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Ear Nose Throat

Vertigo

Vertigo is an illusion in which a person feels that they or the objects around them are spinning. It is generally not a disease itself but a symptom of an underlying health problem.

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ℹWhat is Vertigo?

The sense of balance relies on signals sent to the brain from the eyes, ears, and muscles. The vestibular system (labyrinth) in the inner ear is the structure that assists with balance.

The semicircular canals detect the rotational movement of the head, while the otolith organs (utricle and saccule) sense the position of the head and linear movements. Vertigo occurs when signals from any of these sensory systems do not function properly.

Common Symptoms

Severe Dizziness
A sensation of spinning and loss of balance.
Nausea and Vomiting
Gastrointestinal symptoms accompanying vertigo attacks.
Sweating and Fatigue
Activation of the autonomic nervous system.
Aural Symptoms
Ringing in the ear (tinnitus), a feeling of pressure, or hearing loss.
Blurred Vision
Difficulty focusing.
Neurological Symptoms
Speech disorders, double vision (diplopia), or weakness in the arms/legs (symptoms of central vertigo).

Diagnosis Methods

Medical History and Physical Examination
The duration of complaints, triggering factors, and accompanying symptoms are questioned.
Audiological Tests
Hearing tests and balance measurements reveal inner ear-related problems.
Eye and Balance Tests
Tests examining eye movements and postural balance tests.
MRI and CT
Imaging of the brain and inner ear in cases of suspected neurological vertigo.
Laboratory Analyses
Blood tests to evaluate infections, vitamin deficiencies, or metabolic disorders.

Causes

BPPV (Benign Paroxysmal Positional Vertigo)
The most common cause; displacement of calcium carbonate crystals (otoconia) within the inner ear.
Ménière's Disease
Characterized by excessive fluid accumulation in the inner ear.
Vestibular Neuritis
Viral infection of the vestibular nerve.
Central Causes
Migraine, multiple sclerosis, brain tumors, cerebellar or brainstem pathology.
Neck and Spinal Problems
Vascular compression or muscle spasms may trigger vertigo episodes.

Treatments

Epley Maneuver
The most common treatment for BPPV. Repositioning of displaced crystals through specific head movements.
Vestibular Rehabilitation
Gaze stabilization, habituation exercises, and balance training to retrain the brain.
Medication
Balance-regulating and antiemetic drugs to control dizziness, nausea, and vomiting.
Lifestyle Changes
Reduction of stress, regular sleep, and decreasing salt and caffeine consumption.
Surgical Treatment
Surgical intervention in rare cases due to structural causes such as Ménière's disease or tumors.

Second opinion for Vertigo

A second specialist's review of your Vertigo diagnosis or treatment plan can clarify your next step. On eKonsey this review is done online.

When is a second opinion useful?

  • When the diagnosis is unclear or more than one possibility was discussed
  • When surgery or a long-term treatment was recommended
  • When the response to treatment is not what you expected

About second opinions

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Frequently Asked Questions

Last updated: August 30, 2026

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