Is Your Dizziness Vertigo? Here's How to Tell
By Dr. Sudheer · February 18, 2025
Few symptoms are as widely misunderstood as 'dizziness'. Patients use the word to mean many different sensations, and each one points to a different cause and treatment. Sorting out what you actually feel is the most important step a neurologist takes during the first consultation.
True vertigo is a sensation that you or the world around you is spinning, even when you are stationary. It is usually triggered or worsened by head movement, often produces nausea, and may be accompanied by jerky eye movements (nystagmus). Vertigo points to a problem in the inner ear, the vestibular nerve, or the brainstem.
Lightheadedness, by contrast, is the feeling that you might faint. It often comes on when standing up quickly, in hot environments, or after missing a meal. It usually points to blood pressure, heart or blood sugar issues rather than the inner ear.
Disequilibrium is a sense of unsteadiness while walking, without spinning or faintness. It often appears with age, neuropathy, joint problems or certain neurological conditions. Patients describe it as 'feeling drunk' or needing to hold furniture.
The most common cause of true vertigo is benign paroxysmal positional vertigo (BPPV). Tiny calcium crystals dislodge in the inner ear and trigger brief, intense spinning when you roll over in bed or look up. The good news: a simple repositioning manoeuvre performed in the clinic often cures it in a single visit.
Vestibular neuritis — inflammation of the balance nerve, usually after a viral illness — causes severe vertigo lasting days, with imbalance afterwards. It improves with a short course of medication and gentle vestibular exercises. Meniere's disease produces episodes of vertigo with hearing changes and ear fullness, and needs specific long-term management.
When should dizziness raise alarm? Sudden severe vertigo with weakness, slurred speech, double vision or severe headache must be treated as a possible stroke — particularly in the brainstem or cerebellum — and needs urgent imaging.
If dizziness is interfering with your daily life, do not just 'live with it'. A focused neurological assessment can identify the cause in the majority of cases, and most causes have effective, often immediate, treatment.