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Vertigo in Multiple Sclerosis


Updated July 14, 2014

Vertigo is a fairly common symptom of multiple sclerosis (MS), occurring in about 20% of people with MS at some point. It is an acute, uncomfortable sensation, making those of us who are already a little unsteady feel even more nervous about moving around. Fortunately, it is not a permanent symptom, and may not even indicate a new lesion or inflammation, as vertigo can have non-MS causes.

What Does It Feel Like?

Vertigo is a sensation of spinning, whether it feels like you are spinning or your surroundings are rotating. Think back to when you were a child and spun around and around, then stopped -– that’s pretty much the sensation of vertigo. It can feel like:

  • The ground is suddenly rushing upwards
  • The room (or surroundings) is moving continuously
  • The room only seems to rotate part of the way, return to normal, and rotate partway again
It rarely persists for a long time, but can take weeks to go away, which it does gradually.

What Causes It?

Vertigo can be caused by lesions in the cerebellum. It can also be a result of damage to the nerves that control the vestibular functions of the ear (acoustic cranial nerve, CN VIII) in the brain stem.

However, it appears that a very common cause in people with MS is something called benign paroxysmal positioning vertigo (BPPV), rather than demyelination. This means that, just because you have MS, doesn't necessarily mean that the vertigo is a direct result of the MS disease process.

Vertigo can also be made worse by some of the drugs prescribed for MS symptoms, such as tricyclic antidepressants (such as Elavil) for neuropathic pain or Baclofen for spasticity, as these drugs can cause dizziness.

Lastly, vertigo can be caused by infections, such as the flu.

How Severe Can It Get?

It can be a very powerful feeling of movement and can cause nausea or vomiting. At its worst, it can cause difficulty standing or walking and even lead to falls.

Additional Points/Information

See an Otolaryngologist: This is a fancy name for an ear, nose and throat specialist (ENT). Otoneurologists or a neurotologists are specialists in both matters of the inner ear and neurology. I would highly recommend seeing one of these specialists to investigate the causes of any MS-related vertigo. This is important, because some causes of vertigo (such as BPPV) can be treated without medications, and you can prevent unnecessary MRI scans and drugs with side effects like fatigue.

My Experience

Every other year before my MS diagnosis, for about 10 years, I would have very severe attacks of vertigo. Since it seemed to happen most often in the late winter or spring months, it was declared by doctors to be a symptom of sinusitis caused by mild respiratory infections or allergies. The docs prescribed intranasal steroids (Flonase), which I used religiously until the vertigo eventually subsided a couple of weeks later. I never had any other symptoms of sinusitis, so I have to wonder if this was an MS symptom.


Carol Turkington and Kay D. Hooper. The A to Z of Multiple Sclerosis. New York: Checkmark Books. 2005.

Randall T. Schapiro. Managing the Symptoms of Multiple Sclerosis (5th Ed.). New York: Demos Publishing. 2007.

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