Vertigo is the sense that you’re spinning—or that the environment around you is spinning—when you’re standing still. It can make you feel dizzy, nauseated, and off-balance.
Finding the cause of ongoing vertigo can be difficult. Therefore, it’s important to see physicians who have special expertise in the condition.
Vertigo can arise from the inner ear or the brain, so the University of Iowa Health Care team includes experts from both areas. This multidisciplinary team has decades of experience in diagnosing and treating vertigo.
Vertigo symptoms and diagnosis
Vertigo can be caused by problems in the inner ear or in the brain.
Peripheral vertigo happens because of an inner ear problem, such as Meniere's disease, inflammation, or infection.
Central vertigo is caused by an issue in the brain, such as head trauma, migraine, infection, or stroke.
Note: If you’re having new dizziness along with vision or hearing problems, trouble speaking, or weakness in your limbs, you could be having a stroke. Contact your doctor or call 911 immediately.
Diagnosing the cause of vertigo
If you often feel dizzy or off-balance, or if you get sudden or severe vertigo, you should see your primary care provider for an initial evaluation.
Depending on your symptoms, they may refer you to a UI Health Care neurologist who specializes in balance disorders or a specialist in otology and neurotology.
Your specialist will talk with you about your symptoms and medical history. They will also review your previous medical records and any imaging, such as MRIs, that you have already had done.
They may order additional testing, which could include:
Videonystagmography (VNG), a group of tests performed while you wear special video goggles to record your eye movements. VNG evaluates your brain balance centers, body stability, and inner ear balance function. This testing is sometimes called electronystagmography (ENG).
A hearing test (audiogram)
A brain MRI
After you’re evaluated, your care team will review the results with you and develop a plan to help you get relief. Your results will determine whether you’re treated primarily by specialists in neurology or neurotology. They work together, so you may be seen by providers from both areas.
Vertigo treatment from UI Health Care
Most causes of vertigo are treatable. Depending on the type of vertigo you’re diagnosed with, your provider might recommend a brief in-office procedure, physical therapy, medication, surgery, or time to allow the condition to resolve on its own.
Particle repositioning maneuvers
Particle repositioning maneuvers treat benign paroxysmal positional vertigo (BPPV), the most common kind of vertigo. BPPV is caused when small crystals in your inner ear break loose from their normal position and tumble around.
Particle repositioning maneuvers involve turning your body to move the crystals into a different part of the inner ear, where they won’t cause symptoms. It’s a painless procedure that your provider can perform in the office in just a few minutes.
Specialized physical therapy called vestibular rehabilitation can treat some causes of vertigo, including BPPV or vestibular hypofunction (a condition that causes problems with your balance system). Education on diet, sleep habits, and stress management are also part of the program.
Not many physical therapists are trained in vestibular rehabilitation, but the UI Health Care team has more than 20 years of experience in the technique. If you don’t live near Iowa City, our team can offer guidance to a physical therapist close to your home.
Some medications, including some antihistamines and anti-anxiety medications, can help reduce symptoms of vertigo.
And some medications, including some that treat high blood pressure, infections, or pain, can actually cause vertigo.
Your specialist will talk with you about all the medications you take and may work with your other physicians to adjust the dosages, if needed.
Surgery for vertigo is rare. If your vertigo is caused by a condition such as Meniere’s disease or acoustic neuroma/vestibular schwannoma and other therapies don’t resolve it, your provider might recommend surgery.
Many cases of vertigo will resolve without treatment. After you’re thoroughly evaluated, your specialist will talk with you about whether watching and waiting is the best option.
Our team approach
Our balance disorders clinic and otology and neurotology clinic are both staffed by experts in diagnosing and treating vertigo.
The multidisciplinary UI Health Care team includes specialists in neurology, neurotology, audiology, and physical therapy. They work together to find the cause of your vertigo, determine which specialist should direct your care, and make a treatment plan that’s customized for you.
Their thorough evaluation will ensure that you see the right providers.