vertigo MRI what to expect

Overview

Vertigo is a feeling that you or the world around you is spinning, even when you are still. It is a symptom rather than a condition itself, and it can have many causes. An MRI (Magnetic Resonance Imaging) scan is a safe, painless test that uses strong magnets and radio waves to create detailed pictures of your brain and inner ear. For vertigo, an MRI helps doctors look for serious causes, such as problems in the brain or with the nerve that connects your ear to your brain.

Vertigo is very common. About 20-30% of people experience vertigo at some point in their lives, especially as they get older.

Vertigo can affect people of all ages, but it is more common in older adults. Women experience it slightly more often than men. An MRI is usually recommended when vertigo is severe, persistent, or accompanied by other worrying symptoms.

Symptoms

Common symptoms

• A spinning sensation, often triggered by moving your head
• Feeling unsteady or losing balance
• Nausea or vomiting
• Ringing in the ears (tinnitus) or hearing loss
• Blurred vision or difficulty focusing during a dizzy spell
• A feeling of fullness or pressure in the ear

Symptoms in children

• Children may describe dizziness as feeling 'weird' or 'wobbly'
• Young children may cling to a parent or become suddenly reluctant to walk
• Nausea and vomiting without a clear cause
• Head tilting or holding onto furniture to steady themselves

Symptoms in older adults

• More intense dizziness that increases the risk of falls
• Feeling faint or lightheaded when standing up
• Difficulty walking or needing support
• A general sense of unsteadiness that makes daily activities harder

Causes

Main causes

• Inner ear problems such as benign paroxysmal positional vertigo (BPPV), where tiny calcium crystals move into the wrong part of the ear canal
• Vestibular neuritis or labyrinthitis, which are inflammations, often caused by a viral infection, that affect the balance nerve
• Meniere's disease, a disorder of the inner ear that causes vertigo, ringing in the ear, and hearing changes
• Acoustic neuroma, a non-cancerous growth on the nerve that connects the ear to the brain
• Neurological conditions such as multiple sclerosis or migraine-related vertigo
• Reduced blood flow to the brain, sometimes linked to narrowing of blood vessels

Risk factors

• Being over 50 years old
• A prior head injury
• A recent viral infection (such as a cold or flu)
• A family history of migraine, Meniere's disease, or inner ear disorders
• Taking certain medicines that can upset the balance system
• Smoking or heavy alcohol use

When to see a doctor

See a doctor urgently if:

• Vertigo that comes on suddenly and is severe, especially with the emergency symptoms listed above
• Vertigo after a recent head injury
• Weakness, numbness, difficulty speaking, or visual changes alongside dizziness

Book a routine appointment if:

• If you have repeated attacks of vertigo that worry or disrupt your life
• If your dizziness is not improving within a week or two
• If you have hearing loss, ringing, or a feeling of fullness in your ear along with the vertigo

Diagnosis

A doctor will first ask about your symptoms, your medical history, and any medicines you take. They will examine your eyes, ears, and balance. They may perform simple head and body position tests. If the cause is still unclear, or if they suspect a structural problem in the brain or inner ear, they may recommend an MRI scan.

Tests that may be done

• MRI (Magnetic Resonance Imaging) scan
• CT (computed tomography) scan, which uses X-rays to create images, sometimes used when MRI is not an option
• Videonystagmography (VNG), which tracks eye movements to check the balance system
• Hearing tests (audiometry) to check for inner ear problems
• Dix-Hallpike maneuver, a simple position test used to diagnose BPPV

What to expect at your appointment

During an MRI for vertigo, you will lie on a comfortable table that slides into a tunnel-shaped scanner. You need to stay very still for about 30 to 60 minutes while the scanner takes pictures. The machine makes loud tapping and knocking noises, so you will be given earplugs or headphones. In some cases, a contrast dye is injected into a vein in your arm to make certain structures show up more clearly. The test is not painful, but you can speak to the technologist through an intercom if you feel uncomfortable. If you are claustrophobic or unable to lie flat, tell your doctor beforehand, as they can offer support or alternatives.

Treatment

Treatment for vertigo depends on the underlying cause. Many people improve without specific treatment. If a diagnosis is found, treatment may combine medication, balance exercises, or positional maneuvers. Even if the MRI shows no serious problem, you may still benefit from therapy to help your brain adapt to balance changes.

Self-care at home

• Move your head slowly when changing positions, such as sitting up or turning over in bed
• Avoid bending down or looking upwards if this triggers dizziness
• Sit down immediately when you feel a dizzy spell coming on
• Remove loose rugs and clutter to reduce the risk of falling
• Use a walking stick or a handrail if you feel unsteady
• Get up slowly from lying or sitting to let your blood pressure adjust

Medical treatments

Medicines can relieve the symptoms of vertigo, such as nausea and severe dizziness. Your doctor may prescribe vestibular suppressants, which calm the inner ear, or anti-nausea medicines to make you more comfortable. Specific medicines are chosen based on the cause and your general health. Always take medicines exactly as directed by your doctor.

When is surgery considered?

Surgery is rarely needed for vertigo. It may be considered if a growth, such as an acoustic neuroma, is pressing on the nerve, or if severe Meniere's disease does not respond to other treatments. Surgery is never the first choice and is only recommended after careful discussion with a specialist.

Living with this condition

Living with vertigo can be challenging, but you can plan your day around your symptoms. Slow down and allow extra time for tasks that require bending, reaching, or turning. Keep an eye out for early warning signs, and always have a safe place to sit or lie down available.

Lifestyle tips

• Try to sleep in a supportive position that keeps your head slightly elevated
• Avoid sudden head movements, especially first thing in the morning
• If you drink alcohol, limit it, as it can make imbalance worse
• Avoid stress and fatigue, which can trigger or worsen vertigo
• If you smoke, seek help to quit, as smoking can affect inner ear health

Diet and exercise

In some types of vertigo, such as Meniere's disease, reducing salt in your diet may help control symptoms. Staying well-hydrated is also important. Gentle exercises, like walking or a balance programme, can improve your confidence and help your brain reorganise its balance signals. Always check with your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Vertigo can lead to anxiety and even depression. People often worry about having an attack in public or fear falling. It is normal to feel frustrated or frightened. Talk to your doctor about how you are feeling, and consider relaxation techniques like breathing exercises or mindfulness to reduce stress.

Prevention

Vertigo itself cannot always be prevented, because many underlying causes are not under your control. However, you can reduce your risk of episodes by protecting your head from injury, treating ear infections promptly, managing stress, and staying physically active.

Complications

If left untreated

• Falls that lead to fractures or other injuries
• Difficulty driving or performing daily activities safely
• Chronic anxiety about when the next dizzy spell will happen
• Worsening of an underlying condition, such as an ear infection or neurological disorder, if it is not investigated

Long-term outlook

For most people, vertigo improves with time and the right treatment. Even when vertigo is unpleasant, an MRI is a helpful step that can reassure you and guide your care. With a clear plan, most people return to their normal activities and feel in control again.

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