What is vertigo?

Vertigo is not actually a condition in itself, but it is a symptom. It describes the feeling that everything around you is spinning, or that you are spinning yourself. In most cases, vertigo gets better by itself, but if it happens repeatedly or it keeps affecting you, it should be investigated.

‘Attacks’ of vertigo can last for just a few seconds, but they can also last longer, even for days or months in extreme cases.

What causes vertigo?

Vertigo is generally caused by problems with the inner ear, as the inner ear affects balance, causing the sensation of vertigo. Although sometimes the specific cause is unknown, some common problems with the inner ear causing vertigo include:

• Labyrinthitis (an infection of the inner ear)
• Ménière’s disease (a condition affecting the inner ear)
• Vestibular neuronitis (inflammation of the inner ear)

Certain head movements, certain medications, and migraines can also cause vertigo.

How is vertigo connected to BPPV (Benign Paroxysmal Positional Vertigo)?

BPPV is the most common cause of vertigo and it happens when small crystals in the inner ear's semi-circular canals break loose.

The ‘gravel’ shifts as the head moves - even slightly - and comes into contact with nerve-sensitive structures. In turn, it sends signals to the brain. The brain interprets this as the body, or room, spinning.

BPPV is also known as benign postural vertigo, positional vertigo and top-shelf vertigo. 

How is vertigo diagnosed?

If vertigo is a result of BPPV, an ENT specialist can confirm vertigo is a symptom of this via a positional test, called a Dix-Hallpike manoeuvre.

Vertigo can be caused by other conditions. Doctors may also use instruments to magnify and examine the ear canal and eardrum. A doctor may examine your eye movements or may also get you to track an object from one point to another. 

How is vertigo treated?

Vertigo generally gets better on its own. You can manage vertigo attacks using some of the following measures:

• Lying still in a quiet, dark room
• Moving slowly while you go about your activities
• Trying to relax (stress and anxiety make vertigo worse)
• Getting up slowly from a lying position (e.g when waking up)
• Sitting down immediately if you are feeling dizzy
• Not bending over when dropping something and picking it up. It is better to squat to pick objects up this way
• Not stretching your neck or making sudden head movements

If your vertigo keeps coming back, you should make an appointment with your doctor, who may refer you to a specialist to try and determine the cause. If the vertigo is caused by an infection, then antibiotics or other medication may be prescribed to clear up the infection. Your doctor may give you exercises to do when you experience vertigo to lessen symptoms.

If vertigo is experienced along with hearing loss, double vision, loss of vision, difficulty when speaking, or limb weakness/numbness, you should visit A&E.

How common is vertigo?

According to research by leading medical professionals, dizziness, including vertigo, affects about one in three women - and men - yearly. About a quarter of dizziness cases in patients are the result of vestibular vertigo, and prevalence rises with age. It is about two to three times higher in women than in men. 

Which specialist treats vertigo?

Generally vertigo clears up on its own, but if you are having repeated attacks, your GP may refer you to an ENT doctor (otolaryngologist).