screening for vertigo

Overview

Vertigo is a feeling that you or the world around you is spinning or moving, even when you are still. Screening for vertigo is a series of checks a doctor uses to find out what might be causing this sensation.

Yes. Vertigo is a very common reason for people to see a doctor, especially as they get older.

It can affect anyone, but it happens more often in adults over 40, and women experience it more frequently than men.

Symptoms

Common symptoms

• A spinning or swaying feeling
• Loss of balance
• Nausea or vomiting
• Ringing in the ears or hearing changes
• Unsteady feeling when walking

Symptoms in children

• Dizziness or spinning after sudden head movements
• Clumsiness or tripping
• Complaints of the room moving
• Nausea or stomach upset with no clear cause

Symptoms in older adults

• Feeling unsteady on their feet
• Fear of falling
• Spinning spells that come on with turning over in bed or looking up
• Falls or near-falls

Causes

Main causes

• Problems in the inner ear (the balance centre)
• BPPV: tiny crystals that move into the wrong part of the inner ear
• Vestibular neuritis or labyrinthitis: inner ear inflammation, often after a viral infection
• Meniere's disease: a condition with fluid buildup in the ear
• Migraine-associated vertigo
• Certain medicines, head injury, or problems in the brain (rare)

Risk factors

• Being over 40
• A previous head injury
• A recent viral illness or ear infection
• Family history of vertigo or balance disorders
• Use of certain medicines that can affect balance
• Migraine history

When to see a doctor

See a doctor urgently if:

• If your vertigo is the first time and it is severe
• If you have hearing loss, ringing, or ear pain
• If you have diabetes or heart disease and get dizzy
• If you feel unsteady and you are at risk of falling

Book a routine appointment if:

• If you have repeated episodes of vertigo that worry you
• If you feel off-balance more than a few days a week
• If you need advice on staying safe and preventing falls

Diagnosis

Your doctor will ask about your symptoms, then examine your eyes, ears, and balance. They may do simple tests to see if movements trigger your dizziness.

Tests that may be done

• Hearing test (audiometry)
• Video nystagmography (VNG) or electronystagmography (ENG) to record eye movements
• Vestibular evoked myogenic potentials (VEMP) tests
• MRI or CT scan if a brain or nerve problem is suspected
• Moving your head from one side while lying down (Dix-Hallpike test)

What to expect at your appointment

A typical screening takes 20 to 40 minutes. Some tests may make you feel dizzy for a minute or two. Tell the doctor how you feel so they can adjust.

Treatment

Treatment depends on what is causing your vertigo. The goal is to stop or reduce the spinning sensation, improve your balance, and help you return to normal activity safely.

Self-care at home

• Move slowly and avoid sudden head movements
• Use a handrail and sit down if you feel dizzy
• Sit up or stand gradually, and pause before walking
• Stay hydrated and get enough rest
• If you know certain positions trigger your vertigo, learn a head manoeuvre from a physiotherapist or doctor (not on your own)

Medical treatments

Doctors may recommend medicines to reduce nausea or dizziness for short periods, or prescribed exercises that retrain your balance system. They may also offer physical therapy called vestibular rehabilitation. Some treatments are specific to the cause, such as a guided repositioning manoeuvre for BPPV. Never take medicines for vertigo without a doctor's advice.

When is surgery considered?

Surgery is rarely needed. It is considered only when a clearly treated inner ear condition like Meniere's disease is causing severe, disabling attacks, and other treatments have not helped.

Living with this condition

Living with vertigo means learning to manage your triggers and staying active within your limits. Keep your home well lit, remove trip hazards, and take extra care on stairs and uneven ground.

Lifestyle tips

• Avoid caffeine, alcohol, and salt if they make your symptoms worse
• Get regular sleep and manage stress
• Try simple balance exercises once a doctor has checked you are safe to do them
• Wear low-heeled shoes with good grip

Diet and exercise

A balanced diet and safe, gentle exercise can boost your balance and overall well-being. Ask your doctor or a physiotherapist which activities are safe for you.

Mental health and emotional wellbeing

Vertigo can be distressing and make people feel anxious or depressed, especially when it is unpredictable. It is important to talk about your feelings and seek help if you struggle.

Prevention

Vertigo cannot always be prevented, but you can reduce some risks. Avoid falls by keeping rooms tidy, checking your vision, and managing conditions like diabetes or high blood pressure.

Vaccines

There is no vaccine that prevents vertigo itself, but staying up to date with recommended vaccines, such as the flu vaccine, may help prevent some infections that can affect the inner ear.

Screening programmes

There is no routine national screening for vertigo in the general population. Screening is done when a person has symptoms or risk factors.

Complications

If left untreated

• Falls and injuries, such as fractures from loss of balance
• Difficulty walking or driving safely
• Reduced confidence and social withdrawal
• Dehydration or weight loss from severe nausea

Long-term outlook

For most people, vertigo gets much better with the right treatment. Even conditions with long-term symptoms can be successfully managed so you can stay active and independent.

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