During an evaluation for vertigo, the health care professional may obtain a full history of the events and symptoms. This includes medications that have been taken (even over-the-counter medications), recent illnesses, and prior medical problems (if any).
After the history is obtained, a physical examination is performed. This often involves a full neurologic exam to evaluate brain function and determine whether the vertigo is due to a central or peripheral cause.
The Dix-Hallpike test is done to try to recreate symptoms of vertigo; this test involves abruptly repositioning the patient’s head and monitoring the symptoms which might then occur. However, not every patient is a good candidate for this type of assessment, and a physician might instead perform a “roll test,” during which a patient lies flat and the head is rapidly moved from side to side. Like the Dix-Hallpike test, this may recreate vertigo symptoms and may be quite helpful in determining the underlying cause of the vertigo.
If the cause of your signs and symptoms is difficult to determine, your doctor may order additional testing, such as:
- Electronystagmography (ENG) or videonystagmography (VNG). ENG (which uses electrodes) or VNG (which uses small cameras) can help determine if dizziness is due to inner ear disease by measuring involuntary eye movements while your head is placed in different positions or your balance organs are stimulated with water or air.
- Magnetic resonance imaging (MRI). MRI may be performed to rule out other possible causes of vertigo.
Treatment for vertigo depends on what’s causing it. In many cases, vertigo goes away without any treatment. This is because your brain is able to adapt, at least in part, to the inner ear changes, relying on other mechanisms to maintain balance.
For some, treatment is needed and may include:
Vestibular rehabilitation. This is a type of physical therapy aimed at helping strengthen the vestibular system. The function of the vestibular system is to send signals to the brain about head and body movements relative to gravity.
Canalith repositioning maneuvers. The movements are done to move the calcium deposits out of the canal into an inner ear chamber so they can be absorbed by the body. You will likely have vertigo symptoms during the procedure as the canaliths move.
Medicine. In some cases, medication may be given to relieve symptoms such as nausea or motion sickness associated with vertigo. If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling and cure infection. For Meniere’s disease, diuretics (water pills) may be prescribed to reduce pressure from fluid buildup.
Surgery. In a few cases, surgery may be needed for vertigo. If vertigo is caused by a more serious underlying problem, such as a tumor or injury to the brain or neck, treatment for those problems may help to alleviate the vertigo.
- Vitamin D supplementation.
- Herbal remedies such as gingkgo biloba, giner root, coriander reduce symptoms.
- Avoid substances that can trigger vertigo such as caffeine, tobacco or alcohol.
- Drink plenty of fluids.