What is vertigo?

Unlike dizziness, vertigo is a stronger sensation of you or everything around you ‘spinning’ - you may even lose your balance. An attack of vertigo can be very short, just a few seconds, or can persist for weeks at a time.

What causes vertigo?

Whereas dizziness can occur from a drop in blood pressure or sugar levels, dehydration or stress, vertigo can come from several causes and, occasionally, no cause can be found. It can also be caused by ear conditions such as labyrinthitis, vestibular neuritis and Meniere’s Disease.

What are the different types of vertigo?

There are two types of vertigo – peripheral and central:

Peripheral vertigo

This is the most common and tends to be caused by inner ear problems, however, it can also be as a result of moving your head in a specific way (known as benign paroxysmal positional vertigo), a head injury or even some medication.

Central vertigo

This is caused as a result of problems in your brain most likely at the back of your head and near your spinal cord. The triggers for central vertigo tend to be migraines, strokes, multiple sclerosis, brain tumours (including benign ones known as acoustic neuroma) and types of medication.

What is benign paroxysmal positional vertigo?

Benign paroxysmal positional vertigo (BPPV) is a common inner-ear condition that causes brief episodes of vertigo. It happens when calcium crystals called otoconia become dislodged from their normal position in the ear and migrate to the fluid-filled canals responsible for detecting head movement. When this happens, they can trigger abnormal signs in the brain, leading to feeling dizzy or a spinning sensation.

What hearing conditions can cause vertigo?

Most causes of vertigo will be related, in some way, to the inner ear and the balance receptors. Even positional vertigo, when you get dizzy standing or sitting up too fast, is thought to be as a result of a small piece of the inner ear lining coming loose and over stimulating the balance receptors.

There are three main ear conditions that can cause vertigo:

Labyrinthitis

an inner ear infection that affects the part of the ear related to balance and hearing. Labyrinthitis can be caused through a viral infection such as the common cold or flu, or through autoimmune conditions.

Vestibular neuritis

an infection of the vestibular nerve which is found in your inner ear and is responsible for controlling balance. Vestibular neuritis can develop as a result of a cold or sore throat, where the virus has spread to the vestibular nerve. Bacterial infections can also cause vestibular neuritis as can a head injury.

Meniere’s disease

A chronic condition that affects the inner ear, causing episodes of vertigo, hearing loss and tinnitus. People are affected in different ways with attacks that can last a few minutes or hours. They can happen regularly or days, weeks or even years apart.

Can vertigo be a sign of something more serious?

Although vertigo is an unpleasant condition it is not normally a serious one. However, if it is accompanied by a headache, vomiting/nausea, high temperature/fever or chills – the NHS recommends you call 111.

If you can’t see or are seeing double, can’t speak, can’t hear or have weak/tingly arms and legs call 999 or go to A and E.

How long does vertigo last?

A vertigo attack can last anywhere from a few seconds or minutes, to hours. For severe cases, vertigo can sometimes last days and/or months.

What causes recurrent vertigo?

For some chronic conditions like Ménière's disease, attacks can come and go over the years. Sufferers can sometimes detect a vertigo attack coming on by noticing a change in their hearing or a ‘fullness’ in their ears.

Diagnosing vertigo

Your first point of call will be to see your GP if vertigo is causing you problems. They can then determine what might be causing it based on your symptoms and medical history. They may also test your balance to see if it triggers a vertigo attack.

If a hearing problem is causing vertigo, further examinations can be done by an audiologist or ear, nose and throat (ENT) specialist. They can then perform a hearing test and request MRI or CT scans to determine the root of the vertigo.

How to tell which ear is causing vertigo

To figure out which ear is causing vertigo, you can try the Dix-Hallpike manoeuver. To perform this test, simply sit on a bed with your legs extended and turn your head to the right at a 45-degree angle. Repeat the test but turned to the left to assess the other ear. If turning to the right triggers vertigo, it suggests that your right ear is involved and vice versa.

Vertigo Treatment

Vertigo treatment will depend on the cause of the vertigo. If it is from an infection, then antibiotics might help to clear up the underlying cause. You may also be given anti-dizziness medication that can be used to ease symptoms.

There are also certain exercises that can be done at home to restore your balance or you can see a specialist to perform what is known as Epley’s Manoeuvre – a series of movements performed in a certain way. 

Vertigo treatment at home

If you’re experiencing signs of vertigo, it’s important to go to a healthcare professional. However, there are some at-home remedies you can try to alleviate symptoms:

  • Epley manoeuvre - this exercise can help to reposition displaced crystals in the inner ear that may be causing vertigo. It involves a series of head and body movements. Before attempting the Epley manoeuvre on your own, we recommend consulting your healthcare provider. 
  • Stay hydrated - dehydration can worsen vertigo, so it’s important to keep drinking plenty of water
  • Avoid vertigo-related triggers - these include caffeine, alcohol and excessive salt intake 
  • Get plenty of rest and engage in stress-reducing activities - these might include deep breathing, meditation and yoga

Will vertigo go away on its own?

For most cases, your episodes of vertigo will improve without treatment. But for certain ear conditions you may need medication if the vertigo is really impacting your life.

If you have any concerns about your hearing or balance, contact your GP or book a hearing test.

FAQs

Can I drive with vertigo?

Anything that impacts your driving must be taken seriously. Even if you don’t have it at the time, vertigo can make you feel tired after an attack, likewise you don’t know if it will happen while you are behind the wheel. If you experience any symptoms that affect your driving you need to follow the advice from the DVLA.

Why do I feel dizzy?

Dizziness is a normal feeling that you get when your brain receives conflicting messages from your inner ears or from your eyes. You can feel dizzy for many different reasons and in many ordinary situations. For example:

  • If you move your head suddenly, you may feel dizzy
  • You might feel dizzy if you've drunk too much alcohol
  • Fairground rides often make people feel dizzy, as do many kinds of travel
  • If you are very dizzy, you may feel sick or actually be sick because your balance organs are stimulated - for example, if you are on a boat when the sea is rough
  • Wearing the wrong prescription glasses can cause lightheadedness and dizziness

These are day-to-day reasons for feeling dizzy and people are not usually worried about them, even if they find them unpleasant. The effects are usually temporary and the symptoms disappear when your balance system is given a chance to settle down.

However, dizziness is also a symptom of an ear condition. The structure of the inner ear helps to maintain balance but if it is affected, this could cause the feeling of dizziness. Conditions such as Labryinthis, Meniere’s disease and Tinnitus can cause this. If you are worried about your dizziness, you can book an appointment to speak to our expert audiologists or contact your GP.