Vertigo

Symptoms of vertigo

The sensation that you, or the environment around you, is moving or spinning may be:

• barely noticeable
• so severe that you find it difficult to keep your balance and do everyday tasks

Attacks of vertigo can develop suddenly and last for a few seconds, or they may last much longer.

If you have severe vertigo, your symptoms may be constant and last for several days. This can make normal life difficult.

Other symptoms associated with vertigo may include:

• loss of balance – which can make it difficult to stand or walk
• feeling sick or being sick
• dizziness 

When to see your GP 

You should see your GP if you:

• have vertigo that won't go away or keeps coming back

Ask for an urgent appointment if you:

• also have a severe headache
• are vomiting or feel very sick
• have a very high temperature or you feel hot and shivery

Your GP will ask about your symptoms and can carry out a simple examination to help work out which type of vertigo you may have, and discuss how best to treat it.

Depending on your symptoms, your GP may refer you to a specialist for further tests.

When to go to the emergency department

Go to the emergency department if you have vertigo and:

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

Always take someone who has lost consciousness to an emergency department or call 999.

Causes of vertigo 

Vertigo is commonly caused by a problem with the way balance works in the inner ear. It can also be caused by problems in certain parts of the brain.

Causes of vertigo may include:

• benign paroxysmal positional vertigo (BPPV) – where certain head movements trigger vertigo
• migraines – severe headaches
• labyrinthitis – an inner ear infection
• vestibular neuronitis – inflammation of the vestibular nerve, which runs into the inner ear and sends messages to the brain that help to control balance
• Meniere's disease - thought to be caused by increased fluid pressure in the inner ear - it may occur as a result of viral or bacterial ear infections, or metabolic or immune disorders 

Much less common causes include:

• stroke and ‘mini stroke’ (transient ischaemic attack)
• brain (cerebellar) tumour
• acoustic neuroma
• multiple sclerosis

Depending on the condition causing vertigo, you may experience additional symptoms, such as a high temperature, ringing in your ears (tinnitus) and hearing loss.

Treatment for vertigo 

Some cases of vertigo improve over time, without treatment. Some people have repeated episodes for many months, or even years, such as those with Ménière's disease.

There are specific treatments for some causes of vertigo. A series of simple head movements (known as the Epley manoeuvre) is used to treat BPPV.

If appropriate, your GP may prescribe medication. This can help in the early stages of most cases of vertigo.

If your symptoms are severe or not resolving your GP may refer you to an ear, nose and throat (ENT) specialist.

Many people with vertigo also benefit from referral for vestibular rehabilitation training (VRT), which is a series of exercises for people with dizziness and balance problems.  

Self care 

Depending on what's causing your vertigo, there may be things you can do yourself to help relieve your symptoms. Your GP or the specialist treating you may advise you to:

• do simple exercises to correct your symptoms
• sleep with your head slightly raised on two or more pillows
• get up slowly when getting out of bed and sit on the edge of the bed for a minute or so before standing
• avoid bending down to pick up items
• avoid extending your neck – for example, while reaching up to a high shelf
• move your head carefully and slowly during daily activities
• do exercises that trigger your vertigo, so your brain gets used to it and reduces the symptoms (do these only after making sure you won't fall, and have support if needed)

Safety

If you have vertigo, there are some safety issues to consider. For example:

• you should tell your employer if your job involves operating machinery or climbing ladders
• you may be at increased risk of falls – see preventing falls for advice on making your home safer and reducing your risk

Vertigo could also affect your ability to drive. You should avoid driving if you've recently had episodes of vertigo and there's a chance you may have another episode while you're driving.

If you've had or currently suffer from a medical condition or disability that may affect your driving you must tell the Driver & Vehicle Agency (DVA).

• How to tell DVA about a medical condition

Fear of heights 

The term vertigo is often incorrectly used to describe a fear of heights. The medical term for a fear of heights and the dizzy feeling associated with looking down from a high place is "acrophobia".

• Find out more about vertigo on the NHS website

More useful links

• How to use your health services