In the majority, specialist investigations do not help with the diagnosis but they can be helpful in certain circumstances. The majority of patients who experience episodes of vertigo will recover without any long-term ill effects and usually within a few weeks or month of the onset of the symptoms. Recovery is much quicker in the long run if treatment with anti-dizziness medicines is not prolonged. This is best treated at first with a vestibular sedative such as Stemetil, but any treatment should be stopped quite quickly to allow the brain to compensate and recover from the dizziness. Longer episodes of dizziness (days to weeks)Īn infection of the inner ear (labyrinthitis) or an inflammation of the balance nerve (vestibular neuronitis) can give rise to severe rotatory dizziness for up to two to three weeks, with a slow return to normal balance which can take a further few weeks.Īgain, the initial episode is often associated with vomiting and the patient can be bed-bound because the dizziness is so severe. Treatment of Menière's disease can involve medicines and, more rarely, surgery, but this will be organised by your local ear nose and throat department once the diagnosis of Menière's disease has been made. The hearing recovers once the vertigo has settled, but may gradually deteriorate with time. The dizzy episodes are usually linked with vomiting, and the sufferer can often tell an episode is about to start because he or she notices a drop in their hearing, a feeling of fullness in the ear and some tinnitus. Menière's disease or endolymphatic hydrops result in episodes of severe vertigo that can last up to several hours. These types of vertigo are rarer and are thought to be due to an increase in pressure of the fluid in the inner ear, although nobody really knows for sure.
Medium length episodes of dizziness (half-hour to several hours) This can be carried out either by the ear nose and throat surgeon or physiotherapy department, depending on the hospital. Medicines do not help, but a manoeuvre known as Epley's Manoeuvre can be extremely effective in some patients. Sometimes the attacks start following a whiplash injury or other head injury, but often there appears to be no reason that they should have started. It is probably caused by a little piece of lining coming loose in the inner ear and floating into the balance receptor, causing a sudden increase in nerve stimulus to the brain. In between attacks, the sufferer feels entirely normal. It is often started off by the person suddenly looking upwards or sideways, and some people get it when they turn over in bed. This is typically a very sudden onset of dizziness, which settles rapidly after a few seconds or at most a couple of minutes. Short-lived episodes of dizziness (few seconds to minutes)Īn extremely common type of vertigo is benign positional vertigo. One way to distinguish them is by the duration of the dizziness. Many different factors can affect the inner ear and cause vertigo.
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