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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can usually find the likely cause of vertigo by video and start treatment; the positional test, the Epley manoeuvre, hearing tests and scans are done in person.
- What it is: a false feeling that you, or everything around you, is spinning, enough to affect your balance. It is a symptom, not a disease.
- How common: in a German population survey, 7.4% of adults had had vertigo from the balance system at some point, and 4.9% in the past year.
- How long it lasts: an attack can last from a few seconds to several hours, and severe vertigo can last many days or months. Most people get better without treatment.
- Emergency: call 112 for vertigo with double vision or loss of vision, sudden hearing loss, trouble speaking, weakness or numbness, or a sudden, severe headache.
Do not book a video appointment if your vertigo came on with double vision or loss of vision, sudden hearing loss, slurred or difficult speech, weakness, numbness or tingling in an arm, a leg or the face, trouble walking, a sudden, severe headache, chest pain or fainting. Call 112 or go to an emergency department, and do not drive yourself.
Can an online doctor treat vertigo?
Partly. Most vertigo comes from the inner ear, and a doctor can usually tell the likely cause by video from how the spinning starts, how long it lasts and what comes with it. The doctor can teach exercises, prescribe a short course of medicine for severe spinning and sickness, review medicines that may be causing it, and treat vestibular migraine. The positional test and the Epley manoeuvre for BPPV, hearing and balance tests, and scans need in-person care, and vertigo with the signs of a stroke is an emergency.
How an online consultation helps with vertigo
- Inner ear, migraine or something else?: The trigger and the length of each attack point to BPPV, an inner ear infection, Ménière’s disease or vestibular migraine.
- Stroke signs checked first: Double vision, slurred speech, weakness or trouble walking with vertigo mean 112, and the doctor asks about them before anything else.
- Medicine only when it helps: A short course for severe spinning and sickness, and no long-term tablets that slow your recovery.
- A plan to get your balance back: Exercises, what to avoid at home, driving, and when you need a hearing test, a scan or an ear, nose and throat specialist.
What the doctor checks in an online vertigo consultation
The doctor asks about the warning signs first, then about the spinning itself. The doctor asks about:
- Warning signs: double vision, loss of vision, slurred speech, weakness, numbness, trouble walking, sudden hearing loss, a sudden, severe headache, chest pain or fainting.
- The feeling: whether the room spins or tilts, or whether you feel faint, light-headed or unsteady instead.
- The trigger: rolling over in bed, lying down, looking up, standing up, or no trigger at all.
- How long each attack lasts: seconds, minutes, hours or days, and how often attacks come.
- Your ears: hearing loss, ringing (tinnitus) or a full feeling in one ear, and any recent cold or flu.
- Your health: migraine, a recent head injury, high blood pressure, diabetes, heart problems, pregnancy, and all your medicines, especially new ones.
Before the call, note when each attack started, how long it lasted, what you were doing and what came with it. Sit or lie down for the call if you feel unsteady, and have someone with you if you can.
What is vertigo, and what does it feel like?
Vertigo is the feeling that you, or everything around you, is spinning, enough to affect your balance. It is more than feeling dizzy. Vertigo is a symptom of many conditions rather than a disease in itself, and it most often comes from the inner ear, where the balance organs sit.
It often comes with feeling or being sick and unsteadiness, and sometimes with hearing loss, ringing in the ears, a full feeling in one ear, a headache, or jerky eye movements called nystagmus. Feeling faint or light-headed while the room stays still is a different symptom, covered on the dizziness page.
Inner ear or brain? Peripheral and central vertigo
Doctors divide vertigo into two types by where the problem is. Telling them apart is the most important step, because central vertigo can be a stroke:
Swipe sideways to compare →
| Peripheral vertigo | Central vertigo | |
|---|---|---|
| Where the problem is | The inner ear or the balance nerve | The brain |
| How common | The most common type | Less common |
| Typical causes | BPPV, labyrinthitis, vestibular neuritis, Ménière’s disease | A stroke, an infection, a head injury, multiple sclerosis, rarely a tumour |
| What comes with it | Spinning and sickness; hearing loss or ringing with some causes | Often marked imbalance or difficulty walking, double vision, slurred speech or weakness |
| Eye movements the doctor looks for | Jerky movements in one direction | Movements that change direction, or go up and down |
| What to do | See a doctor if it does not go away or keeps coming back | If it starts suddenly, call 112 |
What causes vertigo?
Inner ear problems that affect balance are the most common cause. Four conditions cause most vertigo, and the way the attacks behave tells them apart:
Swipe sideways to compare →
| Cause | What sets it off | How long it lasts | Other clues |
|---|---|---|---|
| BPPV | Head movements: rolling over in bed, lying down, looking up | Brief spins, usually less than a minute | Most common from age 50 to 70 |
| Vestibular neuritis and labyrinthitis | Often follows a cold or flu; no trigger | Constant spinning that eases after a few days; balance usually returns within 2 to 6 weeks | Labyrinthitis can also cause hearing loss and ringing; vestibular neuritis does not |
| Ménière’s disease | No trigger | Attacks lasting 20 minutes or more | Hearing loss, ringing or a full feeling in one ear |
| Vestibular migraine | Stress, lack of sleep and other migraine triggers | Episodes of 5 minutes to 72 hours | A history of migraine |
| Medicines | Starting or changing a medicine | Varies | Vertigo listed as a side effect on the leaflet |
| A stroke or another brain cause | Comes on suddenly | Constant | Double vision, slurred speech, weakness, numbness, trouble walking: call 112 |
Other causes include head injuries, low blood pressure on standing, heart rhythm problems, shingles in or near the ear, multiple sclerosis and, rarely, a growth on the balance nerve (acoustic neuroma). Long spells in bed can bring it on, hormone changes around the menopause can play a part, and sometimes no cause is found.
Can stress or anxiety cause vertigo?
Anxiety can make vertigo worse, and fast, deep breathing (hyperventilation) can cause dizziness. Stress is also a common trigger of vestibular migraine. Vertigo is unsettling in itself, which can feed the anxiety, so treating both helps: the anxiety page covers what a doctor can do.
How common is vertigo?
Very common. In a German population survey, 7.4% of adults had had vertigo from the balance system at some point in their lives, 4.9% in the past year, and 1.4% developed it for the first time within a year. It was about 3 times more common in older people and nearly 3 times more common in women, and 80% of the people affected said it disrupted their daily life, kept them off work or sent them to a doctor.
How long does vertigo last, and can it be cured?
It depends on the cause. An attack can last from a few seconds to several hours, and severe vertigo can last many days or months. Most people get better without treatment. The pattern by cause:
- BPPV: brief spins, usually lasting less than a minute, set off by head movements. Without treatment, episodes can go on for several weeks, and BPPV often comes back: in a Cochrane review, symptoms returned in 36% of people after treatment.
- Labyrinthitis and vestibular neuritis: symptoms ease after a few days, and balance usually returns within 2 to 6 weeks, sometimes longer. About 15% of people with vestibular neuritis develop BPPV afterwards.
- Ménière’s disease: attacks lasting 20 minutes or more, with hearing symptoms in one ear.
- Vestibular migraine: episodes lasting anywhere from 5 minutes to 72 hours.
Can vertigo be cured permanently?
There is no single cure, because vertigo is a symptom. Some people have one episode and never another; others have attacks that come back. Treating the cause works best: the Epley manoeuvre stops BPPV in about 70% of people at the first attempt, and in nearly all with repeat attempts, and migraine prevention aims to halve the number of vestibular migraine attacks.
Is vertigo serious? When it can be a stroke
Usually not. Most vertigo comes from the inner ear and settles, and the main everyday danger is a fall. Rarely, vertigo is a sign of a stroke or another problem in the brain. These signs point to the brain rather than the ear, and mean 112:
- double vision or loss of vision
- slurred speech or trouble speaking
- weakness, numbness or tingling in an arm, a leg or the face
- being unable to walk or stand without help
- sudden hearing loss
- a sudden, severe headache, chest pain, a pounding heartbeat or fainting
In hospital, doctors use a short bedside examination of the eyes, called HINTS, to tell an inner ear problem from a stroke when vertigo is constant. A US review for family doctors found it more reliable than an early MRI scan for ruling out a stroke, and a normal CT scan does not reliably rule one out in this situation. This is why constant vertigo with trouble walking needs an examination, not a wait at home.
Falls and balance
Falls can cause fractures and other injuries. Balance problems become more common with age: in a US survey using a simple standing test, 35% of adults aged 40 and over had balance problems, and 85% of those aged 80 and over. If you are unsteady, turn the lights on when you get up at night and use a walking stick if you are at risk of falling.
Which vertigo treatment might the doctor recommend?
Treatment follows the cause, and the cause follows the pattern of the attacks. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Brief spins when you roll over, lie down or look up | Assessment for BPPV; the Epley manoeuvre, or exercises at home | Partly | For the positional test and the Epley manoeuvre |
| Constant spinning for days after a cold or flu | A short course of medicine for sickness and spinning, then gentle movement | Yes, to assess | If you cannot stand or walk, your hearing changes, or it is not easing after a few days |
| Attacks of 20 minutes or more with hearing loss, ringing or fullness in one ear | Hearing tests and a specialist assessment for Ménière’s disease | Partly | For hearing tests and an ear, nose and throat specialist |
| Vertigo attacks in someone with migraine | Migraine treatment, prevention and trigger management | Partly | If attacks are new, change, or come with hearing loss |
| Vertigo after starting or changing a medicine | A review of the medicine with the doctor who prescribed it | Yes | Not usually needed |
| Vertigo that keeps coming back, cause unclear | Balance exercises, and the right tests | Partly | For hearing or balance tests, or a scan |
| Sudden vertigo with double vision, slurred speech, weakness, numbness, hearing loss or a severe headache | Emergency care | No | Call 112 now |
Spinning, sickness or attacks that keep coming back? A doctor can tell you in one consultation what is likely to be causing your vertigo.
See available times →Treatment options for vertigo
What you can do yourself
- Lie still in a quiet, dark room during an attack, and sit down as soon as you feel dizzy.
- Move your head slowly and carefully, and get out of bed slowly, sitting on the edge for a while before you stand.
- Sleep with your head slightly raised on 2 or more pillows.
- Squat rather than bending over to pick things up, and do not stretch your neck up to reach high shelves.
- Turn the lights on if you get up at night, and use a walking stick if you are at risk of falling.
- Try to relax: anxiety can make vertigo worse.
- Do not drive during an attack, or while attacks keep coming back.
Exercises that retrain your balance
Vestibular rehabilitation is a set of exercises for dizziness, unsteady vision and balance, from controlling eye movements to marching on the spot, which help the brain adapt. For BPPV, repositioning manoeuvres such as the Epley move loose crystals in the inner ear back into place. In a Cochrane review, a single Epley treatment worked better than a week of Brandt–Daroff exercises, which you can do at home when the manoeuvre is not possible.
Prescription treatment
A prescription is never issued without a consultation. For severe spinning and sickness, for example in vestibular neuritis or a Ménière’s attack, the doctor may prescribe a short course of a medicine such as prochlorperazine, cinnarizine or cyclizine. These are meant for up to 3 days: taken for longer, they slow the brain’s natural recovery and can make falls more likely. Betahistine is used for Ménière’s disease. No medicine has been shown to work for BPPV, which is treated with manoeuvres. Benzodiazepines are sometimes used for severe attacks, but they are controlled medicines and are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Staying in bed for days once the worst has passed: long spells in bed can bring vertigo on, and gentle movement helps the brain adapt. Anti-sickness tablets taken for weeks. Antiviral medicines for vestibular neuritis, which have not been shown to work. Tablets for BPPV instead of the Epley manoeuvre.
Special situations
Pregnancy
Several vertigo medicines, including cinnarizine and betahistine, are not usually recommended in pregnancy, so tell the doctor. Feeling dizzy or faint in pregnancy is covered on the dizziness and faintness in pregnancy page.
Older adults
Vertigo is about 3 times more common in older people, and falls are the main risk. A medicine review is worth asking for: in older adults seen by their family doctor for dizziness, medicines were implicated in 23% of cases, and taking 5 or more medicines raises the risk.
Driving
Do not drive while you have vertigo. In the UK, drivers must tell the DVLA about vertigo, and in Ireland the National Driver Licence Service.
Vertigo while travelling in Europe
Labyrinthitis often follows a cold or flu, which can happen on any trip, and the same warning signs mean 112 wherever you are. Feeling sick on boats, coaches and winding roads is usually motion sickness rather than vertigo: see travel sickness. Carry a list of your medicines.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When vertigo is treated online, and when you need in-person care
Treated online: finding the likely cause from your story, BPPV recognised from the classic pattern with exercises at home, short courses of medicine for vestibular neuritis and Ménière’s attacks, vestibular migraine, vertigo caused by medicines, and follow-up while you recover.
In-person care: the positional test and the Epley manoeuvre, hearing and balance tests, scans, vertigo with any stroke sign, constant new vertigo with trouble walking, and attacks that do not fit a clear pattern.
When to get in-person care
Call 112 or go to an emergency department now for:
- vertigo with double vision or loss of vision
- vertigo with slurred speech or trouble speaking
- vertigo with weakness, numbness or tingling in an arm, a leg or the face
- vertigo with sudden hearing loss
- vertigo that came on suddenly with being unable to walk or stand
- a sudden, severe headache that reaches its worst within 5 minutes, or vertigo after a head injury
- vertigo with chest pain, a pounding or irregular heartbeat, or fainting
Get medical advice the same day for:
- vertigo with a severe headache
- vertigo with being sick, or feeling very sick
- vertigo with a high temperature of 38°C or above, or feeling hot and shivery
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the vertigo: say what sets it off, how long each attack lasts, and whether your hearing, vision or speech has changed, and list the medicines you take.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Vertigo 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.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Dizziness can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about vertigo
What is vertigo?
Vertigo is a false feeling that you, or everything around you, is spinning, enough to affect your balance. It is a symptom rather than a disease, and it most often comes from the inner ear.
What causes vertigo?
Vertigo usually comes from an inner ear problem: BPPV, labyrinthitis, vestibular neuritis or Ménière’s disease. Migraine and some medicines can cause it too, and rarely a stroke or another problem in the brain. Sometimes no cause is found.
How long does vertigo last?
An attack can last from a few seconds to several hours, depending on the cause. BPPV causes spins of usually less than a minute, labyrinthitis eases after a few days with balance back within 2 to 6 weeks, Ménière’s attacks last 20 minutes or more, and severe vertigo can last many days or months.
How do you make vertigo go away at home?
During a vertigo attack, lie still in a quiet, dark room, and sit down as soon as you feel dizzy. Afterwards, move your head slowly and get up in stages. Treatment then depends on the cause: the Epley manoeuvre for BPPV, a short course of medicine for severe sickness, and balance exercises.
What triggers a vertigo attack?
In BPPV, head movements such as rolling over in bed, lying down or looking up. In vestibular migraine, migraine triggers such as stress and lack of sleep. Ménière’s attacks and vestibular neuritis usually have no trigger, and some medicines can bring vertigo on.
What causes recurring vertigo?
Recurring vertigo is most often BPPV, which comes back in about a third of people after treatment, vestibular migraine or Ménière’s disease. Attacks that keep coming back need a diagnosis, because each cause is treated differently.
Can vertigo be cured permanently?
There is no single cure, because vertigo is a symptom. Some people have one episode and never another. Treating the cause often stops the attacks: the Epley manoeuvre works for about 70% of people with BPPV at the first attempt.
Can stress cause vertigo?
Anxiety can make vertigo worse, and anxious, fast breathing can cause dizziness. Stress is also a common trigger of vestibular migraine. Vertigo that keeps coming back still needs a check for an inner ear cause.
Is vertigo a sign of a stroke?
Rarely. Vertigo with double vision, slurred speech, weakness, numbness, trouble walking, sudden hearing loss or a sudden, severe headache can be a stroke: call 112. Brief spins set off by head movements are typical of BPPV, an inner ear problem.
How long should I take prochlorperazine for vertigo?
For vertigo, prochlorperazine is usually taken for no more than 3 days, as the doctor advises. Anti-sickness medicines ease severe spinning and sickness, but taken for longer they slow the brain’s natural recovery and can make falls more likely. Betahistine is different: it is used for Ménière’s disease.
What is the difference between vertigo and dizziness?
Vertigo is a spinning or moving feeling, usually from the inner ear. Dizziness is a wider word that also covers feeling faint, light-headed or unsteady while the room stays still.
Can an online doctor treat vertigo?
Partly. A doctor can usually find the likely cause by video, prescribe a short course of medicine, teach exercises and treat vestibular migraine. The positional test, the Epley manoeuvre, hearing tests and scans are in person, and vertigo with stroke signs needs 112.
- Vertigo, NHS, National Health Service (UK), reviewed 2 May 2023.
- Vertigo, HSE, Health Service Executive (Ireland), reviewed 2 August 2024.
- Vertigo, Cleveland Clinic (US), reviewed May 2023.
- Dizziness: approach to evaluation and management, Muncie HL, Sirmans SM, James E. American Family Physician, 2017.
- Vestibular dysfunction: prevalence, impact and need for targeted treatment, Agrawal Y, Ward BK, Minor LB. Journal of Vestibular Research, 2013.
- Epley manoeuvre for benign paroxysmal positional vertigo, Hilton MP, Pinder DK. Cochrane Database of Systematic Reviews, 2014.
- The Epley maneuver for treatment of benign paroxysmal positional vertigo, Seehusen DA, Chaffee DM. American Family Physician, 2015.
- Prochlorperazine, NHS, National Health Service (UK), updated 15 April 2024.
- Cinnarizine, NHS, National Health Service (UK), reviewed 6 August 2026.
- Betahistine, NHS, National Health Service (UK), reviewed 22 September 2026.
- Labyrinthitis and vestibular neuritis, NHS, National Health Service (UK), reviewed 6 August 2026.
- Benign paroxysmal positional vertigo (BPPV), Mayo Clinic (US), updated 31 December 2025.
- Benign paroxysmal positional vertigo (BPPV), Cleveland Clinic (US), reviewed 31 May 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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