What Is Vertigo?
Vertigo is a specific type of dizziness in which there is a false sensation of movement, most commonly spinning. It is usually caused by a disorder of the inner ear balance system or its connections to the brain.
Dizziness, by contrast, is a broader term and may include:
Light-headedness
Unsteadiness
A floating or off-balance sensation
Benign Paroxysmal Positional Vertigo (BPPV) the most common cause of vertigo.
What causes BPPV?
The inner ear contains tiny calcium crystals that help detect head position. In BPPV, these crystals become displaced into one of the balance canals, sending incorrect signals to the brain and triggering vertigo.
Typical symptoms
Sudden spinning sensation
Triggered by:
- Turning in bed
- Looking up or down
- Getting out of bed
- Episodes last seconds
- Excessive screen time
- No hearing loss or neurological symptoms
Treatment – The Epley Maneuver
The most effective treatment repositioning, commonly known as the Epley Maneuver.
The Epley Maneuver uses a sequence of controlled head and body positions to guide the displaced crystals back to their correct location within the inner ear.
- Non-invasive
- Performed in clinic
- Takes only a few minutes
- High success rate, often with rapid symptom relief
- Medication is usually not required for BPPV and does not correct the underlying mechanical problem
Vestibular Neuritis (Vestibular Neuropathy)
Vestibular neuritis is caused by inflammation of the balance nerve, often following a viral infection.
Key features
- Sudden onset of severe vertigo
- Symptoms last days rather than seconds
- Associated nausea and imbalance
- No hearing loss
Treatment focuses on short-term symptom control and early vestibular rehabilitation therapy, which helps the brain adapt and recover balance function.
Ménière’s Disease
Is a chronic inner-ear disorder related to abnormal regulation of inner-ear fluid.
Typical symptoms
Recurrent vertigo episodes lasting 20 minutes to several hours
Fluctuating hearing loss
Tinnitus (ringing or buzzing)
A feeling of ear fullness or pressure
Management is individualized and aims to control symptoms, preserve hearing, and maintain quality of life.
Other Causes of Dizziness
A Multidisciplinary Approach
Not all dizziness originates from the inner ear.
Other causes may include:
- Neurological conditions such as vestibular migraine or stroke
- Cardiovascular causes including blood pressure or heart rhythm problems
- Metabolic issues such as anemia or blood sugar imbalance
- Neck-related (cervical) dizziness
- Anxiety-related dizziness or persistent postural-perceptual dizziness (PPPD)
Some patients have more than one contributing factor, making a multidisciplinary approach essential.
Specialist assessment is recommended if:
- Vertigo or dizziness is recurrent or worsening
- Symptoms persist longer than expected
- There is hearing loss, tinnitus, or ear pressure
- Dizziness interferes with work, driving, or daily activities
- Neurological symptoms occur (weakness, speech or vision changes)
