vertigo screening test preparation

Overview

Vertigo is the feeling that you or your surroundings are spinning or moving, even when you're still. It's not the same as feeling lightheaded or unsteady. Vertigo screening tests are simple, safe procedures doctors use to find the cause of your spinning sensation.

Yes, vertigo is quite common. About 40% of adults will experience vertigo at some point in their lives, and it becomes more frequent as we get older.

Vertigo can affect anyone, but it happens more often in older adults, people who have had a head injury, and those with certain inner ear conditions like Ménière's disease or BPPV (benign paroxysmal positional vertigo).

Symptoms

Common symptoms

• A spinning or swaying feeling
• Nausea or vomiting
• Loss of balance or trouble walking
• Ear ringing (tinnitus) or hearing changes
• Sweating and feeling unwell

Symptoms in children

• Falling or clutching onto parents
• Complaining of a 'moving room'
• Nausea, vomiting, or fussiness
• Refusing to move the head

Symptoms in older adults

• Sudden loss of balance leading to falls
• Confusion or dizziness that is worse when turning in bed
• Difficulty getting up from lying down
• Fear of falling that limits daily activities

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV) – tiny crystals in your inner ear become dislodged
• Vestibular neuritis or labyrinthitis – inflammation of the inner ear, often after a viral infection
• Ménière's disease – a buildup of fluid in the inner ear that causes vertigo, ringing, and hearing loss
• Migraine-associated vertigo
• Head injury
• Certain medications that can damage the inner ear

Risk factors

• Age over 50
• A previous head injury, even mild
• Viral infections (like a bad cold or flu)
• Family history of vertigo or migraine
• High salt intake (can affect Ménière's disease)
• Stress and lack of sleep

When to see a doctor

See a doctor urgently if:

• You have sudden hearing loss along with vertigo
• You can't stand or walk at all
• You have a very high fever or a stiff neck
• You have persistent vomiting that could lead to dehydration

Book a routine appointment if:

• You've had episodes of vertigo that keep coming back
• The dizziness is affecting your daily life or making you afraid of falling
• You have ringing in your ears or feel pressure in your ear along with vertigo
• You want to find out the cause and get treatment

Diagnosis

Your doctor will ask about your symptoms, health history, and do a physical exam. They may also perform simple tests in the clinic to see what type of vertigo you have. Preparing for these tests can help you get the most accurate results.

Tests that may be done

• Dix-Hallpike test – you are lowered quickly from sitting to lying down with your head turned. This provokes vertigo and eye movements (nystagmus) to diagnose BPPV.
• Videonystagmography (VNG) – you wear goggles that track your eye movements while you watch moving targets or have warm and cool air or water gently placed in your ear canals.
• Caloric test – a part of VNG where warm or cool air or water is put in your ear to test your inner ear function.
• Rotary chair test – you sit in a computer-controlled chair that moves slowly to measure your balance system.
• Posturography – you stand on a platform to test how well you use vision, inner ear, and leg sensation to keep your balance.
• MRI or CT scan – if the doctor suspects a problem in the brain or the inner ear structures.

What to expect at your appointment

For most vertigo screening tests, you do not need special preparation. For tests like VNG, your doctor may ask you to avoid caffeine, alcohol, and certain medications for 24 to 48 hours beforehand, because these can affect your inner ear responses. You may also be asked to not eat a heavy meal right before the test to reduce nausea. For the Dix-Hallpike test, tell your doctor if you have any neck, back, or hip problems. The tests are usually done in a clinic and take about 30 to 60 minutes. You may feel dizzy during the test, but it's temporary. It's best to have someone drive you home, especially after tests that bring on vertigo.

Treatment

Treatment for vertigo depends on the cause. In many cases, simple maneuvers or exercises can reduce symptoms. Other treatments focus on the underlying condition. Your doctor will work with you to create a plan that fits your needs.

Self-care at home

• Avoid sudden head movements or quick changes in position.
• Sit or lie down as soon as you feel vertigo starting to prevent falls.
• Use extra lighting at night and remove trip hazards in your home.
• Try the Epley maneuver at home if your doctor has taught it to you for BPPV.
• Stay hydrated and rest when you need to.

Medical treatments

Doctors may prescribe medications to help control nausea and dizziness during an episode. For inner ear infections, they might recommend anti-inflammatory medicines. For Ménière's disease, a low-salt diet and medications to reduce fluid buildup are common approaches. Some conditions, like vestibular neuritis, may be treated with steroids to reduce inflammation. Always talk to your doctor before taking any new medication.

When is surgery considered?

Surgery is rarely needed for vertigo. It may be considered for severe Ménière's disease that does not improve with other treatments, or for certain inner ear tumors. Procedures can include draining fluid from the inner ear or cutting a nerve that sends balance signals. Your specialist will discuss the risks and benefits if surgery is an option for you.

Living with this condition

Living with vertigo can be challenging, but many people manage well with small adjustments. Plan your day to include rest breaks. Move slowly and use handrails when going up or down stairs. Avoid looking up or down for a long time. Keep a diary of your symptoms to share with your doctor – note when vertigo happens, what you were doing, and how long it lasted.

Lifestyle tips

• Sleep with your head slightly raised on a pillow if you have BPPV.
• Avoid activities that require quick head turns, like certain sports or rides at fairs.
• Always stand up slowly from sitting or lying down.
• Wear supportive, low-heeled shoes to help with balance.

Diet and exercise

A balanced diet can support your overall health. If you have Ménière's disease, your doctor may recommend a low-salt diet (less than 2 grams of sodium per day). Stay well hydrated. For exercise, gentle activities like walking, tai chi, or yoga can help improve your balance. Vestibular rehabilitation therapy (VRT) is a special exercise program designed by a physiotherapist to retrain your brain and inner ear to work together better.

Mental health and emotional wellbeing

Vertigo can cause anxiety about falling or having an episode in public. It may also lead to feeling isolated or depressed. It is normal to feel worried or frustrated. Talk to your doctor or a mental health professional if these feelings are affecting your daily life. Counselling and relaxation techniques can help.

Prevention

Not all vertigo can be prevented, especially if it is caused by an inner ear condition or a virus. However, you can reduce your risk by avoiding head injuries (wear seatbelts, use helmets for cycling or contact sports). If you have BPPV, learning how to avoid positions that trigger your vertigo can help. Managing stress and getting enough sleep may also reduce the frequency of episodes.

Vaccines

There are no vaccines for vertigo itself, but staying up to date on vaccines like the flu shot may help prevent viral infections that can lead to inner ear inflammation.

Screening programmes

There is no routine screening for vertigo in people without symptoms. If you have risk factors (like a history of head injury or Ménière's disease in your family) and you develop vertigo, see your doctor for a full evaluation.

Complications

If left untreated

• Falls and injuries, especially in older adults
• Anxiety and fear of falling that can limit your activities
• Difficulty driving or working
• Persistent balance problems that may not go away on their own
• In rare cases, undiagnosed Meniere's disease can lead to permanent hearing loss

Long-term outlook

For most people, vertigo gets better with the right treatment. BPPV often resolves with a simple repositioning maneuver. Inner ear infections usually clear up in a few weeks. Even conditions like Ménière's disease can be managed so that episodes become less frequent and less severe. With proper care and support, most people with vertigo can return to their normal activities and enjoy a good quality of life.

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