What Causes Dizziness

Feelings of dizziness can mean many things and are often linked to problems affecting the equilibrium system. A few symptoms of dizziness and imbalance include experiencing blurry vision or spinning (vertigo), and feeling lightheaded, faint, weakness and general unsteadiness. The following are a few common causes for dizziness and imbalance:

Benign Paroxysmal Positional Vertigo (BPPV)

Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo, accounting for over half of all cases. According to various estimates, a minimum of 20% of patients presenting to their healthcare provider with vertigo have BPPV.

Approximately 50 to 70% of BPPV cases occur with no known cause and are referred to as primary or idiopathic BPPV. The peak incidence of BPPV has been observed to range from 50 to 70 years of age.

BPPV is caused by small calcium carbonate particles (otoconia), which are normally found in the inner ear. These particles can become displaced and migrate into one of the ear’s semicircular canals, where they do not belong. This condition is characterized by brief and intense episodes of vertigo that occur with a change in position. BPPV may be the result of the natural aging process, illness, a change in medication, or head trauma. Often, no known cause for BPPV can be identified.

Loss of Balance and Unsteadiness

Issues affecting the equilibrium system of the inner ear can result in a feeling of unsteadiness, a loss of balance and/or falls. We use three primary systems to maintain our balance (i.e., vision, touch, and inner ear) and a disruption to any of these systems can result in imbalance. It is important for individuals who are off balance to be appropriately evaluated so the contribution of each system can be closely observed.


When many individuals think of migraine, headache immediately comes to mind. It is important for patients to understand that migraines can present with a number of different symptoms. One of these symptoms is related to the perception of dizziness or vertigo. Interestingly, research has shown that as many as 25 to 30% of individuals who suffer from migraines also experience vertigo as an aura. Many of those with vestibular migraines do not experience headaches at the same time as their dizziness.

Vestibular neuronitis/Neuritis

Vestibular neuronitis is the second leading cause of vertigo. This condition is typically characterized by a rapid-onset vertigo that is not accompanied by hearing loss. Patients may experience an intense spinning sensation with nausea and vomiting. These intense symptoms typically improve over the course of several days, with gradual improvement over the next few months. Vestibular neuronitis can occur as a single attack or multiple attacks. This condition is related to inflammation of the inner ear and may be related to a viral infection.