What Your Doctor Will Look For at Your Appointment
If you’re having symptoms of vertigo, you’ll probably see your primary care doctor first. Your physician will consider various factors, ask you questions, and perform procedures to help come up with a diagnosis.
Vertigo Symptoms
Explaining your symptoms to your doctor is the first step to figuring out what’s going on. People with dizziness often have trouble describing their specific complaints, which can make a diagnosis challenging. (1) To determine if you have true vertigo, your doctor might ask the question: “When you have dizzy spells, do you feel light-headed or does the world spin around you?” If you experience a spinning sensation, you most likely have vertigo. (1) Tell your doctor about all your symptoms and any medicines you’re taking. It’s also important to let your healthcare provider know how severe your symptoms are and if you have any other bothersome issues that aren’t related to the dizziness. If your symptoms sound like true vertigo and you’re not using any drugs that could be triggering episodes, your doctor will continue to investigate a cause.
Types of Vertigo
Your physician will try to determine if you have peripheral or central vertigo. Peripheral vertigo is typically caused by an inner ear issue. Central vertigo is usually due to a problem in the brain. You might be asked how long your vertigo bouts last, what triggers your episodes, and whether you have specific symptoms, such as hearing loss, to help your practitioner determine what type of vertigo you have.
Medical History
Your medical history can offer important clues about what could be causing your vertigo. Certain diseases, like diabetes, heart disease, Parkinson’s, and multiple sclerosis (MS), are linked to vertigo. Also, having a head injury or experiencing migraines may be associated with certain conditions that cause vertigo. Tell your doctor about any medical issues and if you have a family history of vertigo.
Physical Exam
Your physician will likely perform a complete physical exam to help make a diagnosis. He or she might check how you walk, your balance, and how your nerves are working. You might also undergo a head and neck exam to look for any problems. Additionally, your practitioner will probably check your pulse and blood pressure. Blood work is also often recommended to see if anything unusual pops up. You might have your blood sugar, blood counts, electrolytes, and thyroid function tested.
Imaging Tests
Various imaging tests, such as magnetic resonance imaging (MRI) or computerized tomography (CT) scans, may be recommended to get a closer look at what’s going on inside your body.
Referral to a Specialist
Once your doctor has determined a cause for your vertigo symptoms, you may be referred to a specialist, such as a neurologist or otolaryngologist, who deals with that particular condition. But not all people with vertigo will need to see a doctor outside of their primary care physician. (1)
Questions Your Doctor Will Ask You
Some common questions doctors might ask to make a diagnosis include:
What did it feel like the first time you had a vertigo episode?When you feel dizzy, does the room spin or do you feel like you’re in motion?What medications do you take (including vitamins and supplements)?Do your symptoms occur in spells or are they continuous?How long do the episodes last?How often do the bouts occur?Would you describe your symptoms as mild or severe?Does anything seem to trigger your vertigo episodes?Do you feel faint or light-headed when you have dizzy spells?Does your vertigo cause you to lose balance?Do you have hearing difficulties or ringing in your ears when you have an episode?Do you experience blurry vision or headaches during an episode?Are your symptoms worse when you move your head?
Other Specific Tests You May Get
Several specific tests are used to determine if you have vertigo, including the following:
Head impulse testRomberg testFukuda-Unterberger testDix-Hallpike maneuverElectronystagmography (ENG) or videonystagmography (VNG)Rotation testsVestibular evoked myogenic potential (VEMP)PosturographyVision and hearing tests
Doctors Who Specialize in Vestibular Disorders
You may decide to see a specialist to diagnose your vertigo. This expert is often called a “vestibular” disorder specialist, which means he or she focuses on treating inner ear or balance conditions. There are many factors to consider when choosing a specialist, including:
Training You might want to check if the practitioner has training or education in a vestibular specialty.Experience Ask how long the doctor has been working with vertigo patients.Equipment See if the professional has specialized equipment to diagnose and treat vertigo disorders.Practice Choose a practice that focuses on vestibular disorders.Professional Associations Check to see if the doctor is a member of a professional association that’s related to vestibular disorders. (2)
The Vestibular Disorders Association (VeDa) provides an online directory that lists qualified vestibular disorder specialists.
What Are the Next Steps Toward Getting a Diagnosis?
Getting a vertigo diagnosis isn’t always easy. You may have to undergo several tests to determine what’s causing your dizziness. You might even have to see different doctors to get an accurate diagnosis. While the process can be frustrating at times, it’s important to stay the course and keep pressing to find answers. Once you have a firm diagnosis, you and your healthcare provider can come up with a treatment plan for your vertigo symptoms. This may involve medication, surgery, certain procedures, physical therapy, psychotherapy, or other methods. In some cases, vertigo may go away on its own.
