Vertigo is a symptom, rather than a condition itself. It is the feeling that you or your surroundings are moving or spinning.
What is vertigo?
Vertigo is a feeling of dizziness. It is the sensation that you or your surroundings are moving when there is no actual movement. Some people describe it as the room spinning around, or a feeling of falling or tilting. You may be unsteady, it may be hard to walk or stand, and you may lose your balance.
Different people experience different intensities of vertigo:
Mild vertigo – this occurs now and again for a short time and goes away on its own. You may feel a bit sick (nauseous).
Moderate vertigo – this requires that you lie down and lie still (no head motion) to stop the feeling of movement. You may feel sick (nauseous) and you may throw up (vomit).
Severe vertigo – this occurs when the feeling of movement is ongoing even when lying down. Nausea and vomiting are quite severe.
Vertigo could be a sign of a more serious medical condition such as stroke, circulation problems or infection.
Call 111 if you experience vertigo and ANY of the following:
trouble speaking or swallowing
leg or arm weakness, numbness or tingling
a severe headache
vomiting or feel very sick
a very high temperature or feel hot and shivery.
See your doctor or go to A&E straight away if you experience vertigo and:
double vision or loss of vision
hearing loss that gets worse, especially on one side.
If you are unsure what to do call Healthline free on 0800 611 116 for health advice and information anytime.
What causes vertigo?
The following are the most common causes of vertigo. For some people, the cause of vertigo is unknown.
Benign paroxysmal positional vertigo
This is usually caused by sudden changes in the position of your head such as when you tip your head up or down, when you lie down or when you turn over or sit up in bed. It can increase your risk of falls.
Vertigo tends to last for a minute or less and settles if the head is kept still.
This type of vertigo is usually caused by small calcium deposits in your inner ear.
Vestibular neuronitis
Vestibular neuronitis is the inflammation of the vestibular nerve. This nerve carries messages from the inner ear about head movement. When the nerve is inflamed or infected, the sensation of dizziness or vertigo arises.
It's usually caused by a viral infection.
Vertigo lasts from hours to days but usually improves within a week.
Meniere's disease
This is a disorder of the inner ear where you get the feeling of vertigo, ringing in the ear and hearing loss.
Vertigo lasts from 1 to 24 hours.
Migraine
Some people get the feeling of dizziness and the sensation of motion or spinning, during or just before a migraine headache. Read more about migraine.
Other causes
anxiety disorder
ongoing infection of the middle ear (chronic otitis media)
following a head injury
some medications such as some antibiotics, phenytoin, carbamazepine, water tablets (diuretics)
alcohol.
How is vertigo diagnosed?
To diagnose vertigo, your doctor will ask you to describe your symptoms and will carry out tests. Your doctor may ask you:
to describe your symptoms such as whether you felt lightheaded or if your surroundings were spinning
if you also experience other symptoms such as hearing loss, ringing in the ears, nausea (feeling sick), vomiting (throwing up) or fullness in the ear
how often your symptoms occur and how long they last for
if your symptoms are affecting your daily activities such as whether you're unable to walk during an episode of vertigo
whether anything starts your symptoms (called triggers) or makes them worse, such as moving your head in a particular direction what makes your symptoms better.
Your doctor will also examine your ears, examine your eyes, and check your balance. Because vertigo could be a symptom of another medical condition, your doctor may also conduct a variety of different tests.
How is vertigo treated?
The treatment for vertigo depends on the cause and severity of your symptoms.
During a vertigo attack, lying still in a quiet, darkened room may help to ease any symptoms of nausea and reduce the sensation of spinning.
You should also try to avoid stressful situations, as anxiety can make the symptoms of vertigo worse. Read more about how to deal with stress and anxiety.
For vertigo caused by Meniere's disease, your doctor may prescribe betahistine.
Depending on the cause of your vertigo, your doctor may also recommend some special exercises that involve specific movements:
The Epley manoeuvre – this involves head movements.
Brandt-Daroff exercises – this involves movement of the upper body.
Read more about treatment for vertigo, including detailed information about how to do the exercise movements.
Self-care for vertigo
Here are some things you can do at home to prevent vertigo:
Avoid head movements or head positions that can trigger an attack.
If you find that one side of your ear or head is more affected than the other, avoid sleeping on the affected side.
Raise your head on two pillows when resting.
When getting out of bed, do so slowly and sit on the edge of the bed for a minute, before standing up.
Preventing accidents and falls with vertigo
Because vertigo can affect your balance and may make you feel unsteady, you are at risk of falls or accidents. To reduce your risk of a fall or accident:
Get out of a bed or chair slowly.
Wear low-heeled shoes that fit properly.
Use handrails on stairs.
Install grab bars in the bathroom. Don't use towel racks for balance.
Use a shower stool. Also, apply adhesive strips to the shower or tub floor.
Use a walking aid if needed.
If you become dizzy or disoriented while driving, you could hurt yourself and others. It is best to avoid driving until symptoms subside.
At work, let your employer know about your symptoms, especially if your job involves operating machinery or climbing ladders.
Learn more
The following links provide further information on vertigo. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.
Credits: Health Navigator Editorial Team.
Last reviewed: 14 Oct 2019
The treatment of vertigo depends on the cause of your symptoms, and how severe they are. The following are treatments for the common causes of vertigo:
This happens when you have sudden changes in the position of your head such as when you tip your head up or down, when you lie down or when you turn over or sit up in bed. It can increase your risk of falls.
Vertigo tends to last for a minute or less and settles if the head is kept still.
This type of vertigo is usually caused by small fragments or calcium deposits in your inner ear.
BPPV often clears up without treatment after several weeks or months.
To help ease the symptoms, try simple things like:
getting out of bed slowly
avoiding activities that involve looking upwards, such as painting and decorating or looking for something on a high shelf.
BPPV can be treated with some special exercises that involve specific movements:
The Epley manoeuvre – this involves head movements.
Brandt-Daroff exercises – this involves movement of the upper body.
The Epley manoeuvre
The Epley manoeuvre has shown to improve symptoms in about 50% of people with BPPV.
It involves performing four separate head movements to move the fragments that cause vertigo to a place where they no longer cause symptoms.
Each head position is held for at least 30 seconds.
During the movements, you may experience some vertigo.
Your symptoms should improve shortly after the Epley manoeuvre is performed, although it may take up to two weeks for a complete recovery.
(BMJ Learning, 2014)
Tell your doctor if your symptoms haven't improved after four weeks. The Epley manoeuvre isn't usually a long-term cure and may need to be repeated.
Brandt-Daroff exercises
The Brandt-Daroff exercises are designed to break up the fragments and unblock the ear canal.
Sometimes the Epley manoeuvre is not successful or is suitable, such as in people who have neck or back problems. In such cases, your doctor may recommend Brandt-Daroff exercises.
You will need to repeat these exercises 3 or 4 times a day for 2 days in a row. Your symptoms may improve for up to 2 weeks.
(Dr Koch's Channel, 2011)
Your doctor will teach you how to these exercises. The following is a guide:
Sit on the edge of a bed and turn your head slightly to the left (approximately 45 degrees).
While maintaining this head position, lie down quickly on your right side so that the back of your head is resting on the bed.
Wait for 20 to 30 seconds or for any dizziness to go away.
Sit up straight, and again wait for 20 to 30 seconds or for any dizziness to go away.
Turn your head slightly to the right and repeat the sequence in the opposite direction.
Continue as above for 10 minutes (5 or more repetitions to each side). Perform the exercises 3 times daily if possible.
For the exercises to be helpful, you must experience the symptoms of dizziness. If the exercises are done regularly, the symptoms should resolve over a period of several days in most cases.
Vestibular neuronitis
Description
Treatment options
Vestibular neuronitis is the inflammation of the vestibular nerve.
This nerve carries messages from the inner ear about head movement. When the nerve is inflammed or infected, the sensation of dizziness or vertigo arises.
It is usually caused by a viral infection.
Vertigo lasts from hours to days but usually improves within a week.
The symptoms of vestibular neuronitis often get better without treatment over several weeks.
Vestibular neuronitis is often made worse if you drink alcohol, are tired or have another illness. Avoiding these can help to improve your condition.
Vestibular neuronitis can also be treated with vestibular rehabilitation and with medication to help relieve the symptoms of nausea and vomiting such as prochlorperazine or hyoscine hydrobromide (scopolamine).
This is a disorder of the inner ear where you get the feeling of vertigo, ringing in the ear and hearing loss.
Vertigo lasts from 1 to 24 hours.
Although there is no cure for Ménière's disease the symptoms can be helped.
If your vertigo is caused by Ménière's disease, there are a number of possible treatments for Ménière's disease such as:
changes to the diet, for example, eating a low-salt diet, avoiding caffeine or alcohol
medication to treat attacks of Ménière's disease such as prochlorperazine, which may ease the dizziness and vomiting
medication to prevent attacks of Ménière's disease such as betahistine, which This may reduce the amount of fluid inside the inner ear and prevent symptoms from developing. If you take betahistine every day it is unlikely to stop all attacks but it may reduce the number and/or severity of attacks. It does not work in all cases
treatment for tinnitus (ringing in your ears) such as sound therapy
treatment for hearing loss such as using hearing aids
physiotherapy to deal with balance problems.
Information for healthcare providers on vertigo
The content on this page will be of most use to clinicians, such as nurses, doctors, pharmacists, specialists and other healthcare providers.
About vertigo
Vertigo involves a false sensation that the patient or their surroundings are moving or spinning, usually accompanied by nausea and loss of balance. Causes of vertigo can be differentiated into:
Vertigo – Melanie Collins Goodfellow Unit, 2017 "Melanie Collins talks about the management of vertigo in general practice. Melanie is an ENT surgeon at North Shore Hospital and at the ENT group at Mercy Hospital in Auckland."
Regional HealthPathways NZ
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