Vertigo: what you should know

You may feel that you or the room is rotating, tilting, or shifting even when you are still. Nausea, vomiting, sweating, unsteady walking, and difficulty focusing your eyes can occur alongside it. Brief episodes brought on by turning in bed or looking up can fit benign paroxysmal positional vertigo, while vertigo with hearing changes or ringing may point toward an inner-ear disorder such as Meniere's disease. Migraine can cause vertigo with or without a headache. An ear infection may also disturb balance, especially when ear pain, discharge, or reduced hearing is present.

Vertigo is different from feeling faint. Light-headedness can reflect a blood-pressure or circulation problem, whereas vertigo is an illusion of movement. A clinician may ask when episodes began, how long they last, what movements trigger them, and whether hearing, vision, speech, strength, or coordination has changed.

Sit or lie down in a safe place, keep your head as still as you can, and focus on a stationary object. Rise slowly once the spinning settles. Avoid driving, climbing, bathing alone, or operating machinery while you feel unsteady. Drink fluids if you can keep them down, and record triggers, duration, hearing symptoms, headache, recent illness, and medicines. Do not perform a repositioning exercise such as the Epley manoeuvre unless a clinician has advised that it is suitable and has shown you how to do it.

Seek emergency help for vertigo with new weakness or numbness, facial drooping, trouble speaking, severe difficulty walking, fainting, a sudden severe headache, chest pain, or new double vision. Prompt assessment is also needed for sudden hearing loss, repeated vomiting with inability to keep fluids down, a high fever with severe headache or neck stiffness, or symptoms after a head injury. Arrange a medical review if episodes keep returning, last longer than expected, affect daily activities, or begin after a new medicine. A clinician can check your ears, eye movements, balance, nerves, and medicines before recommending treatment.

Ask: What type of vertigo does my pattern suggest? Could my medicines, migraine, ear condition, or another balance problem be contributing? Which movements or activities should I avoid for now? Would a hearing or balance assessment help? If an Epley manoeuvre is appropriate, can you demonstrate the correct side and technique? What warning signs should prompt urgent care if symptoms return?