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Dizziness (also known as giddiness) is the sensation of being lightheaded, or unsteady. Feelings of dizziness may be triggered or worsened by standing or sitting up, or moving your head. Sometimes, dizziness can also be accompanied by nausea, vomiting, headaches, and tinnitus (a ringing or humming in your ear).

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Dizziness has many causes, including problems in your inner ear which affect your body’s balance. It can also be caused by poor blood circulation, a drop in blood pressure, or neurological conditions like a stroke or migraine.

Vertigo is a sensation where you feel like you are spinning, even when there is no movement.

Spells of dizziness and vertigo can affect your quality of life, but are usually not life-threatening. You should see your GP if you have been experiencing dizziness or vertigo for two weeks, or if it greatly interferes with daily life. It can be treated with medication like antihistamines or injections.

If these are not effective, your GP can refer you to an Ear, Nose & Throat (ENT) specialist for most cases. You may also see a neurologist if migraines, strokes or tumours are suspected.

These are the most common types of vertigo you should know about.

1. Positional vertigo

Positional or Peripheral Vertigo is triggered by positional change. It is brought on when you lie down, not worsened when you lie down.

Benign Paroxymal Positional Vertigo (BPPV) is the most common type of positional vertigo. This is when the small calcium stones inside the inner ear become loose, affecting your balance.

BPPV can be treated with physiotherapy. Epley’s manoeuvre can help reposition the stones in your inner ear. Exercises can also help your brain adapt to movements which cause dizziness.

2. Vertigo caused by infection

Labyrinthitis is an infection of the labyrinth channels in the inner ear. It can occur after a flu or cold. It causes vertigo and residual dizziness that lasts a few days or months, and affects your hearing.  Labyrinthitis can be treated with anti-nausea medication or oral steroids.

Vestibular neuritis is the viral infection of the vestibular nerve in the inner ear. It also causes vertigo, but not hearing loss. It can be treated with medication.

3. Meniere’s disease

This type of vertigo is caused by a dysfunctional fluid balance in the inner ear. It is accompanied by hearing loss and tinnitus, and sometimes nausea and vomiting. Symptoms usually last about two to three hours.

Meniere’s disease is uncommon in Asia, where only an estimated 40 in 1,000,000 people (0.0004%) have the disease.

There is no cure for Meniere’s disease, but medication can help control the symptoms. A diet low in salt, sugar and caffeine is also recommended for patients.

See your GP first if you think you have Meniere’s disease, as it can cause permanent hearing loss if untreated.

So, when should you see an ENT specialist for dizziness? To summarise, please see an ENT specialist if you experience:

• Persistent vertigo
• Tinnitus
• Vomitting
• Symptoms that affect your daily life

This article has been verified medically by Dr Samuel Yeak, otorhinolaryngologist and ENT specialist at Amandela ENT Head And Neck Centre Singapore, Mount Elizabeth Novena Hospital (Singapore).

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