Multiple Sclerosis (MS) is a chronic autoimmune disease that targets the central nervous system (CNS), including the brain and spinal cord. This condition involves the immune system mistakenly attacking the protective layer around nerve fibers, a process called demyelination. Dizziness is a common symptom reported by people with MS, and it can be a direct manifestation of the disease. While feeling dizzy is a very common complaint in the general population, understanding the link to MS is important.
The Direct Link: How MS Causes Dizziness and Vertigo
Dizziness, particularly vertigo, is a known symptom of Multiple Sclerosis. The direct cause is the formation of demyelinating lesions—areas of damage—within specific regions of the central nervous system. These lesions disrupt the electrical signals transmitted through nerve fibers that control balance and spatial awareness.
The two most common lesion locations responsible for balance issues are the brainstem and the cerebellum. The brainstem is a crucial relay center connecting the inner ear to the brain, while the cerebellum coordinates voluntary movements and posture. Damage in these areas interferes with the body’s ability to process and synchronize sensory information, leading to the false sensation of movement or unsteadiness.
Vertigo caused by MS lesions is classified as “central vertigo” because the problem originates within the CNS. These episodes often occur during an MS relapse when new lesions form or existing ones grow, sometimes accompanied by other neurological symptoms like double vision or numbness. While some episodes are transient, chronic balance problems can persist due to permanent scarring in the affected areas.
Distinguishing Types of Dizziness and Imbalance
Clearly describing the sensation of dizziness is helpful for diagnosis, as the term covers several distinct feelings.
Vertigo
Vertigo involves the illusion of motion, typically described as feeling like you or your surroundings are spinning or whirling. This rotational feeling is intense and can be accompanied by nausea or vomiting.
Lightheadedness
Lightheadedness is a vague feeling of faintness, wooziness, or feeling as though you are about to pass out. This differs from vertigo as there is no spinning sensation, and it is frequently linked to temporary reductions in blood flow to the brain.
Disequilibrium or Imbalance
Disequilibrium is characterized by a feeling of unsteadiness or wobbliness when standing or walking. People experiencing disequilibrium often feel unsteady on their feet, with the problem becoming worse during movement.
Common Non-MS Causes of Dizziness
Dizziness is an extremely common symptom with many origins that are more frequent than a chronic neurological disease like MS. One frequent cause of true vertigo is Benign Paroxysmal Positional Vertigo (BPPV), an inner ear disorder where tiny calcium crystals become dislodged. Other inner ear issues, such as labyrinthitis or vestibular neuritis, involve inflammation or infection of the balance organ or nerve.
Dizziness can also be a side effect of various medications, including certain blood pressure drugs, antidepressants, and anti-seizure medications. A common, temporary cause is orthostatic hypotension, a brief drop in blood pressure that occurs when a person stands up too quickly, leading to lightheadedness. This is often exacerbated by dehydration or low blood sugar.
Emotional states like anxiety and panic attacks can trigger dizziness by causing hyperventilation, which alters blood gas levels and results in lightheadedness. Migraines, particularly vestibular migraines, can also manifest primarily as episodes of vertigo or imbalance, sometimes without a significant headache.
When to Consult a Healthcare Provider
Any persistent, unexplained, or recurrent episodes of dizziness should prompt a routine consultation with a healthcare provider. If the sensation is disrupting daily life, making driving difficult, or increasing the risk of falling, a medical evaluation is warranted to determine the underlying cause. A doctor can perform a physical examination and necessary tests to rule out common treatable causes like inner ear issues or medication side effects.
Certain “red flag” symptoms accompanying dizziness require immediate medical attention, as they may indicate a more serious neurological event like a stroke. These urgent warning signs include:
- Sudden onset of severe dizziness along with a severe headache unlike any experienced before.
- New double vision.
- Sudden difficulty speaking.
- New weakness or numbness on one side of the body.
- Trouble walking.
- Chest pain.