There are days when Amanda Ellis Graham of Salt Lake City feels like the rug has been pulled out from under her, literally leaving her dizzy. She compares the vertigo she lives with to walking on a trampoline.
Graham, who was diagnosed with multiple sclerosis when she was 18, takes daily medications to help control the dizziness, but even combined with other approaches she has developed over the years, vertigo has had a severe impact on her quality of life.
Now in her 30s, Graham says vertigo has been her most debilitating MS symptom. She’s currently on disability and no longer drives because her intense vertigo is unpredictable and scary.
“It feels like when you go through a fun house, and there are those moving floors and flashing lights," she says, describing her experiences with vertigo. "You feel like you’re going to throw up when it gets really intense." Often she tries just to focus on something that isn’t moving in order to “reset” her brain.
“People will ask, ‘Do you need to go lie down?’" Graham says. "It’s an understandable question, but lying down actually makes it worse." With her doctor’s help, she has developed her own strategies for coping with vertigo, such as focusing on a stationary object, and avoiding noise and bright lights to cut down on sensory overload.
What Causes Vertigo in MS
We don’t know why people with MS get vertigo, says neurologist John Pula, MD, an assistant professor of neurology at the University of Illinois College of Medicine. Research by Dr. Pula published in the Journal of Neurology suggests that when MS is more active, dizziness is more often reported.
“What we found is that there are many parts of the brain responsible for producing dizziness," Dr. Pula says. "Acute vertigo can happen in MS and may be responsible for some of the symptoms and disability that happen in MS.”
Beyond the relationship between brain lesions and dizziness, Pula says there are other reasons why people with MS might experience more dizziness than others, including:
- Benign positional vertigo. This is a sensation caused by dislocation in your inner ear. Because falls and trauma may cause this, people with MS, who tend to fall more often, also might be at greater risk for lasting dizziness.
- Changes in vision. Your sense of balance relies in part on your visual system. MS-related vision changes also can lead to a sensation of dizziness even if you are standing or sitting still.
- Changes in brain structures. If MS attacks the cerebellum, your balance can be affected.
Because the possible causes of dizziness vary, the treatments do as well. Work with your doctor to pinpoint the cause of your vertigo. When you see your doctor, try to be as specific as you can in describing what you are feeling.
One tip when talking with your doctor: If possible, stay away from the word "dizziness."
“It’s not that descriptive,” says vestibular rehabilitation specialist Helen Cohen, EdD, OTR, a professor and associate director of the Center for Balance Disorders at the Baylor College of Medicine in Houston. “I’ve had people come in and say they feel dizzy, but they really mean off balance, while another person means lightheaded. People with vertigo typically feel that they are moving -- it’s a sense of internal motion.”
“Be careful what you say to your doctor because it’s your description that will put your doctor on the track to solving your problem,” stresses Dr. Cohen.
She points out that for most people, dizziness is not an emergency situation and can be addressed at your next doctor visit. However, she advises going to the emergency room for acute vertigo if:
- You have sudden hearing loss.
- You have heart disease risk factors.
- You have other signs of a stroke, such as a sudden headache or loss of speech and motor coordination.
- You also are nauseous and vomiting.
- You have fallen or lost consciousness.
- You suspect an overdose or a negative interaction involving alcohol, drugs, and, possibly, medications.
Coping With Vertigo
Vertigo can be scary, annoying, frustrating, and worrying. Experiment with various strategies to reduce vertigo:
- Review your medications. Medications can cause side effects such as lightheadedness and dizziness. Go over your medications with your doctor or pharmacist to make sure you’re taking them correctly and that there are no unwanted interactions.
- Get a total health check. Though vertigo and MS go hand in hand for some people, others who have MS also can develop vertigo or dizziness because of another health problem. Stroke, infections, dehydration, low blood sugar, aging, and heart disease can all contribute to dizziness. Don’t assume MS is the root cause. If you’re experiencing dizziness, let your doctor know.
- Treat the vertigo. Based on your doctor’s evaluation, you might need additional medications temporarily or on a longer-term basis to treat the vertigo or its cause.
- Use assistive devices. Graham says it took her a while to accept that using a cane would be helpful to her. Now, looking back over the past few years, “I don’t know how many times I would have fallen over if I wasn’t using that cane," she says. A cane or walker can stabilize you when you’re feeling out of balance.
- Stay hydrated. Graham makes drinking enough fluids a priority and says this helps reduce her feelings of vertigo. It’s also good health advice in general – so drink up!
- Try acupressure. Graham gets some relief from touching key pressure points. Work with an acupuncturist or acupressure specialist to figure out which pressure points work best for you.
- Know your best times. If there’s a pattern to when you feel vertigo during your day, respect it. Complete tasks that require a good sense of balance, such as showering or cleaning your home, when you’re less dizzy.
- Consider vestibular rehabilitation. Work with a specialist in this area of rehab on specific exercises that can improve your quality of life.
- Consult a chiropractor. Occasionally, Pula says, manual manipulation of the head improves dizziness.
- Exercise. Vertigo might make you want to stay still, but Cohen believes that being physically active can help reduce sensations of vertigo in some people. Choose safe and appropriate activities.
The bottom line, Cohen says, is that you don’t have to accept living with vertigo forever. “It’s extremely rare to have vertigo that can’t be treated or helped,” she says.
Last Updated: 11/5/2013