Dizziness and vertigo can be deeply distressing experiences that disrupt your daily routine, work, and personal independence. Because the sensations can feel disorienting and unpredictable, many individuals experience heightened anxiety before an accurate cause is identified.
Vertigo is a symptom rather than an isolated illness. It typically stems from either an inner ear balance mechanism disorder (peripheral vestibular system) or pathways connecting the inner ear to the brain (central vestibular system). With thorough clinical evaluation and targeted neuro-otological assessment, balance disorders can be identified and managed effectively.
Watch: Patient experiences and recovery through targeted vestibular care at The Vertigo Clinic.
Common Causes of Vertigo and Dizziness
1. Benign Paroxysmal Positional Vertigo (BPPV)
BPPV is the most frequently diagnosed cause of positional vertigo. Patients typically report brief, intense spinning sensations triggered by specific head movements—such as turning over in bed, tilting the head backward to look up, or bending down. These episodes usually last less than a minute but can be accompanied by nausea and unsteadiness.
Common Factors: Natural age-related changes in the inner ear, head trauma, or prolonged recumbency.
Clinical Management: Following diagnostic positional testing (such as the Dix-Hallpike test), BPPV is treated with non-invasive canalith repositioning procedures (such as the Epley or Semont maneuver). These evidence-based maneuvers help guide displaced microscopic calcium crystals back into their proper chamber, providing significant symptom relief for the majority of patients.
2. Meniere's Disease
Meniere's disease is an inner ear disorder characterized by fluctuating fluid balance in the inner ear chambers. Symptoms typically occur in episodic attacks that can last from 20 minutes to several hours.
Key Symptoms: Spontaneous rotational vertigo, fluctuating hearing loss, ringing or buzzing sounds (tinnitus), and a feeling of fullness or pressure in the affected ear.
Clinical Management: Management focuses on reducing episode frequency and severity. This includes structured lifestyle and dietary modifications (such as sodium management), medical therapy, and ongoing audiometric monitoring.
3. Vestibular Migraine (Migraine-Associated Vertigo)
Vestibular migraine is a nervous system disorder where dizziness or balance instability occurs in connection with migraine mechanisms. Notably, a classic throbbing headache does not always happen simultaneously with the vertigo episode.
Key Symptoms: Imbalance or motion sensitivity lasting minutes to days, often accompanied by sensitivity to bright lights, loud noises, visual triggers, or nausea.
Clinical Management: Identified through clinical history and the exclusion of structural ear conditions. Care involves trigger management, sleep and routine regulation, vestibular rehabilitation, and medical preventive therapy.
4. Vestibular Neuritis
Vestibular neuritis involves inflammation of the vestibular nerve, often following a viral upper respiratory infection. It presents with sudden, constant spinning vertigo that can persist for multiple days.
Clinical Management: Short-term supportive medications may be used during the acute onset to manage severe nausea. Once the acute phase stabilizes, the primary evidence-based approach is Vestibular Rehabilitation Therapy (VRT)—a specialized physical therapy program designed to retrain the brain's balance pathways (central compensation).
Our Clinical Diagnostic Approach
Because numerous conditions can cause feelings of unsteadiness, an accurate diagnosis is the cornerstone of recovery. At The Vertigo Clinic, evaluations are led by fellowship-trained neuro-otology specialists and include:
- Comprehensive Clinical History: In-depth evaluation of your symptom timeline, triggers, and balance history.
- Bedside Neuro-Otological Examination: Specialized ocular motor tracking, nystagmus evaluation, and vestibular testing.
- Individualized Care Pathway: Selecting the precise clinical maneuver, balance retraining regimen, or medical therapy suited to your diagnosis.
Schedule a Balance & Vertigo Evaluation
Take a step toward understanding and managing your balance symptoms. Consult with our specialist at our JP Nagar 7th Phase clinic or book an online video consultation.
The Vertigo Clinic
Kothanur Main Road, South, opp. Navodaya Nagar Bus Stop, JP Nagar 7th Phase, Bengaluru, Karnataka 560078