How to Diagnose Vertigo

Medically reviewed by Luba Lee, FNP-BC, MS

Last Updated: November 18, 2024 References

Vertigo is a type of dizziness in which you may feel as though you are spinning or the environment around you is spinning. It is commonly caused by a peripheral vestibular system disorder and occurs in all age groups, though it can be more prevalent in women. Sometimes, it may be what's known as Benign Paroxysmal Positional Vertigo (BPPV), which basically means you sometimes get dizzy when you change positions.^{[1]
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Go to source} However, it can also indicate other conditions, so it is important to see your doctor if you are experiencing vertigo.

Part 1

Part 1 of 3:

Checking for Symptoms

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Notice dizziness and feelings of imbalance. Primary symptoms of vertigo include dizziness and a sense of imbalance. If you feel as though you are spinning or your environment is spinning, this suggests vertigo. Feeling as though you are going to fall over or being unable to balance yourself also suggest vertigo.^{[2]
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- These symptoms could be caused by inflammation of the vestibular cranial nerve, so it’s important to visit your doctor and get a definitive diagnosis.
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Determine if your dizziness is related to moving your head. Changing the position of your head can often increase dizziness or vertigo symptoms. Everyday activities like lying down, turning over in bed, bending down, and tilting your head can cause light-headedness or nausea.^{[3]
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- The most common cause of this type of recurrent positional dizziness is Benign Paroxysmal Positional Vertigo (BPPV).^{[4]
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The feeling of unsteadiness can make you nauseated. In turn, that can cause you to vomit. If you notice these symptoms in addition to the dizziness, you likely have vertigo.^{[5]
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If parts of your body feel numb or weak, or if you have trouble walking along with symptoms of vertigo, you could be suffering from a more serious condition. Also, note if your speech is slurred, which could indicate a stroke or transient ischemic attack.^{[6]
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Figure out if your symptoms are recurrent. If you experience these symptoms often, rather than once in a long while, you may be suffering from vertigo. If you have recurrent episodes of dizziness, nausea, vomiting, imbalance, and hearing loss, you could be suffering from Meniere’s disease.^{[7]
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- Other symptoms of this disease include ringing in your ears or a sensation of fullness in your ears. See your doctor if you are experiencing any of these issues.

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Visiting the Doctor

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Write down your symptoms. It can help to write down your symptoms ahead of time, so that you can be prepared to talk to your doctor. Make note of when the symptoms are worse and how often you have them, for instance. That way, you won't forget when you get to the doctor.^{[8]
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- Also, note any related symptoms, such as ringing in your ears or having trouble hearing.
While vertigo usually isn't life-threatening, you still need to visit your doctor. That way, they can determine if your vertigo is benign or a symptom of something else.
Usually, your doctor will start with a physical exam. They may look in your ears, for instance, since your sense of balance is regulated by your inner ear. They may also have you stand up and lie down to figure out when you're having the symptoms, as well as examine your eye movement.^{[9]
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Go to urgent care immediately if you have vertigo with other symptoms. Vertigo is a good reason to see your doctor soon, but if you have vertigo with other symptoms, including a severe or different headache, a fever, double vision, limb weakness, difficulty walking, slurred speech, or fainting spells, you should go to urgent care.^{[10]
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- Other symptoms include trouble speaking, tingling, numbness, or vision loss.

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Looking for Underlying Causes

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Be ready for a test of eye movement. Two tests, electroencephalography (ENG) or videonystagmography (VNG), are used to test eye movement. The first one uses electrodes while the second one uses tiny cameras. Essentially, this test looks at the movements your eyes make when air or water are used to stimulate the organs that maintain your balance.^{[11]
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- With an ENG, the technician or doctor will place electrodes around your eyes to test movement. VNG uses special goggles.^{[12]
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- The doctor is looking to see if your eyes are making involuntary movements.^{[13]
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Expect imaging tests. Your doctor may also order imaging tests, such as an MRI. With this test, the doctor will scan your body to look for anything else that may be causing your issues.^{[14]
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- For instance, sometimes a benign brain tumor may be causing the vertigo.
This test is designed to analyze issues with your balance. It looks at how you are using your inner ear, feet, and eyes to maintain balance and where they may be having issues. In turn, this information can be used to help you work on your vertigo.^{[15]
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If you are having ear problems, such as hearing loss or ringing in your ear, it may be appropriate for you to see a specialist. The ENT specialist will likely test your hearing with an audiometry test, as well as check your ears for infection or blockages.^{[16]
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For BPPV, the most common treatment is canalith repositioning.^{[17]
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Go to source} This treatment involves you learning a way to position your head with slow movements. The doctor will teach them to you, and then you will do them at home. The idea is to reposition particles in your ear so they don't throw you off balance. It can take a month or 2 for treatment to work.

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If you’re diagnosed with vestibular neuritis, your doctor may treat your symptoms with antihistamines, antiemetics, or benzodiazepines. Sometimes, you may also be directed to take steroids by mouth for 14 days.^{[18]
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Surgery is another option, but it's pretty rare for a doctor to recommend this treatment. Generally, they will only recommend this treatment if canalith repositioning isn't working. In this treatment, they plug up part of your inner ear so that it doesn't cause dizziness anymore.

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