What should you know about POTS vertigo?

Vertigo can feel as though you or the room is turning. Head movement may trigger short bursts, while other episodes last longer and come with nausea, imbalance, hearing change or ringing. Benign Paroxysmal Positional Vertigo is one inner-ear cause. Meniere's Disease can combine vertigo with hearing symptoms, while Middle Ear Infection may cause ear pain or pressure. Migraine can produce vertigo even when head pain is mild or absent. The pattern, associated symptoms and examination help separate these possibilities.

Sit or lie still when the spinning starts, keep the room well lit and avoid driving, heights and machinery until balance is reliable. Move your head slowly and keep nearby floors clear. Small sips of fluid may help if nausea has made drinking difficult. Keep a note of triggers, duration, hearing changes and medicines. An Epley Manoeuvre may help positional vertigo, but it is best used after a clinician confirms that pattern and checks whether it is suitable.

Get emergency help for vertigo with new weakness, facial drooping, difficulty speaking, severe sudden headache, fainting, chest pain or inability to walk safely. Seek prompt medical review for new hearing loss, severe ear pain, repeated vomiting, fever, a head injury or symptoms that do not settle. Do not assume spinning is harmless solely because it follows movement.

What pattern does my vertigo follow? Do I need hearing or balance tests? Could a medicine or migraine be involved? Is a repositioning manoeuvre appropriate, and what should make me stop it?