Vertigo And Tinnitus – How The Two Conditions Are Related

Vertigo isn’t just a hit Alfred Hitchcock movie – it’s a type of dizziness that can be unusually strong. It can happen for seconds or hours at a time and often feels like spinning, rotating, or general disequilibrium. In extreme cases, vertigo can also lead to nausea or vomiting.

While vertigo can cause unpleasant symptoms, it’s important to note that vertigo itself isn’t a disease, but rather a symptom of a condition. Vertigo is common, with 40% of Americans experiencing it at some point in their lives. It usually happens for only seconds or minutes, but in certain cases can extend to hours, days, weeks, or months. In addition to vertigo, you may be experiencing tinnitus, or ringing in the ears. This article will discuss the relationship between vertigo and tinnitus.

Can Vertigo And Tinnitus Occur Together?

The short answer is yes – they can definitely occur together. Some conditions have both vertigo and tinnitus as symptoms, and hearing loss may also be involved. These include Meniere’s disease, labyrinthitis, acoustic neuroma (vestibular schwannoma), cholesteatoma, otosclerosis, Usher’s syndrome, and enlarged vestibular aqueduct. Certain medications can also be toxic to the hearing and balance systems and lead to these symptoms. Treating these conditions may also act as a treatment for tinnitus. 

How This Happens

Vertigo can often originate from the inner ear, which partially explains why it can be related to tinnitus. While the inner ear houses the cells and structures that allow us to hear, it also helps us to maintain balance. Certain cells in the inner ear transmit sound stimuli to the auditory nerve, while other cells help detect your head’s motion and body’s position in relation to gravity. 

Furthermore, the vestibular nerve helps carry the signals from the inner ear to the brain regarding your body and head position. It runs next to the auditory nerve, which carries signals related to sound, and they are both branches of the eighth cranial nerve. Vertigo can be caused by damage to the vestibular nerve, or disruption to the cells in the inner ear. This also helps explain how vertigo and tinnitus can be related to one another. 

The same things that may cause vertigo can also affect the cells and nerve fibers related to hearing. If the function of the inner ear or auditory nerve cells is impacted, the central nervous system may respond, causing an increase in neural activity which may be perceived as tinnitus by the brain. 

In some conditions where symptoms are caused by changes in fluid pressure in the inner ear, such as Meniere’s disease, vertigo and tinnitus may occur at around the same time, as these changes are occurring due to a specific event. Tinnitus may or may not be present after a vertigo episode. 

Possible Conditions That Cause Vertigo And Tinnitus

Meniere’s Disease

Meniere’s disease, one possible cause of vertigo and tinnitus, is a rare disease. Fluid pressure builds up inside the ear, causing vertigo. Those with Meniere’s disease may also have hearing loss and a feeling of fullness in their ears. It does worsen over time and may cause a more permanent hearing loss.

Labyrinthitis

Labyrinthitis is another possible cause of combined vertigo and tinnitus. It is when the labyrinth (inner ear), the part of the ear that has tiny organs that deal with hearing and balance, becomes inflamed or infected. In addition to the previously mentioned symptoms, those with this condition may also have headaches, ear pain, vision changes, and hearing loss. 

Non-cancerous growths 

Noncancerous growths like an acoustic neuroma (vestibular schwannoma) and cholesteatoma are more possible causes. Cholesteatoma is a growth behind the eardrum, while an acoustic neuroma grows on the vestibular or auditory nerves and can go into the inner ear. Both must be monitored because they can grow large enough to affect hearing or cause other serious conditions. 

Otosclerosis

Otosclerosis and certain medications are other possibilities. Otosclerosis usually happens when a bone (the stapes) in the middle ear becomes stuck in place. Hearing loss may appear gradually and start in one ear before the condition affects the other as well. Medicines that can cause vertigo and tinnitus include the antibiotics gentamicin and tobramycin (Tobrex), antimalarial or autoimmune medicines (such as for arthritis), and chloroquine and hydroxychloroquine (Plaquenil).

Genetic Conditions

Finally, we have enlarged vestibular aqueduct (EVA), and Usher’s disease. Both of these are genetic conditions that are present from birth. They are usually diagnosed in childhood, but it is possible for them to go undiagnosed until adulthood. EVA is caused by a malformation of a structure connecting to the inner ear. Vertigo isn’t as common as hearing loss is for those with EVA, but it is possible. Usher’s disease has balance, hearing, and visual symptoms. 

It is important to note that if you have a sudden onset of tinnitus and vertigo, along with other neurological symptoms like weakness or numbness in the limbs or face or difficulty with speech, a trip to the emergency room is needed. Vertigo and tinnitus can be caused by a stroke.

What To Do If You Have Vertigo and Tinnitus

The first important step is to see a physician for evaluation, including a hearing test. While some cases of vertigo will resolve on their own, some conditions may need to be medically treated and managed.

As you can see, vertigo and tinnitus are symptoms that can be caused by many conditions. Sometimes, your doctor may recommend lifestyle and diet changes to reduce your vertigo symptoms, particularly when they think you have Meniere’s disease. These changes may be beneficial in managing tinnitus, particularly if they lead to a reduction of symptoms overall, improved general health, and reduction of stress.

If your tinnitus persists and becomes bothersome, management techniques that promote relaxation and improve coping mechanisms can be helpful. It’s important to manage stress caused by tinnitus, as reducing stress has been shown to help tinnitus symptoms. For more stress-relieving tips and tinnitus treatments, reach out to our team of tinnitus experts!