vertigo specialist tests overview

Overview

Vertigo is a feeling that you or everything around you is spinning or moving, even when you are still. It is not the same as feeling lightheaded or dizzy from standing up too fast. Specialist tests help doctors find the exact cause of vertigo so they can recommend the right treatment.

Yes, vertigo is very common. About 3 in 10 people will experience vertigo at some point in their life.

Vertigo can happen at any age, but it becomes more common as you get older. Women are slightly more likely than men to have certain types of vertigo, such as BPPV and Meniere's disease.

Symptoms

Common symptoms

• A spinning or whirling sensation, as if you are moving or the room is moving
• Loss of balance or feeling unsteady on your feet
• Nausea or vomiting
• Rapid, jerking eye movements (called nystagmus)
• Sweating or feeling clammy
• Headache or a feeling of fullness in the ear

Symptoms in children

• Children may describe vertigo as 'feeling wobbly' or 'the room is spinning'
• They might have trouble walking straight or suddenly cling to furniture
• Nausea and vomiting, similar to motion sickness
• They may cry or appear frightened without clear reason

Symptoms in older adults

• Increased risk of falling or losing balance
• Vertigo episodes may be longer and harder to recover from
• They might worry about falling and become less active
• Sometimes vertigo is mistaken for just 'getting older'—so it is important to get it checked

Causes

Main causes

• Benign paroxysmal positional vertigo (BPPV) – tiny calcium crystals in the inner ear move out of place
• Vestibular neuritis or labyrinthitis – inflammation of the inner ear nerves, often after a viral infection
• Meniere's disease – a disorder of the inner ear with episodes of vertigo, hearing loss, and ringing
• Migraine – some people with migraine get vertigo as part of their attacks
• Less common: stroke, brain tumours, or multiple sclerosis (but these are rare)

Risk factors

• Being over 50 years old
• Having had a head injury
• Viral infections (like cold or flu) that affect the ear
• Family history of vertigo or migraine
• Conditions that affect blood flow, such as diabetes or high blood pressure

When to see a doctor

See a doctor urgently if:

• Vertigo with sudden hearing loss, especially in one ear
• Vertigo together with severe headache, slurred speech, or weakness on one side of the body
• Vertigo after a fall or blow to the head
• Vertigo that prevents you from standing or walking

Book a routine appointment if:

• Mild vertigo that keeps coming back
• Vertigo that bothers you but does not have any emergency signs
• You want to understand what is causing your vertigo and how to prevent it

Diagnosis

Doctors start by asking about your symptoms and doing a physical exam, especially checking your ears, eyes, and balance. They may then refer you to a specialist (like an ear, nose, and throat doctor or a neurologist) for further tests.

Tests that may be done

• Dix-Hallpike test – a simple test where you lie back quickly with your head turned to one side to see if it triggers vertigo and eye jerking
• Videonystagmography (VNG) – you wear goggles that track your eye movements while you watch moving lights and while your head is turned
• Vestibular evoked myogenic potentials (VEMP) – a test that uses sound clicks to check how certain ear muscles react
• Audiometry (hearing test) – to see if your hearing is affected, which can point to Meniere's disease
• MRI scan – if your doctor suspects a problem in the brain, such as a stroke or tumour

What to expect at your appointment

Specialist tests for vertigo are usually done in an outpatient clinic. They may involve sitting, lying down, or wearing special goggles. Some tests can make you feel dizzy for a moment, but they are safe and only last a short time. Your doctor will explain each test and help you feel comfortable.

Treatment

Treatment for vertigo depends on the cause. Many people improve with simple repositioning maneuvers or vestibular rehabilitation exercises. Medicines can help with nausea and dizziness, but they are not a cure for the underlying problem. The goal is to reduce symptoms and help you return to normal activities.

Self-care at home

• During a vertigo episode, sit or lie down in a quiet, dark room until the spinning stops
• Avoid sudden head movements or looking up and down quickly
• Stay hydrated and eat small, frequent meals if you feel nauseous
• Do not drive or operate machinery during an attack
• Follow any specific exercises or maneuvers your doctor or physiotherapist teaches you

Medical treatments

Your doctor may recommend medications to reduce dizziness, nausea, or inflammation. These are usually taken only during episodes or for a short time. They might also suggest vestibular rehabilitation therapy (a special type of physical therapy that retrains your balance system). For migraine-related vertigo, treatments that prevent migraines can help.

When is surgery considered?

Surgery is rarely needed for vertigo. It may be considered for severe cases of Meniere's disease that do not respond to other treatments, or for certain structural problems in the inner ear. Your specialist will discuss all options before recommending any procedure.

Living with this condition

Living with vertigo can be challenging, but most people learn to manage it well. You can adapt your home to prevent falls—remove loose rugs, keep rooms well-lit, and install grab bars in the bathroom. Plan activities for times when you feel steady, and let friends and family know what to do if you have an episode.

Lifestyle tips

• Get enough rest – tiredness can trigger vertigo
• Avoid triggers like bright lights, loud noises, or stressful situations if they make your vertigo worse
• If you have BPPV, sleep with your head slightly elevated on two pillows
• Learn relaxation techniques such as deep breathing to reduce anxiety during an attack

Diet and exercise

Eating a balanced diet with low salt may help if you have Meniere's disease. Avoid caffeine, alcohol, and tobacco, as they can worsen symptoms for some people. Regular gentle exercise, like walking or tai chi, can improve your balance over time. Always start slowly and stop if you feel dizzy.

Mental health and emotional wellbeing

Vertigo can cause anxiety, fear of falling, and even depression. It is normal to feel worried or frustrated. Talking to a counsellor or joining a support group can help. Remember that you are not alone, and with treatment, most people see great improvement.

Prevention

Not all types of vertigo can be prevented, but you can lower your risk. Avoid sudden head movements, protect your head during sports, and manage conditions like high blood pressure or diabetes. If you know your triggers, try to avoid them.

Complications

If left untreated

• Falls and injuries, especially in older adults
• Ongoing dizziness that affects your daily life, work, or driving
• Anxiety or panic attacks related to fear of having another episode
• Rarely, untreated inner ear infections can lead to permanent hearing loss

Long-term outlook

For most people, vertigo improves greatly with the right diagnosis and treatment. Even conditions that cannot be cured can often be managed so that you can live a full, active life. With help from your healthcare team, the outlook is positive.

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