Multiple sclerosis (MS) is an autoimmune disease that damages the central nervous system. Depending on where the damage is, some people experience dizziness, lightheadedness, or vertigo.

Multiple sclerosis (MS) can cause dizziness, lightheadedness, and vertigo, along with other symptoms.

MS symptoms result from temporary demyelination, or damage to protective tissue around nerves, or long-term scars in the central nervous system.

When demyelination heals, symptoms improve. However, sometimes the damage is permanent and leads to scars, often called plaques, and can cause persistent symptoms.

If demyelination or damage occurs in the parts of the brain and central nervous system (CNS) that help you maintain equilibrium (balance), such as the brainstem or cerebellum, you may experience dizziness or vertigo.

Dizziness, lightheadedness, and vertigo are common symptoms of MS. However, they can also have other causes. It’s important to rule out other causes to manage these symptoms effectively.

Keep reading to learn more about the causes of dizziness and vertigo, how they’re treated, and how they relate to MS.

Dizziness vs. vertigo vs. lightheadedness: How are they different?

Although dizziness, vertigo, and lightheadedness have similar and overlapping features, they describe different sensations:

  • Dizziness refers to a feeling of overall physical imbalance. It may cause you to feel off-balance or like you could fall while walking.
  • Vertigo refers to a sense of spinning that continues even when you’re still. The sensation can be intense, making you feel like you’re spinning or the world is spinning around you, even if you’re not moving.
  • Lightheadedness describes feeling like you may pass out or that your head feels too light.

Ongoing dizziness and vertigo may interfere with daily tasks, increase the risk of falls, and even become disabling. In people with MS who experience other balance issues, these risks may be more pronounced. According to a 2022 review of research, an estimated 20% of people with MS experience vertigo.

MS typically causes a type of vertigo known as central vertigo, which stems from problems in the CNS.

Another more common type of vertigo, peripheral vertigo, results from problems with the inner ear.

Vertigo and dizziness may sometimes last for hours or days. They may also occur with other symptoms, including:

If you experience new or worsening MS symptoms, contact a member of your care team, as this may indicate an MS exacerbation that requires treatment.

Inflammation from MS damages myelin, which is the protective layer that covers the nerve cells.

This process is known as demyelination. It may interfere with nerve signals.

This causes symptoms of MS, which vary according to the location of the lesions.

For example, areas of demyelination in the cerebellum and brain stem are especially likely to cause dizziness.

Other MS symptoms, like impaired vision or fatigue, can contribute to sensations of dizziness and vertigo.

It’s also possible to have MS and vertigo independently of each other.

For example, an inner ear problem may cause peripheral vertigo, or benign positional vertigo, which accounts for 90% of cases of vertigo.

Other possible causes of dizziness or vertigo might be short-term or long-term. Short-term causes can include:

Long-term causes of persistent dizziness that require treatment can include:

  • stroke or past stroke
  • low blood pressure
  • heart disease
  • kidney disease

If your symptoms of dizziness or vertigo result from MS, managing MS or treating an MS exacerbation may resolve them. If these symptoms are new or have recently worsened, it’s important that you contact a member of your care team for treatment.

Other options, like medication or other remedies for dizziness and vertigo, can also help these symptoms go away.

If your current MS treatment plan doesn’t seem to be working as well as it used to in reducing and managing your symptoms, it may be time to talk with your neurologist about reevaluating it.

Medication

If an MS exacerbation is causing your vertigo, a doctor may suggest a short course of IV corticosteroids to help treat the exacerbation.

Over-the-counter (OTC) anti-motion sickness medications may help manage dizziness and vertigo. These are available as oral tablets or skin patches. OTC options may include:

  • dimenhydrinate (Dramamine)
  • diphenhydramine (Benadryl)
  • meclizine (Antivert)

If dizziness or vertigo becomes chronic (long-lasting), a doctor may prescribe more powerful anti-motion sickness or anti-nausea medications.

Prescription options may include:

  • scopolamine (Transderm Scop, Scopace, Maldemar)
  • promethazine

Vestibular rehabilitation

Physical therapy tailored for MS may also help improve balance and coordination.

If you have peripheral vertigo caused by an inner ear issue, a physical therapist may guide you through exercises to relieve it.

Home remedies

When vertigo occurs, certain behavioral strategies might help you feel safer and more comfortable, such as:

  • sitting down until it passes
  • avoiding moving your head or body position
  • turning down bright lights
  • avoiding screens and reading
  • avoiding stairs
  • not driving until you’re sure the vertigo has passed
  • moving very slowly when you feel better
  • drinking fluids
  • eating

If vertigo occurs at night, try to slowly sit up straight, turn on soft lighting, and remain still until you feel better. Certain positions may help you sleep with vertigo.

Vertigo may return when you turn the light off and lie down, so a comfortable recliner or a wedge pillow may help.

The balance issues caused by dizziness and vertigo could increase your chances of injury due to falls. This is especially true for people whose MS symptoms already include trouble walking, weakness, and fatigue.

A few safety measures around the home may help reduce this risk, such as:

  • clearing your home of tripping hazards, especially throw rugs
  • using a cane or a walker
  • installing handrails and grab bars
  • using a shower chair

Most importantly, sit down when you feel dizzy or notice a spinning feeling coming on.

Dizziness and vertigo can be symptoms of MS, a chronic immune disease affecting the central nervous system.

Speak with a doctor if you experience frequent bouts of dizziness or vertigo. They can help you figure out if MS is the cause of your symptoms and then develop a treatment plan that can help you manage your symptoms and improve your quality of life.