What should you know about objective vertigo?

Some episodes are triggered by turning in bed or looking upward, as in benign paroxysmal positional vertigo. Others occur with ringing, ear pressure, or reduced hearing, which can point toward Meniere's disease. Headache, light sensitivity, or visual symptoms may accompany migraine-related vertigo. An inner-ear infection can disturb balance and may cause vertigo with ear pain or hearing change.

A clinician may ask when the sensation began, how long each spell lasts, what movement triggers it, and whether you have hearing, neurological, or headache symptoms. Examination of eye movements, walking, hearing, and balance helps decide whether further testing is needed.

Sit or lie down during an episode, move slowly, and avoid driving, climbing, or operating machinery while balance is affected. Keep the environment well lit and reduce fall hazards. Note triggers, duration, nausea, hearing changes, headache, and medicines taken. A healthcare professional can assess whether treatment such as the Epley Manoeuvre is suitable; do not perform repositioning exercises without guidance if neck or back movement is unsafe.

Seek emergency help for sudden vertigo with facial weakness, trouble speaking, new severe headache, fainting, chest pain, inability to walk, or one-sided weakness or numbness. Arrange prompt medical assessment for new persistent vertigo, repeated vomiting, new hearing loss, severe headache, fever, or symptoms after a head injury. Even when episodes settle, recurring symptoms deserve review.

Could the timing and triggers fit an inner-ear problem, migraine, or another cause? Do I need hearing or balance tests? Which movements and activities should I avoid, and when is a repositioning manoeuvre appropriate?