Vertigo living patient overview

Overview

Vertigo is a feeling that you or everything around you is spinning or moving when there is no actual movement. It is often caused by a problem in the inner ear or brain.

Vertigo is very common. About 40% of people will experience it at least once in their lives.

It can affect anyone, but it is more common in older adults and people with certain medical conditions like migraines or ear infections.

Symptoms

Common symptoms

• A spinning or rocking sensation
• Loss of balance or feeling unsteady
• Nausea or vomiting
• Headache
• Ringing in the ears (tinnitus)
• Feeling like you might fall

Symptoms in children

• Complaining of dizziness or feeling like the room is spinning
• Clumsiness or falling
• Nausea or upset stomach
• Crying or irritability if unable to explain
• Ear pain or pressure

Symptoms in older adults

• More frequent falls
• Unsteadiness while walking
• Difficulty getting out of bed
• Sometimes dizziness without spinning
• May be mistaken for general weakness

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV) – tiny crystals in the inner ear get loose
• Labyrinthitis or vestibular neuritis – inflammation of the inner ear, often due to a viral infection
• Meniere's disease – a disorder of the inner ear with fluid buildup
• Migraines – migraines can cause vertigo even without headache
• Head injuries
• Stroke or transient ischemic attack (TIA) – less common but serious

Risk factors

• Age over 50
• History of migraines
• Previous head injury
• Ear infections
• Cardiovascular disease or high blood pressure
• Certain medications that can damage the ear

When to see a doctor

See a doctor urgently if:

• If you have sudden hearing loss along with vertigo
• If vertigo is so severe you cannot stand or walk
• If you have a fever or ear discharge
• If you have a severe headache or stiff neck

Book a routine appointment if:

• If vertigo keeps coming back
• If it affects your daily activities
• If you are worried about the cause

Diagnosis

Your doctor will ask about your symptoms and medical history, and may perform a physical exam. They may also do simple tests to see if you have nystagmus (involuntary eye movements) or balance problems.

Tests that may be done

• The Dix-Hallpike test – a test to trigger vertigo and check for BPPV
• Hearing tests (audiometry)
• Blood tests
• MRI or CT scan of the head if serious causes are suspected
• Electronystagmography (ENG) – a test to record eye movements

What to expect at your appointment

The doctor may move your head and body in different positions to see what triggers the dizziness. Most tests are painless. You may feel dizzy during some tests, but this is temporary.

Treatment

Treatment depends on the cause. Many cases of vertigo improve without specific treatment. For BPPV, a simple series of head movements (the Epley manoeuvre) can often resolve the problem. Your doctor can show you how to do this.

Self-care at home

• Avoid sudden head movements
• Sit or lie down when you feel dizzy
• Use a walking stick if needed
• Do not drive or operate machinery during an episode
• Sleep with your head slightly elevated

Medical treatments

Medications such as medicines to relieve nausea (antiemetics) and drugs to suppress dizziness (vestibular suppressants) may be prescribed for a short time. Antibiotics may be given if there is an ear infection. For migraines, specific treatments may help. Always follow your doctor's advice.

When is surgery considered?

Surgery is rarely needed but may be considered for severe Meniere's disease or if a tumor is causing the vertigo.

Living with this condition

Living with vertigo can be challenging, but most people learn to manage their symptoms. Avoid triggers like bright lights or rapid head movements. Keep your home well-lit and free of tripping hazards.

Lifestyle tips

• Maintain a regular sleep schedule
• Reduce stress with relaxation techniques
• Avoid caffeine, alcohol, and tobacco as they can worsen symptoms
• Stay hydrated

Diet and exercise

A balanced diet can help. Avoid salty foods if you have Meniere's disease. Gentle exercises like walking, tai chi, or vestibular rehabilitation therapy can improve balance over time. Always check with your doctor before starting new exercises.

Mental health and emotional wellbeing

Vertigo can cause anxiety, fear of falling, and frustration. It is common to feel worried about the next episode. Talk to your doctor if anxiety is affecting your life. They can recommend support or therapy.

Prevention

Not all cases can be prevented, but you can reduce your risk by avoiding head injuries (e.g., using seatbelts), managing migraines, and treating ear infections promptly.

Complications

If left untreated

• Falls and injuries from loss of balance
• Increased risk of accidents (e.g., while driving)
• Anxiety or panic attacks
• Depression due to chronic dizziness
• Complications from underlying causes like stroke or infection if not treated promptly

Long-term outlook

Most people with vertigo recover well with treatment or on their own. The outlook depends on the cause, but for many, symptoms improve over time. Early diagnosis and management can help you return to your normal activities.

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