What Is Vertigo?
Vertigo is the sensation that you or your surroundings are spinning or moving when they are not. It is a symptom — not a diagnosis. The cause can be in the inner ear (peripheral vertigo, 80%) or the brain (central vertigo, 20%).
Types of Vertigo
| Type | Cause | Key Features |
|---|---|---|
| BPPV | Calcium crystals misplaced in semicircular canals | Brief episodes (seconds) triggered by head position change |
| Vestibular neuritis | Viral inflammation of vestibular nerve | Sudden onset, severe, lasts days; no hearing loss |
| Labyrinthitis | Viral infection of labyrinth | Vertigo + hearing loss/tinnitus |
| Menière's disease | Fluid accumulation in inner ear | Vertigo + one-sided hearing loss + tinnitus + aural fullness — comes in attacks |
| Central vertigo | Brainstem/cerebellum — stroke, TIA, MS | Often persistent, associated with neurological symptoms |
Central Vertigo — Seek Emergency Care If:Sudden onset vertigo with double vision, difficulty swallowing, facial weakness, severe headache or difficulty walking — these suggest a brainstem stroke.
Tests
| Test | Purpose |
|---|---|
| Dix-Hallpike test | Clinical diagnosis of BPPV — nystagmus on repositioning |
| Hearing test (audiometry) | Menière's disease — low-frequency hearing loss |
| MRI brain | Central vertigo: rules out stroke, acoustic neuroma, MS |
| Thyroid (TSH) | Hypothyroidism can cause dizziness |
| Full Blood Count | Anaemia as a cause |
| Fasting Glucose | Hypoglycaemia causes dizziness |
FAQs
What is the Epley manoeuvre?
A series of head position changes that repositions displaced crystals in BPPV — very effective (80–90% success) and can be done by a doctor or physiotherapist.
How long does vestibular neuritis last?
Acute phase: 1–3 days. Full recovery over weeks to months. Most people recover fully, though subtle imbalance may persist.
Can anxiety cause vertigo?
Persistent postural-perceptual dizziness (PPPD) is a functional dizziness disorder linked to anxiety and prior vestibular events — common but distinct from true vertigo.
Medical Disclaimer: New-onset vertigo with neurological symptoms should be assessed as a potential stroke emergency before assuming a peripheral cause.