Vertigo is a unique sensation of spinning or dizziness, often described as feeling like you or your surroundings are moving when they are not. It can be very nauseating when these symptoms appear

 It is commonly caused by issues in the inner ear (behind the ear drum) or the vestibular nerve, which helps control balance. 

It must be said that 'true' vertigo is different to more common symptoms of lightheaded or general balance issues of which, the causes for this are numerous and cause by several factors. So clinicians will often ask you what you mean by feeling dizzy to tease out if this is true vertigo or not. 

• Benign Paroxysmal Positional Vertigo (BPPV) (most common presentation we see)
• Meniere's Disease (very rare)
• Vestibular Neuritis or Labyrinthitis (rare)
• Certain medication (very rare)

Vertigo is a truly horrible feeling to experience and quite debilitating when a true attack comes on. Often patients describe to us waking up first thing in the morning with the onse of symptoms.

common symptoms are: 

• Spinning or tilting sensation
• Nausea and vomiting
• Loss of balance
• Sweating
• Abnormal eye movements (nystagmus)

Sudden severe headache, posterior neck pain or speech issues associated with vertigo symptoms might be suggestive of something more serious  and we would recommend seeking medical assessment as an emergency .

Also very severe vertigo symptoms that:

• cause difficulty standing causing regular falls
• vertigo that is severe, sudden and constant and NOT positionally triggered
• and not reducing  in severity after a few minutes 

again we advise to seek urgent medical assessment such as an A+E setting 

BPPV is a a fairly benign common inner ear disorder that causes brief episodes of dizziness or vertigo, typically triggered by changes in head position. It occurs when tiny calcium crystals in the inner ear become dislodged and move into the semicircular canals, disrupting normal balance signals. The cause is largely unknown but we often seeing it in patient over 40 -50 and more commonly in females.

The key symptom is sudden vertigo when moving the head into a certain positions and with it feeling of unusual movement , room spinning. This can be quite nauseating feeling leading to vomiting and feeling unsteady or unbalanced. The symptoms tend to reduce or resolve after a few minutes by lying still and avoiding certain head positions.

Often the history from the patient is telling but examination by a clinician can help to confirm it .

Treatment Options:

• Canalith Repositioning (Epley) Manoeuvers: Specific head and body movements to move the dislodged crystals.
• Vestibular Rehabilitation: Physical therapy to improve balance.
• Medications: To relieve nausea and vertigo symptoms.
• Surgery: Rarely needed, but an option for severe cases.

Key Tips while living with vertigo:

• Avoid sudden head movements.
• Use caution when getting up or lying down.
• Take time when walking or moving about in the house
• avoid driving or operating any machinery

The recovery time from Benign Paroxysmal Positional Vertigo (BPPV) can vary but for most, time is simply needed and eventually the symptoms resolve within a few days to weeks as the balance centres in the ear re-adjust and synchronise. However, it's not uncommon for individuals to feel "off" or experience mild imbalance for a few weeks even after the vertigo has subsided. If symptoms persist or recur, additional treatments or vestibular rehabilitation therapy may be necessary.  Please see the video link above or download the sheet below  for useful exercises to help with recovery. 

Some people experience significant relief after just one or two sessions of special repositioning maneuvers, such as the Epley Manoeuvre which some clinicians have special training to perform this skill . Moreover , the  Ear, Nose & Throat (ENT) specialists at the Lauriston buildings in centre of Edinburgh ,run a regular vertigo clinic to see and help people with persistent and or severe vertigo symptoms. This requires a referral from us.

We can prescribe short term treatments that can lessen the effects of vertigo and nausea however we must stress these treatments are not curative but  aimed at reducing the severity of symptoms while you recover from an episode.