Vertigo

Overview

Vertigo is a specific type of dizziness: a false sensation that you or the room is spinning or moving. It usually points to a problem with the inner ear or, less commonly, the brain. Most vertigo is benign and treatable, but certain features require urgent assessment. This page covers vertigo specifically; for dizziness in general, see Dizziness, and for near-fainting sensations, see Lightheadedness.

Peripheral (inner-ear) causes — most common

• BPPV (benign paroxysmal positional vertigo) — brief, intense spinning triggered by changing head position, such as rolling over in bed; treated with repositioning manoeuvres.
• Vestibular neuritis — sudden, continuous vertigo with nausea lasting days, often after a viral illness.
• Meniere’s disease — recurrent vertigo episodes with hearing loss, fullness and ringing in the ear.

Central causes — less common, more serious

• Vestibular migraine — recurrent vertigo episodes in someone with migraine.
• Stroke — vertigo with other brain signs (see red flags below).
• Other brain conditions affecting the balance centres.

Red flags suggesting a central cause

• Vertigo with double vision, slurred speech, weakness, numbness or difficulty walking.
• Vertigo with a new, severe headache.
• Vertigo that is continuous and worsening rather than episodic.
• Inability to stand or walk, or abnormal eye movements.
• Sudden hearing loss with vertigo.

Evaluation and management

Evaluation includes a detailed description, examination of eye movements, balance tests and a neurological examination, and may include specific bedside manoeuvres (such as the Dix-Hallpike test for BPPV). Blood pressure and the heart are checked. Management depends on the cause: repositioning manoeuvres for BPPV, medication and vestibular exercises for neuritis, and urgent imaging or referral when central signs are present.

How we help

Dr. Nayak distinguishes peripheral from central vertigo, performs appropriate bedside tests, treats inner-ear causes, and arranges urgent referral when red flags are present. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Dizziness
• Lightheadedness
• Migraine
• Hypertension & Cardiovascular Risk
• Palpitations & Cardiovascular Symptoms