Intense vertigo with nausea is most often caused by a disorder of the vestibular system of the inner ear. This often begins abruptly and lasts days or weeks. When self-limited and not associated with other neurological problems, the condition is termed labyrinthitis or vestibulitis . Although the cause is unknown, viral inflammation is suspected in many cases. Another condition, positional vertigo, occurs with a change in head position, such as leaning forward or backward, looking up or down, or turning quickly.
Attacks last several seconds.
Positional vertigo is most common in middle-aged patients. Vertigo may also occur immediately after head trauma or stroke. If a transient drop in blood flow or pressure is suspected, medication, extra fluids, and additional diagnostic evaluation may be prescribed. Medication may be given for several weeks or only when symptoms are exacerbated. Reassuringly, labyrinthitis and positional vertigo are typically self-limited disorders.