Dizziness and vertigo can be common symptoms of multiple sclerosis (MS). They can be both related and unrelated to MS and require careful assessment by your neurologist or GP, to determine the best way to manage and treat episodes.
With the right information and support, dizziness and vertigo can be managed effectively to maintain a healthy and active lifestyle.
Dizziness is a feeling of being light-headed and “woozy”, while vertigo is the feeling that your surroundings are spinning even if you’re standing still. It’s an acute, uncomfortable feeling of unsteadiness or disequilibrium. It’s like the sensation you may recall from childhood when you have spun around and then stopped suddenly.
It can feel like:
• The ground is suddenly rushing upwards
• The room is moving continuously
• The room only seems to rotate part of the way, return to normal and rotate part way again.
Vertigo can be a very powerful feeling of movement and can also be associated with nausea or vomiting. At its worst, vertigo can cause difficulty standing or walking and even lead to falls. It rarely persists for a long time but can take weeks or months to go away (which it usually does gradually). Some people, however, experience it chronically.
Our ability to feel orientated when being still or moving depends on a complex and intricate sensory nerve system including our eyes and inner ears. Dizziness and vertigo for people with MS may be caused by damage to the nerves, which alters the perception of these signals. There are also other common causes of vertigo unrelated to MS, that the general population can experience, related to inner ear issues, which can also happen in people with MS. Dizziness can also be caused by other factors unrelated to MS, such as low blood pressure, low blood sugar level, anemia or other medications.
As there can be many causes of dizziness and vertigo, both related and unrelated to MS, a full assessment by your GP or neurologist is recommended as early as possible, to guide the right management.
Once all possible causes of dizziness and vertigo have been assessed and identified, management will depend on the cause of the symptoms. If the dizziness/vertigo is related to MS lesions, physiotherapy can be a useful management tool, with specific exercises prescribed by the physiotherapist aimed at positioning and balance.
Vestibular physiotherapists specialise in dizziness and vertigo and retraining people to manage these symptoms. Simple measures such as taking care when changing position, especially bed to standing and chair to standing can also be helpful.
There are certain medications that can be prescribed by your doctor that may help if exercises and other management strategies are ineffective. Additionally, if the dizziness and vertigo is related to MS activity or new lesions, there may be treatments initiated for relapse management, or disease modifying therapies that can help prevent new activity.
There is support available to help you manage your MS.
Your neurologist, MS Nurse or GP should be the first contact for any new and/or persistent dizziness or vertigo concerns, so they can perform a detailed assessment and tailor a management plan or referrals if needed.
Contact your state or territory MS organisation to access services such as MS nurses, peer support and other resources.
The following support services may be able to provide advice on anxiety, mental health, wellbeing and other lifestyle factors: