutes after performing the exercise before resuming everyday activities.


Note that the steps mentioned above are for when you have left ear BPPV. For right-ear BPPV, simply reverse the directions & turn your head 45 degrees to the right first.



The Brandt-Daroff exercises:


The Brandt-Daroff is another popular peripheral vertigo treatment exercise. These exercises utilize gravity to dislodge the calcium crystals from inside the inner ear to help the patients with their vertigo symptoms.


To perform these exercises, follow the steps below.


  • Sit on the edge of a couch or a bed,
  • Lie down on your left side, & turn your head such that you are looking upwards.
    Perform both of these movements within 1 or 2 seconds, keeping your head at a 45-degree angle. Stay in this position for about 30 seconds.
  • Now, sit up on the bed for 30 seconds.
  • Repeat all of these steps on the right side.
  • Perform this exercise in a set of five repetitions each time.
  • Next, sit up & wait 30 seconds to let the dizziness pass.


It’s important to wait for at least 15 minutes before resuming everyday activities immediately after performing the Brandt-Daroff exercise.



Vestibular Rehabilitation Therapy:


Vestibular Rehabilitation Therapy is another commonly used set of exercises for peripheral vertigo treatment, as well as for cervical vertigo. Vestibular Rehabilitation Therapy is a set of specially designed exercises used to train the body to compensate for the losses in the natural vestibular system. It does so by employing other organ systems to make up for the loss of the body’s natural balance, & by teaching the brain to rely less on the signals received from the inner ear, & more on what the eyes & the legs tell it.


Over time, & with proper discipline & routine, vestibular rehabilitation therapy helps vertigo patients lead better, more meaningful lives.

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