Need to Know: Is My Vertigo Caused by MS?

Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by the forum topic “Multiple Sclerosis-related Vertigo: What Can You Do?” from Nov. 23, 2018.

About a year ago, I experienced a strange encounter with dizziness — while I was asleep.

It seems odd that one should feel dizzy while asleep. Yet there I was, feeling as if the world was spinning all around me.

At first, I thought it was an earthquake that awakened me. When I rolled over to get out of bed, I crashed to the floor, completely out of balance as the room continued to spiral.

I pressed my hands flat against my nightstand, then the wall, then the door, struggling to make a sideways path to my bathroom. Not only was I unable to “straighten up and fly right,” I was now feeling nauseated by it all.

The feelings subsided, but came and went a few more times until I finally called my MS specialist. A follow-up visit taught me two things.

Vertigo can be an MS symptom

According to the National Multiple Sclerosis Society, “These symptoms are due to lesions — damaged areas — in the complex pathways that coordinate visual, spatial and other input to the brain needed to produce and maintain equilibrium (balance).”

MS-related vertigo is a common problem. Recent research to address the challenges of identifying and monitoring MS-related vertigo suggests that using the vestibular evoked myogenic potentials (VEMP) test is one way to better view tiny lesions along the inner ear pathways, as MRI may not be sensitive enough to identify them.

Vertigo can be a symptom of something besides MS

MS Focus Magazine suggests that a number of reasons beyond demyelinating events can cause vertigo, such as:

• Inner ear problems
• Medication side effects
• Cardiovascular disease
• Infections (such as the flu)
• Benign paroxysmal positioning vertigo (BPPV)

Other symptoms that can accompany vertigo include common MS symptoms such as ringing ears, vision problems, and problems with standing or walking. This makes it hard to know if one’s vertigo is actually MS-related or a separate problem entirely.

What is BPPV?

It turns out that I had BPPV. This occurs when your ear canal collects tiny crystals of calcium. They can loosen and collect in the tiny “hair cells,” or stereocilia, in your ears. The stereocilia are disturbed when this happens, sending confusing signals to the brain that can lead to balance problems originating in the inner ear.

For those with frequent BPPV, you can learn a simple procedure known as canalith repositioning to relocate those crystals into a different part of the ear where they can be reabsorbed. My MS neurologist taught me this simple form of physical therapy in about five minutes.

What you can do about vertigo

1. First things first: Be safe. Find a position where you can be the most comfortable and where you can also access the help of another, when possible.
2. Take note of it in a symptom journal. If it happens several times over more than 48 hours, it’s a good time to seek advice from your MS specialist. If it happens randomly, but does not persist or is infrequent, you might want to see your primary care doctor. If it rarely happens and it doesn’t bother you, just sitting things out might be the best recourse.
3. Seeing a doctor will help you to identify whether it is MS-related or due to other problems. Whatever the case, follow your doctor’s advice.
4. For MS-related vertigo, treatments might include medications used to treat motion sickness or nausea. For longer periods of MS-related vertigo, these medications can be applied in a patch form.
5. For other forms of vertigo, you might need to review your current medications for side effects, treat other health problems you might have, or confirm and treat BPPV accordingly.

Have you experienced vertigo? What tips and tricks can you share with others who are looking for relief? Post your replies in the comments below or at the original “Multiple Sclerosis-related Vertigo: What Can You Do?” forum entry.

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