Vertigo

What is vertigo?

Vertigo is the false sensation that you, or the room around you, is spinning or moving, even when you're completely still. It's a symptom rather than a condition on its own, and it's much stronger than simply feeling dizzy or lightheaded.

What are the common causes of vertigo?

Common causes include:

• benign paroxysmal positional vertigo (BPPV), where tiny crystals in your inner ear move out of place, causing brief spinning when you move your head
• labyrinthitis or vestibular neuritis, an inner ear infection or inflammation, often following a cold or flu
• Ménière's disease, a rare inner ear condition that can also cause tinnitus (ringing in your ears) or hearing loss
• migraine
• certain medicines, including some antibiotics.

Less often, vertigo is linked to a problem in the brain, such as:

• a head or neck injury
• stroke
• multiple sclerosis
• a brain tumour or growth pressing on the nerve that controls balance
• low blood pressure, or prolonged bed rest.

Are there different types of vertigo?

Vertigo is usually divided into two main types:

• Peripheral vertigo: This is the most common type, caused by a problem in your inner ear or the nerve that controls balance
• Central vertigo: This is less common and caused by a problem in your brain, such as a migraine, stroke, or growth – symptoms tend to be more severe and may include difficulty walking, double vision or slurred speech.

How is vertigo diagnosed?

A doctor will ask about your symptoms and examine you, checking your balance, eye movements and hearing. They may do a simple test that involves moving quickly from sitting to lying down, since this can bring on your symptoms and helps show whether the problem is in your inner ear or your brain.

If needed, you may be referred for further tests, such as blood tests, hearing tests, or a CT or MRI scan, or to a specialist in ear, nose, and throat conditions.

How is vertigo treated?

Many cases of vertigo settle on their own without treatment. While you're waiting for it to pass, or to reduce how often it happens, it can help to:

• lie still in a quiet, dark room to reduce the spinning feeling
• move your head carefully and slowly during daily activities
• sit down straight away when you feel dizzy
• sleep with your head slightly raised on 2 or more pillows
• get up slowly from lying down, sitting on the edge of the bed for a while first
• squat down to pick things up, rather than bending over
• try to relax, since anxiety can make vertigo worse.

If a specific cause is found, treatment depends on what it is. This might include antibiotics for an infection, a short course of medicines such as antihistamines to ease symptoms, or a physiotherapy programme to retrain your balance.

If your vertigo or balance problems continue for more than 6 weeks, you may be referred to a specialist balance physiotherapist or an ENT (ear, nose, and throat) specialist.

If BPPV (benign paroxysmal positional vertigo) is the cause, a doctor or physiotherapist may perform a series of head movements called the Epley manoeuvre to move the crystals in your inner ear back into place. This manoeuvre can also be done on your own if your therapist has advised it is safe for you to perform at home.

When should I see a doctor?

See a doctor if your vertigo doesn't go away, keeps coming back, or is affecting your daily life.

Get urgent advice from a doctor or NHS 111 if you have vertigo along with:

• a severe headache
• feeling or being very sick
• a high temperature, or feeling hot, cold, or shivery.

Call 999 or go straight to A&E if you have vertigo along with:

• double vision or loss of vision
• hearing loss
• trouble speaking
• weakness, numbness, or tingling in an arm or leg.