Vertigo and Dizziness: When to See a Neurologist

Dizziness is among the most common reasons people visit doctors, but the term encompasses different sensations requiring distinct approaches.

Vertigo involves false sensations of spinning or movement, often with nausea—feeling like you or the room is rotating. Lightheadedness feels like impending fainting, often related to blood pressure or dehydration. Disequilibrium presents as unsteadiness or balance loss without spinning.

BPPV (Benign Paroxysmal Positional Vertigo) is the most common cause—tiny calcium crystals in the inner ear trigger brief spinning with head movements. Highly effective repositioning maneuvers provide relief. Vestibular neuritis involves inner ear inflammation causing severe vertigo lasting days, usually viral in origin. Meniere's disease is an inner ear disorder causing vertigo episodes, hearing loss, tinnitus, and ear fullness. Migraine-associated vertigo causes dizziness related to migraine, even without headache.

Seek immediate neurological evaluation for sudden severe vertigo with headache, vision changes, or weakness; vertigo with hearing loss or facial numbness; persistent dizziness lasting weeks; frequent recurrent episodes; dizziness after head injury; or associated neurological symptoms.

Diagnosis involves detailed symptom history, positional testing (Dix-Hallpike maneuver), hearing tests, balance assessment, and MRI if central causes are suspected.

Treatment depends on cause: Epley maneuver for BPPV (highly effective), vestibular rehabilitation therapy, medications for symptom control, dietary changes for Meniere's, and migraine prevention if applicable.

Struggling with dizziness or vertigo? Accurate diagnosis leads to effective treatment. Schedule a consultation today.