Your GP will ask about your symptoms and carry out some simple tests to help them make an accurate diagnosis.
In some cases, you may be referred for some further tests.
Your GP will first want to know:
- details of the first episode of your symptoms and what they were – for example, whether you felt lightheaded or if your surroundings were spinning
- if you also experience other symptoms – such as hearing loss, tinnitus, nausea, vomiting or fullness in the ear
- how often your symptoms occur and how long they last for
- if your symptoms are affecting your daily activities – for example, whether you're unable to walk during an episode of vertigo
- whether anything triggers your symptoms or makes them worse, such as moving your head in a particular direction
- what makes your symptoms better
Your GP may also carry out a physical examination to check for signs of conditions that may be causing your vertigo. This could include looking inside your ears and checking your eyes for signs of uncontrollable movement (nystagmus).
Your GP may check your balance or try to recreate your symptoms by asking you to move quickly from a sitting to a lying position.
Depending on your symptoms, your GP may refer you to a hospital or specialist for further tests.
If you have tinnitus (ringing in your ears) or hearing loss, your GP may refer you to an ear, nose and throat (ENT) specialist, who can carry out some hearing tests.
These may include:
- an audiometry test – a machine called an audiometer produces sounds of different volume and pitch. You listen to the sounds through headphones and signal when you hear a sound, either by raising your hand or pressing a button.
- tuning fork test – a tuning fork produces sound waves at a fixed pitch when it's gently tapped. The tester will tap the tuning fork before holding it at each side of your head.
Read more about how hearing tests are carried out.
Videonystagmography (VNG) is sometimes used to check for signs of nystagmus in more detail. Nystagmus can indicate a problem with the organs that help you to balance.
During this test, special goggles are placed over your eyes and you'll be asked to look at various still and moving targets. The goggles are fitted with a video camera to record the movements of your eyes.
Electronystagmography may also be used, where electrodes are placed around the eye instead of goggles.
A caloric test involves running warm or cool water or air into your ear for about 30 seconds. The change in temperature stimulates the balance organ in the ear, allowing the specialist to check how well it's working.
This test isn't painful, although it's normal to feel dizzy during the test. This can sometimes continue for a few minutes afterwards.
A machine to test your balance may be used to give valuable information about how you are using your vision, proprioception (sensations from your feet and joints) and the input from your ear to maintain balance. This may help to plan your rehabilitation and monitor your treatment.
In some cases, a scan of your head may be used to look for the cause of your vertigo, such as an acoustic neuroma (a non-cancerous brain tumour).
Usually, either a magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan is used. An MRI scan uses a strong magnetic field and radio waves to produce a detailed image of the inside of your head, whereas a CT scan uses a series of detailed X-rays to create an image.