“I feel dizzy” is one of the most common complaints in clinic — but it means different things to different people. A false sense that you or the room is spinning is vertigo. Light-headedness, blacking out or unsteadiness are also described as dizziness. An accurate description helps find the cause.
Common causes of vertigo
- BPPV: tiny calcium crystals shift inside the inner-ear balance organ. Turning in bed or looking up triggers a few seconds of intense spinning — the most common cause.
- Vestibular neuritis: severe vertigo and vomiting for several days, often after a viral infection.
- Ménière's disease: vertigo with ringing in the ear, ear fullness and hearing loss.
- Vestibular migraine: vertigo in people with migraine, with or without headache.
- Anaemia, low blood pressure, low blood sugar, dehydration and medicine side effects.
Diagnosis
In most cases a detailed history and specific bedside tests — such as observing eye movements and the Dix-Hallpike test — reveal the cause. MRI or other tests are used when needed.
Treatment
Treatment depends on the cause. For BPPV, a simple head-positioning manoeuvre (Epley manoeuvre) done in clinic works better than medicine. Long-term use of anti-vertigo tablets slows the brain's natural adaptation, so don't take them for long without medical advice.
What to do at home
- Sit or lie down as soon as the dizziness starts
- Get up slowly — sit first, then stand
- Drink enough water; keep salt and caffeine moderate
- Prevent falls in older people with good lighting and bathroom grab bars
If dizziness keeps coming back, see a neurologist to find and treat the real cause.