The sensation of the room spinning or the person spinning. The symptoms of vertigo typically get worse with head movement, and decrease with the eyes closed. Nausea and vomiting are frequently associated with vertigo. There are many causes of vertigo with the most common being: labyrinthitis, vestibular neuronitis, benign paroxysmal positional vertigo, motion sickness syndrome and Meniere's disease. Rarer causes include: vestibular migraines, inner ear trauma, perilymphatic fistula, medication damage to inner ear (ototoxicity), acoustic neuromas and other cerebellopontine angle tumors, vertebral basilar insufficiency, and multiple sclerosis.