Mareo tipo vértigo


El vértigo es una patología muy frecuente. Aparece bruscamente. Todo te da vueltas y tienes una sensación nauseosa. Es frecuente que aparezcan episodios de manera repetida. A lo largo de varios post vamos a hablar de la causa más frecuente de vértigo: el vértigo posicional o postural. Trataremos de explicaros qué es, por qué se produce y qué podéis hacer para tratarlo.

¿Qué es el vértigo posicional?

El vértigo se caracteriza por la aparición brusca de una sensación de giro de objetos (“todo me da vueltas”) acompañados de naúseas y en ocasiones de vómitos.

Es frecuente que notes empeoramiento con los movimientos de cabeza y los cambios posturales, mejorando tras estar un rato en la misma posición. Los movimientos que con mayor frecuencia desencadenan el vértigo son levantarse de la cama o darse la vuelta, agachar la cabeza o extender el cuello. Hay personas que se sienten ligeramente mareadas e inestables al caminar o hacer actividades cotidianas.

El episodio suele resolverse de forma espontánea pasados unos días. No obstante, puede ocurrir que se convierta en un problema crónico y recidivante. Hay veces que dura semanas, meses o incluso años.

¿Por qué se produce?

La mayoría de las veces el vértigo posicional es de causa idiopática, es decir, desconocida. Se cree que la causa está en el oído interno. Se debe a unas partículas llamadas otolitos u otoconias que flotan libremente en el interior de los canales semicirculares. Al mover la cabeza, estas partículas se desplazan hacia el utrículo, donde están las células con sensores del equilibrio, provocando un estímulo desproporcionado en dichos sensores. Cuando estas partículas vuelven a su sitio y dejan de estimular a las células del equilibrio, el vértigo desaparece.

Otras causas de vértigo son la postraumática, la infecciosa (laberintitis vírica), la enfermedad de Menière, el reposo prolongado en cama, la ototoxicidad por sustancias o la otitis media crónica.

¿Necesito que me hagan alguna prueba para diagnosticarme?

No se necesita ninguna prueba especial para hacer el diagnóstico. Únicamente con la exploración y los síntomas tu médico podrá diagnosticarte.

Tu médico te hará una exploración neurológica y otorrinolaringológica completa. Cuando hay un vértigo posicional, puedes oírle decir que en la exploración te ha detectado un “nistagmo”. No te preocupes, esto no es más que un signo frecuente en los vértigos posicionales. Consiste en un movimiento ocular y puede orientar el diagnóstico.

Una de las pruebas que puede realizar tu médico al explorarte es la de Dix-Halpike. Tu médico te pedirá que te sientes en la camilla con las piernas estiradas. A continuación se realizan giros con la cabeza que pueden reproducir la sensación vertiginosa.

¿Qué tratamiento debo hacer?

  1. Tratamiento médico: Para el vértigo posicional se puede iniciar tratamiento con supresores vestibulares: sulpirida (Dogmatil®) o betahistina (Serc®). Si tienes muchas naúseas o vómitos puede que te recomiende un tratamiento con algún antiemético.
  2. Tratamiento con maniobras de recolocación de partículas.
  1. Ejercicios de reeducación vestibular: Estos ejercicios si se hacen de forma continua y persistente, son muy eficaces a la hora de conseguir reducir el número de episodios de vértigo. Es frecuente que cuando uno siente ya mejoría, se confíe y deje de realizarlos, lo que es un error. Conviene ser constante y realizarlos todos los días, no te llevarán más de 5 minutos.
    Pinche aquí para descargar algunos ejercicios. 


¿Cómo suele evolucionar el vértigo?

Normalmente el vértigo cura de manera espontánea. Cuando se realizan las maniobras de reposición vestibular, suele durar menos días. Es frecuente la aparición de episodios de manera recidivante con mayor o menor periodicidad. La ejecución diaria de los ejercicios de rehabilitación vestibular puede lograr que esos episodios sean menos frecuentes.

Marta Cano Pazos
Médico residente, Centro de Salud Arturo Eyries, Valladolid


  • Bhattacharyya N, Baugh RF, Orvidas L, Barrs D, Bronston LJ, Cass S, et al.; American Academy of Otolaryngology-Head and Neck Surgery Foundation. Clinical practice guideline: benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 2008;139(5 Suppl 4):S47-81. PubMedPMID: 18973840
  • Hall SF, Ruby RR, McClure JA. The mechanics of benign paroxysmal vertigo. J Otolaryngol. 1979;8(2):151-8. PubMed PMID: 430582

Revisado: septiembre 2019

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