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Many people with multiple sclerosis (MS) experience dizziness. According to the Multiple Sclerosis Trust, at least 1 in 3 people diagnosed with multiple sclerosis will experience dizziness sometime during their life. More than 18,000 MyMSTeam members report experiencing dizziness or vertigo — the sensation that your surroundings are spinning or swaying or that you are completely out of balance with the room and objects around you. This sensation is often accompanied by a feeling of lightheadedness.

MS is an autoimmune condition in which the immune system mistakenly attacks the myelin (protective coating around nerve fibers) in the central nervous system (CNS), which includes the brain and spinal cord. The resulting demyelination (damage to the myelin) can cause lesions, or areas of damaged tissue, that lead to a wide array of symptoms that may include dizziness and vertigo. However, these can also be symptoms of another condition or a side effect of medication.

Dizziness can cause balance problems that affect daily life and even lead to falls, especially alongside symptoms like muscle spasticity (involuntary muscle spasms or stiffness). Read on to better understand the symptom of dizziness and learn ways to manage it to improve your quality of life.

1. Dizziness Can Be an Early Symptom of MS

Dizzy spells are a common symptom of MS, and several members of MyMSTeam identified dizziness as an early sign of their condition. “My very first symptom of MS was dizziness,” one member shared. Another commented, “A couple of years ago, I started with random dizzy spells, but I never went to the doctor because it always passed.”

2. Vertigo and Dizziness Can Be Disabling

Dizziness and vertigo can make a person feel sick and can interfere with daily life. “Today, I couldn’t get out of bed,” one MyMSTeam member wrote. “The room was spinning, and the feeling of nausea was huge. I had to call in sick.”

“I went to church, then came home and cooked dinner,” another member shared. “During dinner, I got a dizzy spell and had to sit down. I was barely able to finish.”

Sometimes, dizziness can be very disabling. “I’ve been extremely dizzy all day. I’m so dizzy I can’t walk straight,” a member wrote.

3. MS Lesions Can Cause Dizziness and Vertigo

Dizziness and vertigo in MS may be caused by new or growing MS-related lesions. Specifically, MS-related dizziness and vertigo can result from lesions in the pathway responsible for coordinating visual information, spatial information, and other data to help a person navigate through space. This pathway is called the vestibular system. It is key to helping you know where you are relative to your surroundings and maintaining proper equilibrium (balance).

MS lesions may also be found on the brainstem where it connects the inner ear (which is essential to balance) to the brain. They may also form on the cerebellum — the area of the brain that helps with balance. Demyelination in these regions may worsen symptoms of dizziness.

4. MS Flare-Ups Can Worsen Symptoms Like Dizziness

Dizziness and vertigo can occur during an MS flare-up — a period of worsening symptoms. Flare-ups happen periodically for most people diagnosed with relapsing forms of MS, which include clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), and active secondary progressive MS (SPMS). Flare-ups, also known as exacerbations, are usually associated with a new lesion on the CNS. These periods usually develop gradually, over hours or days, and subside after a time.

5. Vertigo and Dizziness Can Be Side Effects of Medications

Some people diagnosed with multiple sclerosis experience dizziness and vertigo as a side effect of certain medications they are taking, whether disease-modifying therapies (DMTs) for MS or for another condition. Many medications have dizziness as a possible side effect, so it’s important to work with your health care team to determine whether MS treatment or anything else you’re taking might be causing dizziness or vertigo.

6. Dizziness May Be Caused by Unrelated Conditions

Sometimes, people diagnosed with multiple sclerosis experience dizziness because of a separate health condition. Other possible causes of dizziness and vertigo can include:

• Inner-ear problems
• High blood pressure
• Blood vessel diseases
• Strokes
• Migraine attacks
• Brain tumors
• Dehydration
• Anemia (low red blood cell count)

A health care provider can determine the exact cause of your symptoms and offer medical advice.

7. Immediate Steps Can Help End Dizzy Spells and Keep You Safe

If you are dizzy or lightheaded or feel that the room is spinning, it’s important to take a few steps right away to help yourself feel better and to avoid falls and potential injury. MS Focus Magazine recommends taking several actions as soon as possible if you start experiencing dizziness or vertigo.

• Sit down — Find the nearest place to sit yourself down safely. If it helps, anchor your head on a wall or the back of a chair.
• Don’t move — Avoid moving your head or body position while experiencing dizziness or vertigo.
• Dim bright lights — Don’t try to read or watch TV. Just sit until the sensation passes.
• Have support ready — Keep a support device nearby in case you must move around while dizzy. If you experience frequent dizzy spells, it’s important to use a cane or walker, install grab bars, and ensure your home is free of tripping hazards.
• Let yourself recover — Wait until you start feeling better to try to get up. Start by moving slowly and seeing if the symptoms return.

8. Motion-Sickness Medications May Help

Many people diagnosed with multiple sclerosis find that taking motion-sickness medication helps alleviate symptoms of dizziness and vertigo. “I take a motion-sickness pill that stops the dizziness, and I lie down until I start feeling better,” one MyMSTeam member shared.

Consider purchasing over-the-counter motion-sickness medications and keeping them on hand for whenever a dizzy spell occurs. If your dizziness persists or becomes chronic (ongoing), your neurologist may prescribe stronger motion sickness medications for you. Be sure to confer with your doctor before trying any new medications or treatments.

Other Medications

If motion-sickness medications don’t help or you don’t want to take them long term, your doctor may prescribe another type of medication. Some people find that antihistamines, benzodiazepines, or a short course of corticosteroids help relieve their dizziness and vertigo.

9. Different Types of Therapy Can Help Reduce Dizziness Over the Long Term

If moving your head brings on dizziness or causes you to experience vertigo, it might be time to work with a physical therapist. Physical therapy can help you build up a tolerance to having your head in the positions that make you feel ill, lessening or even eliminating these unpleasant sensations. Vestibular rehabilitation therapy — which might include vision-stability training, balance retraining, and other exercises — can also help reduce dizziness or vertigo in MS.

You Are Not Alone

You are never alone with your multiple sclerosis. On MyMSTeam, the social network and online support group for those living with multiple sclerosis, more than 196,000 members talk about a range of personal experiences and struggles. Dizziness and vertigo are some of the most discussed topics.

Have you experienced dizziness or vertigo with MS? Have any treatments worked for you? Share your experiences in the comments below or start a conversation on the Activities page.

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