What should you know about extreme vertigo?

Vertigo is a symptom, not a single diagnosis. Inner-ear balance disturbances are common causes. Benign Paroxysmal Positional Vertigo often brings brief spinning after turning the head or changing position. Meniere's Disease may combine vertigo with hearing changes, ear pressure or ringing. Migraine can cause vertigo with or without a headache. A Middle Ear Infection may affect balance, particularly when ear pain or fever is present.

Sit or lie somewhere safe, keep your head still, and use good lighting when moving. Avoid driving, climbing, swimming alone or operating machinery until your balance has recovered. Ask someone to stay nearby if walking is unsafe. Note what brought the attack on, how long it lasted, hearing symptoms, headache, vomiting and any new medicines. A clinician can decide whether an Epley Manoeuvre is suitable; do not perform it without guidance when the diagnosis is uncertain.

Until assessed, move slowly and keep essential items within reach. A symptom diary covering position, movement, hearing and nausea can make the consultation more useful.

Call emergency services for vertigo with facial drooping, arm or leg weakness, trouble speaking, new severe headache, fainting, chest pain, double vision or inability to walk. Seek prompt assessment for sudden hearing loss, repeated vomiting, severe dehydration, fever with a stiff neck, or a first intense episode that does not settle.

Ask whether the pattern suggests an inner-ear disorder, migraine or another cause, and whether you need hearing, balance or neurological checks. Explain your triggers, duration, falls, hearing changes, headache, vomiting, medicines and any neurological symptoms.