Types & Common Causes

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1. Benign Paroxysmal Positional Vertigo (BPPV)

Brief, intense spinning episodes triggered by head movements due to displaced calcium crystals (otoconia) in the inner ear.

2. Vestibular Neuritis / Labyrinthitis

Inflammation of the inner ear nerves or labyrinth often following viral infections, causing prolonged vertigo and imbalance.

3. Meniere’s Disease

Inner ear fluid imbalance leading to recurrent vertigo spells, hearing loss, tinnitus, and ear fullness.

4. Central Causes (Neurological)

Stroke, multiple sclerosis, or brainstem/cerebellar lesions can cause vertigo — these require urgent evaluation.

5. Cardiovascular & Other Causes

Low blood pressure, arrhythmias, anemia, medication side effects, or hypoglycemia may present with giddiness.

Symptoms to Watch For

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• Sensation of spinning or movement (vertigo)
• Unsteadiness, imbalance, or falling
• Nausea or vomiting
• Hearing loss, tinnitus, or ear fullness (with inner ear causes)
• Blurred vision, difficulty concentrating, or fainting

Diagnosis & Tests

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Proper diagnosis includes a detailed history, physical exam, and targeted tests to determine whether the cause is peripheral (inner ear) or central (brain).

• Clinical bedside tests (Dix–Hallpike, head impulse, Romberg)
• Audiometry and tympanometry (when hearing symptoms are present)
• Videonystagmography (VNG) or electronystagmography to measure eye movements
• Imaging (MRI/CT) when a neurological cause is suspected
• Blood tests and cardiovascular evaluation if systemic causes are suspected

Treatment Options

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Treatment depends on the underlying diagnosis. Many inner-ear causes respond well to specific maneuvers, medications, or rehabilitation.

1. Repositioning Maneuvers (for BPPV)

Epley, Semont, or similar maneuvers safely move displaced crystals back to their proper position and often provide immediate relief.

2. Medication

Short-term vestibular suppressants (meclizine, promethazine) relieve severe vertigo and nausea. Infections may require antivirals or antibiotics; steroids can help vestibular neuritis.

3. Vestibular Rehabilitation Therapy (VRT)

Targeted physiotherapy exercises improve balance, reduce dizziness, and promote central compensation — especially after vestibular loss.

4. Management of Meniere’s Disease

Dietary measures (low-salt), diuretics, intratympanic steroid or gentamicin injections, and surgery in refractory cases.

5. Treatment of Central Causes

Neurological causes require specific management — stroke protocols, neurology referral, MRI-guided treatment planning.

6. Lifestyle & Supportive Measures

Hydration, avoiding sudden head movements, fall precautions, and adjusting offending medications can reduce episodes.

Prevention & Home Care Tips

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• Stay hydrated and maintain stable blood sugar levels
• Avoid rapid head movements and sudden position changes
• Limit salt and caffeine if you have Meniere’s disease
• Use handrails and assistive devices to prevent falls during episodes
• Review medications with your doctor to identify possible side effects

Why Choose Dr. Shrekha Padmakshan?

Dr. Shrekha Padmakshan offers expert, evidence-based care for dizziness and vertigo — combining accurate diagnosis with personalized treatment plans to restore balance and quality of life.

• Comprehensive vestibular assessment and testing
• Expertise in repositioning maneuvers and vestibular rehabilitation
• Multidisciplinary approach with neurology and physiotherapy when needed
• Individualized care plans focused on rapid recovery and fall prevention

If you experience recurrent giddiness, spinning sensations, or imbalance, book a consultation for a thorough evaluation and a treatment plan tailored to your needs. Early assessment improves outcomes and reduces the risk of falls and complications.