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Conditions

Dizziness and balance problems

Vertigo, lightheadedness and unsteadiness from ear, brain or general causes. The most common types are treatable, sometimes in a single appointment.

Dizziness covers a spinning sensation (vertigo), lightheadedness and unsteadiness. Most cases have a clear cause and many improve quickly once it is identified; the commonest, BPPV, is often cured in a single visit. Sudden dizziness with weakness, slurred speech, double vision or a severe headache needs emergency assessment, not a clinic appointment.

Common ear-related causes

  • BPPV: brief spinning brought on by turning over in bed, looking up or bending down
  • Vestibular neuritis: sudden severe vertigo lasting days, usually after a viral illness
  • Ménière’s disease: episodes of vertigo with hearing fluctuation, fullness and tinnitus on one side
  • Vestibular migraine: episodes of dizziness in someone with a history of migraine, sometimes without the headache

When dizziness is not the ear

Some dizziness comes from outside the ear: blood pressure, heart rhythm, medication side effects, anxiety or persistent postural-perceptual dizziness (PPPD). Part of the assessment is sorting out which group your symptoms belong to, because the treatments differ.

Assessment and treatment

A careful history is the most useful single tool. Examination includes positional and eye-movement tests, examination of the ear, and a hearing test; most dizziness does not need a scan. Treatment matches the cause: the Epley manoeuvre for BPPV in clinic, vestibular rehabilitation, Ménière’s management, or migraine prevention, with vestibular physiotherapy colleagues involved where rehabilitation is the answer.

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This page is general information and not a substitute for individual medical advice.