Repeated spells of vertigo can stem from damaging disorders affecting the inner ear or brain but can also be caused by temporary malfunctions that are otherwise harmless to the ear. Recurrent vestibulopathy is a non-specific term that simply means that repeated spells of vertigo are occurring for which a cause has not yet been determined. Spells of vertigo that last up to hours at a time are more likely to indicate a damaging process, while spells lasting for only seconds are likely to be benign, but there are exceptions to these trends. In order to determine whether damage to the ear is accumulating, examination by a physician and testing of the balance system will usually be necessary.
A progressively damaging process affecting one ear will often give rise to repeated severe and prolonged vertigo spells, usually lasting twenty or thirty minutes and up to several hours. Often the room can spin or shift during the spells. A strong clue to the presence of a damaging disorder is gradually worsening hearing in just one ear. A loud ringing sound in one ear (tinnitus) during vertigo spells can indicate hearing involvement and should be evaluated by a physician. Progressive diseases that affect the brain can also cause recurrent dizziness, but there are usually other symptoms, such as slurred speech or worsening clumsiness in one or both hands. In order to determine whether or not a problem is progressive, it may be necessary to repeat vestibular testing over time.
If a disease of the balance system is very slowly progressive (for example, the slow-growing tumor inside the skull near the ear called acoustic neuroma), the spells of dizziness can be short but repetitive. This type of problem requires balance testing and imaging of the head for diagnosis and is the reason why a physician should always be consulted when repetitive dizzy spells are happening.
Repeated spells can also occur in other vestibular disorders that do not cause any permanent damage. Some types of migraine can cause these kinds of spells, which can be quite variable in duration, sometimes momentary or for minutes, and at other times lasting for hours or days, often associated with a headache.
Brief positional dizzy spells brought on by movements like rolling over in bed are often due to a minor mechanical malfunction in the ear, called benign positional vertigo . This does not permanently damage the ear, even though the dizziness can feel very violent when it happens.
Some diseases that affect the ear can cause both damaging and non-damaging dizziness. For example, sleep apnea can cause very brief jolts of dizziness that do not damage the ear but is also associated with hours-long spells of more severe vertigo that can be damaging.
In our next post, we will go over common triggers for repeated spells of dizziness.