Vertigo sensation

Overview

Vertigo is a false sensation of movement, often described as feeling like you or the world around you is spinning. It is a type of dizziness that usually comes from a problem in the inner ear or the brain.

Yes, vertigo is very common. About 1 in 10 people will experience it at some point in their lives.

It affects people of all ages, but is more common in adults over 40 and in people who have had a head injury or an ear infection.

Symptoms

Common symptoms

• A spinning or swaying sensation
• Feeling unsteady or off-balance
• Nausea or vomiting
• Sweating
• Rapid eye movements (nystagmus)

Symptoms in children

• Complaints of feeling like they are moving
• Clinginess or fear of moving
• Falling more often
• Nausea or refusal to eat

Symptoms in older adults

• Increased risk of falls
• Feeling faint or lightheaded
• Harder to stand or walk
• May be mistaken for general 'dizziness' or weakness

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV) – tiny calcium crystals in the inner ear move out of place
• Labyrinthitis or vestibular neuritis – inflammation of the inner ear, often from a viral infection
• Meniere's disease – a condition with fluid buildup in the inner ear, causing vertigo, ringing, and hearing loss
• Migraine – some migraines cause vertigo even without a headache
• Less common: stroke, brain tumour, or multiple sclerosis (affecting balance centres)

Risk factors

• Age over 40
• Previous head injury
• Ear infections
• Family history of migraine or Meniere's disease
• Long periods of bed rest or inactivity

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above (e.g., signs of stroke or sudden hearing loss)
• If you have vertigo after a fall or blow to the head

Book a routine appointment if:

• First episode of vertigo that doesn't go away after a few days
• Vertigo that keeps coming back and affects your daily life
• If you are worried about your symptoms

Diagnosis

Your doctor will ask about your symptoms, when they happen, and your medical history. They may perform simple head movements to see if they trigger vertigo and eye movements.

Tests that may be done

• Dix-Hallpike test – a head movement test to check for BPPV
• Hearing tests (audiometry)
• Balance tests (e.g., electronystagmography)
• Imaging such as MRI or CT scan (if a brain cause is suspected)

What to expect at your appointment

Diagnosis is often straightforward with a physical exam. You may be referred to an ear, nose, and throat (ENT) specialist or a neurologist. Tests are usually painless. For BPPV, diagnosis can lead to a simple treatment called the Epley manoeuvre, which your doctor can perform.

Treatment

Treatment depends on the cause. Many cases improve on their own. For BPPV, a series of head movements called the Epley manoeuvre can reposition the inner ear crystals. For infections, rest and time are often enough. For Meniere's disease or migraines, lifestyle changes and medications (like motion sickness medicines or preventives) may help.

Self-care at home

• Sit or lie down immediately when you feel dizzy
• Avoid sudden head movements
• Move slowly when getting up from bed or a chair
• Use good lighting and hold onto handrails when walking
• Avoid driving or operating machinery during a vertigo episode

Medical treatments

Your doctor may recommend specific head repositioning manoeuvres (for BPPV), prescribe medicines to reduce motion sickness or nausea, or suggest vestibular rehabilitation therapy (exercises to retrain your balance system). For migraines, medications that prevent attacks may be used. For inner ear infections, anti-inflammatory drugs or steroids might be prescribed. Always follow your healthcare provider's advice; do not self-prescribe.

When is surgery considered?

Surgery is rarely needed. It may be considered for severe Meniere's disease that doesn't respond to other treatments, or for a rare brain cause like a tumour.

Living with this condition

Vertigo can be unpredictable. Learn your triggers (certain head positions, loud noises, flashing lights). Keep your home clutter-free to reduce fall risk. Tell family and friends what to do if you have an episode – they can help you stay safe.

Lifestyle tips

• Stay hydrated – dehydration can worsen dizziness
• Avoid caffeine, alcohol, and tobacco if they trigger symptoms
• Manage stress through relaxation exercises or therapy
• Get enough sleep

Diet and exercise

A balanced diet helps overall health. For Meniere's disease, a low-salt diet may reduce fluid buildup. Gentle exercise like walking or tai chi can improve balance over time – but avoid activities that require rapid head movements until you know your triggers.

Mental health and emotional wellbeing

Vertigo can cause anxiety, fear of falling, or depression. It's normal to feel frustrated or worried. Talking to a counsellor or joining a support group can help. If you feel overwhelmed, speak with your doctor.

Prevention

Not all vertigo can be prevented, but you can reduce the risk of some types. For BPPV: avoid sleeping on the ear that triggers symptoms. For infections: practice good hand hygiene and stay up to date with vaccines. For migraines: avoid known triggers.

Vaccines

Vaccines help prevent viral infections that can lead to labyrinthitis. Talk to your doctor about recommended vaccines like the flu shot or pneumococcal vaccine.

Screening programmes

There is no routine screening for vertigo. If you have risk factors (e.g., frequent migraines, Meniere's family history), your doctor may suggest preventive strategies.

Complications

If left untreated

• Increased risk of falls and injuries
• Chronic dizziness leading to balance problems
• Anxiety or depression from persistent symptoms
• Rarely: untreated infections could spread or cause hearing loss

Long-term outlook

For most people, vertigo improves with time and simple treatments. Even chronic cases can be managed well with lifestyle changes and therapy. The outlook is positive with proper care – many people return to their normal activities.

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