Vertigo & Dizziness (BPPV)
Vertigo — a spinning sensation that throws off your balance — usually comes from the inner ear, and most cases are very treatable once the cause is found. An ENT specialist can pinpoint why it is happening and, for the most common type, often settle it quickly.
Medically reviewed by Dr. Marwan Alhalalmeh, ENT Specialist · Last reviewed: 2026-06-16
Overview
Vertigo is the false sensation that you or the room is spinning or tilting, often with unsteadiness and nausea. It usually comes from the balance organs of the inner ear. The most common cause is benign paroxysmal positional vertigo (BPPV), where brief spinning is triggered by head movements such as rolling over in bed or looking up; it happens when tiny crystals in the inner ear become displaced. Other causes include labyrinthitis and vestibular neuritis (inner-ear inflammation after a virus) and Meniere disease, which can also bring hearing loss and ringing. An ENT specialist examines the ears and balance system to find the cause. BPPV is often corrected with a simple set of head-position movements (the Epley manoeuvre) done in clinic, and other types respond to balance-retraining exercises and treatment of the underlying cause.
Symptoms
- A spinning or whirling sensation, even when still
- Brief spinning triggered by head movements or rolling over in bed
- Unsteadiness or loss of balance
- Nausea or vomiting with the spinning
- Ringing in the ear or a feeling of fullness, with some causes
- Hearing changes alongside the dizziness, with some causes
When to see a doctor
- Sudden severe vertigo, or vertigo that will not settle
- Dizziness with new hearing loss or ringing in one ear
- A severe headache, double vision, or slurred speech (seek urgent care)
- Weakness, numbness, or trouble walking with the dizziness (seek urgent care)
- Repeated attacks that affect your safety or daily life
Treatment options
- Examining the ears and balance system to identify the cause
- The Epley manoeuvre — repositioning head movements that resolve most BPPV
- Balance-retraining (vestibular rehabilitation) exercises
- Treating inner-ear inflammation or Meniere disease when present
- Reviewing medication and referring on if a non-ear cause is suspected
Common questions
What is the most common cause of vertigo?
Benign paroxysmal positional vertigo (BPPV) is the most common. It causes short bursts of spinning when you move your head — for example rolling over in bed or looking up — and is caused by tiny displaced crystals in the inner ear. It often responds quickly to a repositioning manoeuvre.
What is the Epley manoeuvre?
The Epley manoeuvre is a sequence of slow, guided head and body positions that move the displaced inner-ear crystals back to where they belong. Performed in clinic, it relieves BPPV in most people, sometimes after one or two sessions.
What is the difference between vertigo and dizziness?
Dizziness is a general term for feeling lightheaded or off-balance. Vertigo is more specific — a false sense that you or your surroundings are spinning — and most often points to a problem in the inner ear.
Should I worry if vertigo comes with hearing loss?
Vertigo with new hearing loss or ringing in one ear should always be assessed promptly, as it points to the inner ear and occasionally to conditions that benefit from early treatment. An ENT specialist can examine your hearing and balance together.
Will vertigo go away on its own?
Many episodes settle by themselves, and BPPV can come and go. But because simple in-clinic treatment often resolves it quickly — and because some causes need specific care — recurring or severe vertigo is worth assessing rather than waiting.
Further reading
General information about this topic from an independent health authority:
NHSIf spinning or unsteadiness is affecting your daily life, Dr. Marwan can find the cause and, for the common type, often settle it in clinic.
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