Dizziness is a common complaint characterized by the sensation that the surroundings are spinning, along with imbalance, lightheadedness, a “floating” feeling, and sometimes nausea or vomiting. Although many people refer to vertigo as if it were a disease, vertigo is not a disease—it is a symptom. In other words, vertigo is the medical term used to describe a specific type of dizziness, typically a spinning sensation.
In ENT (Ear, Nose and Throat / Otolaryngology) practice, a significant proportion of dizziness cases originate from the inner ear (the balance system). With an accurate diagnosis, symptoms can often be brought under clear control in most patients.
· Nausea and/or vomiting
· Sweating and a sensation of palpitations
· Loss of balance, veering while walking
· Ringing in the ear (tinnitus)
· A feeling of fullness/pressure in the ear
· Reduced hearing
· Involuntary eye movements (nystagmus)
· Symptoms that worsen with head movements
Vertigo can occur for many reasons. From an ENT perspective, the most common causes include:
· The most common cause of vertigo.
· Causes sudden, brief spinning attacks triggered by specific head movements (turning in bed, looking up, bending forward).
· Diagnosis is usually made with positional tests, and many patients improve rapidly with repositioning maneuvers.
· May develop after a viral infection.
· Can cause intense vertigo, nausea, and imbalance lasting for days.
· If hearing is not affected, vestibular neuritis is more strongly suspected.
· Vertigo attacks may be accompanied by fluctuating hearing, ear fullness, and tinnitus.
· Episodes can last from minutes to hours; follow-up and lifestyle adjustments are important.
· Vertigo episodes may occur in people with migraine.
· In some cases, vertigo can occur without headache.
· Diagnosis is based on clinical history, associated findings, and exclusion of other causes.
· Less commonly, other ear-related disorders may affect balance.
Important note: Dizziness is not always caused by the inner ear. Blood pressure changes, anemia, metabolic conditions, and neurological causes may also play a role. For this reason, a comprehensive evaluation is essential.
The key to diagnosis in vertigo is a detailed medical history and physical examination. During the consultation, we focus on:
· Is the sensation true “spinning,” or more of an imbalance/lightheadedness?
· How long do episodes last (seconds/minutes/hours/days)?
· Is there a trigger (turning in bed, head rotation, positional change)?
· Are there ear symptoms (hearing loss, tinnitus, fullness)?
· Did it begin after an infection? Is there a migraine history?
When needed, additional tests may include:
· Balance tests / vestibular evaluation
· Hearing tests (audiometry)
· In selected patients, imaging or collaboration with other specialties (Neurology, Internal Medicine)
Treatment is planned individually, based on the underlying cause.
· After diagnostic positional testing, repositioning maneuvers (such as Epley or Semont) can provide marked improvement in most patients.
· Some patients may require repeated sessions.
· In the early phase, symptom control for nausea and severe vertigo may be necessary.
· This is followed by vestibular rehabilitation exercises that retrain the balance system (crucial for sustained recovery).
· Attack control, lifestyle modifications, and appropriate medical management when indicated.
· With regular follow-up, the frequency and severity of attacks can often be reduced.
· Trigger management, lifestyle regulation, and medication when needed.
· Correctly identifying the migraine–vertigo relationship speeds up diagnosis and guides effective treatment.
· Avoid sudden head movements; move slowly, especially during attacks.
· Stay well hydrated; irregular sleep and high stress can trigger episodes.
· Do not drive a car or ride a motorcycle during vertigo.
· Avoid “internet maneuvers” without a confirmed diagnosis—incorrect maneuvers can worsen symptoms.
Immediate evaluation is recommended if vertigo is accompanied by any of the following:
· New, severe headache
· Speech difficulty, weakness in an arm/leg, facial drooping
· Double vision, marked confusion or altered consciousness
· Severe imbalance with inability to walk
· Chest pain or fainting
· Sudden and significant hearing loss
Vertigo is a medical term for a specific type of dizziness, typically a spinning sensation. Many people use the terms interchangeably, but not all dizziness is vertigo.
BPPV is generally benign, but it can significantly reduce quality of life. With the correct maneuver, most patients improve quickly.
Some cases may improve spontaneously; however, recurrence is possible. Waiting without identifying the cause can prolong symptoms and delay proper management.
If you have a spinning sensation, ear symptoms (tinnitus/fullness/hearing reduction), or dizziness triggered by head movements, an ENT evaluation is highly important. If needed, a multidisciplinary approach may be used.
Not always. In BPPV, the most effective approach is often repositioning maneuvers. Other causes may require short-term symptom control and rehabilitation.
Vertigo is often a manageable condition when the correct diagnosis is made. A comprehensive ENT examination helps identify the source of symptoms, guides appropriate testing, and allows a personalized treatment and exercise plan.
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Medical information note: The content on this page is for general informational purposes only and does not replace a physician’s evaluation. A clinical assessment is required for diagnosis and treatment.
