Dizziness
Dizziness, unsteadiness, vertigo and light-headedness are often very hard to describe. The most serious disease causing dizziness is a stroke but there are many other brain disorders that can also cause this. In addition, dizziness can be due to irregular heart rhythms, blood pressure changes, or inner ear disorders. Neurologists can help narrow down the cause with a careful understanding of the s
What it is
Common causes include benign paroxysmal positional vertigo (BPPV — short episodes triggered by head position, treatable with Epley manoeuvre), vestibular neuritis (sudden severe vertigo lasting days), Meniere's disease (episodes with hearing loss and tinnitus), vestibular migraine (often missed), orthostatic hypotension, cardiac arrhythmia (covered under fainting), and (rarely) central causes including stroke.
Symptoms and signs
- Brief episodes of room-spinning triggered by looking up, turning in bed or bending forward (BPPV).
- Sudden severe constant vertigo with nausea, lasting days, settling over 2–3 weeks (vestibular neuritis).
- Recurrent attacks of vertigo with hearing loss, tinnitus and ear fullness (Meniere's disease).
- Visual motion sensitivity, busy-environment dizziness and a migraine history (vestibular migraine).
- Persistent imbalance with walking difficulty, double vision, or new neurological signs — needs urgent assessment for central cause.
How we investigate
Bedside vestibular examination including Dix-Hallpike, HINTS test, head impulse test and gait assessment. Audiogram via partner audiology. Brain and inner-ear MRI where central cause or Meniere's is suspected. Postural BP for orthostatic causes; ECG and 24-hour Holter where cardiac syncope is in the differential.
Treatment options at The Vesey
- Epley / Semont manoeuvres for BPPV — performed in the same consultation. Most patients are symptom-free after one or two treatments.
- Vestibular neuritis — short-course steroids in selected acute presentations, vestibular rehabilitation referral.
- Vestibular migraine — migraine preventative therapy (beta-blocker, candesartan, topiramate), trigger management.
- Meniere's disease — low-salt diet, betahistine, diuretics; ENT referral for grommets or intra-tympanic steroid in refractory cases.
- Vestibular rehabilitation — structured physiotherapist-led programme — the highest-quality evidence for chronic dizziness recovery.
Frequently asked questions
What is BPPV and how is it treated?
Benign Paroxysmal Positional Vertigo (BPPV) causes brief, intense spinning triggered by specific head movements. It is caused by displaced calcium crystals in the inner ear. The Epley manoeuvre — a series of head movements performed in clinic — repositions the crystals and resolves symptoms in most patients within one or two treatments.
Can anxiety cause dizziness?
Yes. Anxiety and panic attacks commonly cause lightheadedness and a floating, unsteady feeling. However, a thorough clinical assessment is needed to ensure a primary vestibular or cardiac cause is not missed before attributing dizziness to anxiety alone.
Is vestibular migraine different from a regular migraine?
Vestibular migraine causes episodes of vertigo or dizziness (often without headache) in people with a migraine tendency. It is one of the most commonly missed causes of recurrent dizziness in adults and responds well to migraine preventative treatments once a formal diagnosis is established.
How long does dizziness last after vestibular neuritis?
The acute phase typically lasts 1–3 days. The brain compensates progressively over 2–6 weeks. Some patients are left with residual imbalance or motion sensitivity that responds well to structured vestibular rehabilitation physiotherapy.
Private consultation at The Vesey
From £90 (Private GP) · Specialist from £260 · No GP referral required · Open 7 days 8am–8pm
Book an appointment
When to see a specialist
Book if your dizziness has lasted more than 2 weeks, if Epley manoeuvre has not been offered for positional symptoms, or if you have been told to "just get used to it" without a diagnosis.
Cost and pathway
Initial neurology / vestibular consultation £260 (60 minutes, includes bedside vestibular testing). Audiogram from £140. MRI brain from £450. Vestibular rehabilitation referral coordinated via partner physiotherapy.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our consultant neurology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
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Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
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