What should you know about true vertigo?

True vertigo is a false sensation that you or the room is moving, often linked to the balance system in the inner ear or brain. The feeling may be spinning, tilting, swaying, or being pulled in one direction. It can occur when you are still and may worsen when you turn your head, roll in bed, or stand. Nausea, vomiting, sweating, unsteadiness, or unusual eye movements can occur alongside it.

Vertigo is different from feeling faint or generally off-balance. A brief episode brought on by a particular head position can occur with benign paroxysmal positional vertigo, when tiny inner-ear particles disturb motion signals. Recurrent attacks with hearing changes or ringing may occur with Meniere's Disease. An inner-ear infection can affect balance, while Migraine can cause vertigo with or without a headache. These are examples, not a diagnosis based on the sensation alone.

A clinician will consider when the episodes began, how long they last, what movements trigger them, and whether hearing, vision, speech, strength, sensation, or coordination has changed. The examination may include eye movements, walking, balance, hearing, and positional tests.

Sit or lie down in a quiet, safe place until the spinning eases. Move your head slowly, keep a light on if you need to walk, and use support to reduce the chance of falling. Avoid driving, heights, ladders, and machinery while symptoms are present. Small sips of fluid can help if nausea allows; repeated vomiting or difficulty keeping fluids down needs medical advice.

Arrange an assessment if vertigo is new, keeps returning, lasts longer than expected, or interferes with walking, work, or daily activities. Do not perform a repositioning exercise without guidance if the diagnosis is uncertain, especially if neck or back movement is unsafe. If positional vertigo is confirmed, a clinician may recommend the Epley Manoeuvre.

Seek emergency help for vertigo with sudden weakness or numbness, facial drooping, trouble speaking, new double vision, severe difficulty walking, fainting, a sudden severe headache, chest pain, or new confusion. These symptoms can signal a serious problem and should not be watched at home.

Get prompt medical assessment for sudden hearing loss, severe or persistent vomiting, fever with a stiff neck, a recent head injury, or symptoms that are rapidly worsening. Do not drive yourself if you are unsteady or your vision is affected.

You could ask: Does my description fit vertigo or another type of dizziness? Which features suggest an inner-ear cause? Do I need hearing or balance testing? Is a positional test appropriate for me? Would the Epley Manoeuvre be suitable? Which symptoms should make me seek emergency help, and what activities should I avoid until this settles?