There are multiple symptoms of dizziness in older adults depending on the underlying causes.

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common cause of vertigo in older people. Our ears have three parts: the external ear, middle ear, and inner ear. The inner ear contains structures called semicircular canals of the labyrinth. There are calcium crystals inside these canals that help nerves sense movement and gravity. Sometimes, the calcium crystals in your inner ear get dislodged. This can be caused by things such as an ear infection, a bump on the head, or ear surgery. (Sometimes the reasons are unknown.) If this happens, incorrect messages may be sent to your brain about your head position, resulting in vertigo. BPPV comes on suddenly and powerfully. Attacks are provoked by changes in head position, such as lying down, rolling over in bed, standing up, and looking upward. Episodes usually last less than one minute, but tend to reappear frequently over the course of many days. Along with vertigo, you may also experience dizziness and lightheadedness; unsteadiness and loss of balance; blurred vision; rapid side-to-side eye movements that are not under your control; nausea and vomiting; and migraines.

Labyrinthitis (acute vestibular neuritis)

Inflammation and swelling in your inner ear is called labyrinthitis. This can cause intense, constant vertigo that starts suddenly and can last for days. With labyrinthitis, side-to-side eye movements stop when the eyes are fixed on an object. The main causes of labyrinthitis are upper respiratory infections and other viral infections, but stress, fatigue, allergies, smoking, or alcohol use can raise the risk for labyrinthitis. You may also have nausea, vomiting, loss of balance, or hearing loss.

This condition usually clears up on its own after a few days, but you may have to stay in bed until your symptoms disappear.

Meniere’s Disease

Meniere’s disease is much less common than BPPV or labyrinthitis. It is a long-term condition caused by a buildup of fluid in the inner ear, which can result from viral infections, allergies, or any number of other factors.

Meniere’s disease can cause the following symptoms:

  • sudden feelings of vertigo lasting for 20 minutes to several hours
  • hearing loss that comes and goes, but eventually results in some permanent deafness
  • buzzing, ringing, whistling, or roaring sound in the ear (tinnitus)
  • a feeling of fullness in the ear

Vestibular Migraine

Some people who get migraine headaches also experience vertigo and other types of dizziness during the migraine or between migraine headaches. Dizziness may last minutes to hours, however some people may have symptoms for days to weeks.

Vestibular Schwannoma

A vestibular schwannoma (acoustic neuroma) is a benign (non-cancerous) growth on the nerve that connects the inner ear to the brain. Symptoms may include slowly progressive hearing loss, and tinnitus in one ear. Vertigo is less common because the gradual change in vestibular function is compensated for over time.

Other Causes of Vertigo

Vertigo can also be a signal of a stroke, brain hemorrhage, or multiple sclerosis. With these serious conditions, you will have other symptoms along with the vertigo. These include severe balance problems, double vision, slurred speech, facial weakness or numbness, and others. However, a healthcare provider will quickly recognize that these symptoms are related to the conditions mentioned above.

See a healthcare professional or call 911 right away if you have dizziness or vertigo along with any of the following:

  • a head injury
  • a severe or unusual headache
  • fever higher than 101 degrees Fahrenheit
  • a stiff neck
  • blurred vision
  • sudden hearing loss
  • speech difficulties
  • leg or arm weakness or numbness
  • a fall
  • trouble walking
  • chest pain
  • unusually fast or slow heart rate
  • loss of consciousness


Last Updated December 2020