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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Dizziness is assessed by video from the pattern of the episodes, with short courses of vertigo medicines prescribed where they help and repositioning exercises taught for inner-ear vertigo; dizziness with stroke signs is a 112 call.
- What it is: vertigo (a spinning sensation, from the inner ear or the brain) or lightheadedness (faintness, from blood pressure, the heart, dehydration, medicines or anxiety); about 1 in 4 adults has a significant episode in any year.
- Inner-ear vertigo: brief spins on rolling over, lying down or looking up usually come from loose inner-ear crystals (BPPV) and respond to the Epley repositioning manoeuvre in about 8 in 10 people.
- Medicines: blood-pressure tablets, diuretics, sedatives, some antidepressants and sedating antihistamines are common causes of faintness on standing, especially after 65 or when doses change.
- How long: BPPV spins last under a minute; vestibular neuritis causes constant vertigo for days then settles over weeks; lightheadedness on standing passes in seconds once you sit.
- Emergency: call 112 for dizziness with any FAST stroke sign (Face drooping, Arm weakness, Speech difficulty, Time to call), double vision, sudden severe imbalance, a thunderclap headache, chest pain, or a blackout.
Think FAST. Call 112, do not book online, if dizziness comes with any stroke sign: Face drooping on one side, Arm weakness, Speech that is slurred or strange, Time to call 112 immediately. The same applies to dizziness with double vision, sudden severe imbalance, a thunderclap headache, chest pain, palpitations with fainting, or a blackout. Sudden dizziness that arrives with any of these is treated as a stroke or heart problem until proven otherwise.
What causes dizziness?
Dizziness has two main forms with different causes. Vertigo, a false sense of spinning or movement, usually comes from the balance organs of the inner ear: benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Ménière’s disease or vestibular migraine. Lightheadedness, feeling faint without spinning, usually reflects blood pressure, medicines, dehydration, anaemia, heart rhythm or anxiety.[1] Most causes are identified from the story alone, although some need in-person examination, and sudden dizziness with stroke signs is an emergency.
That is why “dizziness” on its own is not a diagnosis but a starting question. The pattern that matters is which sensation you have, what sets it off, how long each episode lasts and what comes with it. Those four answers separate an inner-ear crystal problem from a blood-pressure dip, and a harmless faint from something that needs a heart tracing, better than any single test.
Listen: Dizziness Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with dizziness
- The vertigo-or-lightheadedness sort: the doctor takes the one history that matters, sensation, trigger, duration and company, and places your dizziness in the right family, which is the step self-diagnosis most often gets wrong.
- A medication review with fresh eyes: dizziness is a common side effect of blood pressure tablets, sedatives, antidepressants and more. The doctor goes through your list and doses, and coordinates changes rather than telling you to simply stop.
- Treatment where treatment helps: guidance on repositioning manoeuvres for BPPV, short courses of vestibular suppressants where appropriate, and practical measures for blood-pressure-related lightheadedness.
- Straight answers about examination limits: some dizziness needs an in-person examination of eye movements, blood pressure lying and standing, ears or heart rhythm. When yours does, the doctor says so and tells you exactly where to go and how urgently.
What the doctor checks in an online dizziness consultation
The consultation is a structured history, because in dizziness the history carries most of the diagnosis. The doctor will typically check:
- The sensation itself: spinning or tilting (vertigo), feeling about to faint (presyncope), unsteadiness on the feet, or a vague woozy fogginess, each of which points down a different path.[1]
- Triggers: rolling over in bed or looking up suggests BPPV; standing up suggests a blood-pressure drop; head movement in general, busy visual scenes, stress or too little sleep suggest other patterns, including vestibular migraine.
- Episode length: seconds points to BPPV or a blood-pressure dip, minutes to hours to Ménière’s disease or migraine, and days of constant spinning to vestibular neuritis.[1]
- Ear symptoms: hearing loss, ear fullness or tinnitus alongside vertigo, which raise Ménière’s disease and change the referral.
- Red flags: stroke signs, new severe headache or neck pain, double vision, difficulty walking, repeated unexplained falls, or fainting during exertion.
- Your medicines: everything, including recently started or increased blood pressure tablets, sleeping tablets, antidepressants and over-the-counter antihistamines.
- Context: recent viral illness, fluid intake, alcohol, meals, hot weather, pregnancy, anaemia history and anxiety, all of which are common and fixable contributors.
- Home numbers where useful: if you have a monitor, blood pressure readings taken lying and then after standing for one and three minutes; a drop on standing is a finding a video consultation can put to work.[2]
Is it vertigo or lightheadedness?
Ask one question: does the world seem to move? If the room spins, tilts or slides, that is vertigo, an inner-ear or, rarely, brain problem. If you feel faint, distant or about to black out while the world stays still, that is lightheadedness, and the causes sit in circulation, medicines, hydration or anxiety rather than the ear.[1] The distinction decides both the likely cause and the right treatment, which is why it opens every good dizziness consultation.
The main vertigo patterns
BPPV is the most common: loose crystals in the inner ear set off intense spins lasting under a minute, triggered by rolling in bed, lying down or looking up, and it responds to repositioning manoeuvres rather than tablets.[3][5] Vestibular neuritis follows a viral infection and causes constant severe vertigo for days, easing over weeks as the brain compensates. Ménière’s disease brings attacks of vertigo lasting 20 minutes to hours with hearing loss, fullness or tinnitus in one ear. And vestibular migraine causes recurrent vertigo with or without headache in people with a migraine history; if that sounds like you, the migraine treatment page covers the attack patterns and preventive options in depth.
The main lightheadedness patterns
Feeling faint on standing, especially in older adults, after meals or in heat, suggests orthostatic hypotension: blood pressure dipping when you rise, often helped along by blood pressure medicines, diuretics, dehydration or long days on your feet.[2] Missed meals and low blood sugar, anaemia, alcohol, and anxiety with overbreathing produce similar faintness by different routes; anxiety in particular also causes a persistent swimming fogginess between episodes. Palpitations with lightheadedness, or fainting without warning, point at heart rhythm and need in-person testing promptly.
When is dizziness a sign of a stroke?
Rarely, but the exceptions matter. Suspect a stroke and call 112 when dizziness starts abruptly and comes with any FAST sign (face drooping, arm weakness, slurred speech), or with double vision, severe new imbalance, trouble swallowing, numbness down one side or a sudden severe headache.[4] Isolated brief positional spins are almost never a stroke. The combination and the suddenness carry the risk, not the dizziness alone, and minutes matter when they appear.
One more in-person rule: constant new vertigo in someone over 60, or in anyone with vascular risk factors such as high blood pressure, diabetes, atrial fibrillation or smoking, deserves same-day examination even without FAST signs, because a cerebellar stroke can imitate an inner-ear problem convincingly.
Which dizziness care might the doctor recommend?
Treatment follows the pattern. This is the decision framework the doctors use, aligned with cited guidance:[1][3]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Brief spins on rolling over, lying down or looking up (BPPV pattern) | Repositioning treatment such as the Epley manoeuvre, with guidance on how and where to have it done | Usually yes, for diagnosis and direction | No response to repositioning, atypical features, or spins with hearing change |
| Constant spinning for days after a viral illness (vestibular neuritis pattern) | Short course of vestibular suppressant medicine, then early movement to speed compensation | Often yes | Unable to walk, one-sided hearing loss, new headache, or not improving within days |
| Faintness on standing (orthostatic pattern) | Medication review, fluid and salt advice, slow position changes, lying-and-standing blood pressure checks | Often yes, with home readings | Falls or blackouts, heart disease, or no improvement after adjustments |
| Vertigo attacks with hearing loss, fullness or tinnitus (Ménière’s pattern) | Assessment, symptom relief for attacks, and referral for hearing tests and specialist confirmation | Initial assessment and attack advice | Always, for audiometry and ENT-led long-term management |
| Sudden dizziness with FAST signs, double vision or severe imbalance | Emergency assessment | No | Call 112 now; treated as a stroke until proven otherwise |
Not sure which row is you? A doctor can tell you in one consultation.
See available times →Treatment options for dizziness
What you can do yourself
Match the measure to the pattern. For positional spins, move deliberately rather than freezing all movement, because avoiding motion delays recovery; if BPPV is confirmed, repositioning manoeuvres such as the Epley can often be taught and, once learned, repeated at home. For faintness on standing: rise in stages, sit on the edge of the bed first, drink regularly through the day, do not skip meals, ease off alcohol, and be extra careful in heat, after hot showers and during illness. Cross your legs and tense the muscles when you feel a faint coming; it genuinely buys time. Keep a short episode diary (what you felt, what triggered it, how long it lasted), which does more for diagnosis than most tests. And if you feel dizzy, do not drive until a doctor has told you it is safe.
Prescription treatment
A prescription is never issued without a consultation, and in dizziness the honest rule is that tablets are the smaller half of treatment. Short courses of vestibular suppressants such as prochlorperazine or antihistamines can settle severe vertigo in vestibular neuritis or during Ménière’s attacks, but they are deliberately time-limited: used for more than a few days they delay the brain’s own compensation and can prolong the problem.[1] BPPV is treated with manoeuvres, not medicines. Orthostatic lightheadedness is treated mainly by adjusting culprit medicines, which the doctor coordinates with whoever prescribes them rather than leaving you to experiment. Benzodiazepines, sometimes used in hospital for intractable vertigo, are controlled medicines and are not prescribed through online consultations. Where anxiety is driving the dizziness, treating the anxiety is the treatment that works.
Dizziness in older adults: falls are the complication that counts
In older adults, dizziness is not a nuisance symptom but the leading edge of fall risk, and falls are a major cause of injury in people over 65.[2] The highest-yield fixes are straightforward: a proper medication review (sedatives, overlapping blood pressure treatment and anticholinergic medicines are the usual suspects), checking lying and standing blood pressure, treating BPPV rather than tolerating it, vision and footwear checks, and strength and balance work. An online consultation can run the medication review, organise the right checks and involve family in the plan; repeated falls, fainting or new unsteadiness still need in-person assessment, and the doctor says so plainly.
When dizziness is treated online, and when you need in-person care
Treated online: the classic BPPV story, with direction to effective repositioning treatment; vestibular neuritis follow-up and short-course symptom relief; lightheadedness with an obvious contributor such as a recently changed medicine, poor fluid intake or missed meals; medication reviews for recurrent dizziness; anxiety-related dizziness, alongside mental health care; and follow-up of diagnosed Ménière’s disease between specialist reviews, within the specialist’s plan.
In-person care: any FAST sign, double vision, sudden severe imbalance or blackout goes to emergency care by 112, not to a video queue. Constant new vertigo in older or vascular-risk patients needs same-day in-person examination. Vertigo with one-sided hearing loss, fullness or tinnitus is referred for audiometry and ENT assessment. Fainting during exertion, palpitations with faintness, or falls with injury need in-person cardiac and physical examination. And BPPV that fails repositioning, or any diagnosis that stays unclear after a good history, earns an examination rather than a guess. Recurrent headaches with your dizziness are worth their own look: see the headache assessment page, or the full headaches and migraines service for every condition covered.
When to get in-person care
Call 112 for dizziness with any FAST stroke sign: Face drooping, Arm weakness, Speech difficulty, Time to call. Do the same for dizziness with double vision, severe new imbalance or trouble walking, numbness down one side, a thunderclap headache, chest pain, palpitations with fainting, a blackout, or dizziness after a head injury. Seek same-day in-person care for constant new vertigo if you are over 60 or have vascular risk factors, for vertigo with sudden hearing loss, or for repeated falls.
Managing dizziness at home: what helps and what does not
For brief, mild dizziness with an obvious cause, home care is reasonable: drinking more fluids, standing up slowly in stages, eating regularly, easing off alcohol, and resting until it passes. Certain inner-ear causes also respond to specific repositioning manoeuvres a doctor can guide you through properly.
What home care cannot do: it cannot tell benign dizziness from dangerous. Dizziness with chest pain, palpitations, slurred speech, facial drooping, weakness, double vision or a sudden severe headache is 112 now. Recurrent spinning attacks, dizziness with hearing changes, or light-headedness on standing that keeps happening deserves diagnosis, because most causes are very treatable once named.
The strongest at-home treatment is still a doctor. A video consultation brings one to your sofa: you can see a doctor over video, usually within 15 minutes. The doctor gives an honest assessment, and a prescription to a local pharmacy when treatment is right. Book a video consultation: the exact price is shown before you pay.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about dizziness: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Get your diagnosis, plan and follow-up: if medicine is right for you, the prescription follows the consultation. If your doctor decides you need to be seen in person, you get a full refund.
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Dizziness can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Frequently asked questions about dizziness
What causes dizziness?
Dizziness has two families of causes. Spinning vertigo comes from the inner ear (loose crystals, vestibular neuritis after a virus, Ménière's disease, vestibular migraine) or, rarely, the brain. Lightheadedness comes from a brief drop in blood pressure on standing, dehydration, heart rhythm problems, low blood sugar, anaemia, medicines, alcohol, anxiety and over-breathing. The pattern of the episodes identifies most causes.
Is it vertigo or lightheadedness?
Vertigo is dizziness with a false sense of movement: you or the room spin, tilt or sway, often with nausea and worse on moving the head, and it points to the inner ear or, rarely, the brain. Lightheadedness is faintness or feeling about to pass out, worse on standing and better lying down, and it points to blood pressure, the heart, dehydration, medicines or anxiety. Doctors ask this first because the two have different treatments.
How do I know if my dizziness is serious?
Judge dizziness by the company it keeps. Dizziness with face drooping, arm weakness, slurred speech, double vision, severe imbalance, chest pain or blackout is an emergency: call 112. Brief spins triggered by rolling over, or faintness after standing quickly, are common and usually harmless. Constant vertigo for more than a day, hearing loss, or dizziness in someone with heart disease needs prompt assessment.
What is BPPV, and can it be treated at home?
Benign paroxysmal positional vertigo is dizziness caused by loose crystals in the inner ear and produces short intense spins when you roll over, lie down or look up. It is treated with repositioning manoeuvres such as the Epley, which move the crystals out of the canal and clear BPPV in about 8 in 10 people within one to three sessions; the doctor can teach the manoeuvre by video.
Why do I feel dizzy when I stand up?
Dizziness on standing usually means your blood pressure dips briefly before circulation catches up, a pattern called orthostatic hypotension. Dehydration, heat, alcohol, long periods lying down, large meals and blood-pressure medicines all make it worse. Rise in stages, drink through the day and review your medicines with a doctor if it happens most days or you have fainted.
Can blood-pressure tablets or other medicines cause dizziness?
Yes, commonly. Blood-pressure medicines, diuretics, sedatives, sleeping tablets, some antidepressants and sedating antihistamines can all cause dizziness, particularly faintness on standing, particularly in older adults or when doses change. Do not stop a prescribed medicine on your own; book a review, because adjusting a dose or timing often fixes the dizziness.
Can an online doctor prescribe medication for vertigo in the EU?
Yes, when it is the right treatment, and never without a consultation. Short courses of vestibular suppressants such as prochlorperazine can be prescribed for vertigo-type dizziness after a video assessment, with the prescription usable at a pharmacy near you. The doctor will also tell you when medicine is the wrong answer, as it is for BPPV, where repositioning works better.
How long does dizziness last?
It depends on the cause. BPPV spins last seconds to a minute and the condition clears with repositioning. Vestibular neuritis causes constant vertigo for one to three days, then improves over two to six weeks. Lightheadedness on standing passes within a minute of sitting. Dizziness that is constant for days, keeps worsening or comes with hearing loss or neurological symptoms needs prompt assessment.
How can I stop feeling dizzy?
To settle dizziness, sit or lie down until it passes, drink water, rise slowly in stages, avoid alcohol, eat regularly, and treat the cause: repositioning exercises for BPPV, balance exercises for vestibular neuritis, a medicine review for faintness on standing, and slow breathing for anxiety-related dizziness. Vertigo medicines help for a few days of acute vertigo but delay recovery if used for weeks.
Do I need a scan for dizziness?
Usually not. Most dizziness is diagnosed from the pattern of the episodes, sometimes plus simple checks such as lying-and-standing blood pressure, an ECG or a repositioning test. Imaging is reserved for stroke suspicion, new neurological signs, unexplained constant vertigo, hearing loss on one side or unusual features, and the doctor says plainly when yours needs one.
Is dizziness in pregnancy or in older people different?
Dizziness in pregnancy is common and usually lightheadedness from lower blood pressure, blood-sugar dips or lying flat late in pregnancy; it is managed with fluids, regular meals and rising slowly, and fainting or dizziness with bleeding needs prompt care. In older people the complication that counts is falls, so medicines are reviewed, blood pressure checked standing, and vision and balance assessed.
How can I prevent dizziness coming back?
Prevent recurrent dizziness by staying hydrated, limiting alcohol, standing up in stages, eating regularly, keeping active to maintain balance, reviewing medicines with a doctor, treating anxiety and migraine where they drive it, and repeating repositioning exercises at the first spin if BPPV returns, which it does in about a third of people within a few years.
- Vertigo: diagnosis and management, NICE Clinical Knowledge Summaries, National Institute for Health and Care Excellence, 2023.
- Falls fact sheet, WHO, World Health Organization, 2021.
- Benign paroxysmal positional vertigo: diagnosis and management, NICE Clinical Knowledge Summaries, National Institute for Health and Care Excellence, 2023.
- Stroke and TIA: recognition and management, NICE Clinical Knowledge Summaries, National Institute for Health and Care Excellence, 2024.
- The Epley manoeuvre for benign paroxysmal positional vertigo (Cochrane Review), Cochrane, Cochrane Collaboration, 2014.
- Dizziness, NHS, National Health Service (UK), accessed October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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