Vertigo- symptoms, causes & treatment
Medically Reviewed by Dr John Phillips
Last updated on 19.06.2023
What is vertigo?
- Light-headedness, faintness or dizziness are not the same as vertigo.
- A fear of heights is also not vertigo.
- Vertigo is defined as the feeling you’re moving when you’re not. It’s usually a sensation of spinning. Being clear on this single detail is very important.
- Vertigo is often accompanied by nausea, vomiting & sweating.
What tests will the doctor do for vertigo?
The most important thing the doctor will do is to ask you detailed questions about your vertigo, for example:
- How long have you had it?
- Does it come and go? How long does each episode last?
- Is your hearing affected? Do you have any ringing in your ears (tinnitus)?
- Is it affected by head position or head movements?
- Have you hit your head or injured your neck recently?
- Are you taking any medications currently?
- Do you have a headache?
- Do you have any weakness on one side of your body?
- Do you have any other symptoms?
The doctor will then examine you. This may include:
- Checking your blood pressure.
- Looking in your ears.
- Pressing a tuning fork to your head.
- Performing the Dix-Hallpike Manoeuvre.
- This useful test involves moving you around on the couch so that your head moves back quickly, showing the doctor what triggers your vertigo. It can feel pretty unpleasant, but gives the doctor helpful information.
Other tests the doctor may wish to organise, depending on the circumstances:
- Blood tests.
- A hearing test (audiogram).
- Imaging (for example CT or MRI scans) of your inner ear, your neck or your brain.
- However, it is common not need any tests done at all.
What are the causes of vertigo?
Vertigo can be caused by:
- problems in your inner ear.
- problems in your brain.
- problems with a nerve in your skull.
- certain medications or alcohol.
The commonest diagnoses (making up more than 90% of cases) are:
- BPPV (Benign Paroxysmal Positional Vertigo).
- Short attacks of vertigo.
- Triggered by head movements.
- It’s a disorder of the inner ear.
- Usually goes away on its own within a few days.
- Can sometimes last a long time – even years.
- In rare resistant cases, sometimes surgery can be performed (as a last resort).
- Vestibular Neuronitis.
- Usually a prolonged period of vertigo.
- Not usually affected by head movements or position.
- It’s a disorder of a nerve in the ear.
- Usually makes you feel awful and stops you from getting out of bed.
- Often causes vomiting.
- Usually starts to improve after a few days.
- Usually takes a few weeks to resolve.
- Ménière’s Disease.
- Attacks or clusters of vertigo episodes coming & going over years.
- Usually over many years it tends to resolve.
- Some or all of 3 main symptoms:
- Vertigo.
- Temporary or permanent hearing loss.
- Ringing in the ears (tinnitus).
- It’s a disorder of the inner ear.
What is the treatment for vertigo?
For the 3 commonest causes of vertigo, treatment is usually as follows:
- BPPV.
- One treatment involves the doctor performing a short non-invasive procedure.
- This is called “Epley’s Manoeuvre”.
- Another treatment involves moving the head around in a certain way.
- This is known as “Brandt-Daroff Exercises”
- Both treatments will trigger the vertigo symptoms. They work by moving your head in such a way that the problem with the inner ears is cured.
- Sometimes a short course of anti-sickness medications can help.
- One treatment involves the doctor performing a short non-invasive procedure.
- Vestibular Neuronitis.
- “Vestibular Rehabilitation Exercises” may help recovery.
- Sometimes a short course of anti-sickness medications can help – for a maximum of 2 or 3 days. (If you take them for longer than that they can slow recovery).
- Ménière’s Disease.
- Wherever possible, lie down and stay still during an attack.
- Try to fix your gaze on a distant object.
- There is a variety of medications used in Ménière’s Disease. The evidence for their effectiveness is mostly lacking.
If you have any questions about vertigo or other symptoms discussed in this article, you should speak to your doctor
Further Patient Resources
Benign Paroxysmal Positional Vertigo (BPPV) betterhealth.vic.gov.au
Article resources
Murdin L, et al (2016). Betahistine for symptoms of Vertigo.
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