The term “vertigo” describes a spinning sensation or a feeling as though the surroundings are rotating. It is a more specific label than dizziness – a distinction not necessarily understood by patients – so someone complaining of either should be questioned closely in order to determine exactly what they are experiencing. 

Accompanying symptoms depend on the underlying issue, but often include nausea and vomiting. The vertigo may be fleeting or constant and last several days, which can be very debilitating. 

Vertigo can incapacitate in several ways: not just in terms of increasing the risk of falls, particularly in the elderly, but there is also an increased likelihood of anxiety or depression, and a significant negative impact on activities such as working and driving. 

Vertigo can have a central or peripheral cause. The most common reason for central vertigo is migraine, but other causes include stroke, transient ischaemic attack (mini stroke) and multiple sclerosis. As central vertigo has its origins outside the ear, it will not be covered in detail in this module.