Vestibular disorder — the plain-language one-pager.

What are Vestibular Disorders?Diagnosis

Vestibular disorders are problems with the inner ear and the brain's balance system. They cause vertigo (a spinning sensation), dizziness, imbalance, nausea, and falls. Benign Paroxysmal Positional Vertigo (BPPV) is by far the most common — and one of the most rewarding to treat: a single 1-minute Epley maneuver fixes most cases. Other vestibular disorders include vestibular neuritis, Meniere's disease, vestibular migraine, and bilateral vestibular hypofunction.

• BPPV — Brief (seconds to a minute) spinning vertigo triggered by head position changes (rolling over in bed, looking up). Caused by dislodged calcium crystals (otoconia) in the semicircular canals. Treatment: the Epley maneuver — repositions the crystals; one or two visits usually fix it.
• Vestibular Neuritis — Sudden severe vertigo lasting days to weeks, often after a viral illness. No hearing loss. Treatment: short course of corticosteroids early; vestibular rehabilitation.
• Meniere's Disease — Episodes of vertigo (lasting 20 minutes to hours) + fluctuating hearing loss + tinnitus + ear fullness. Diet changes (low salt), diuretics, sometimes intratympanic injections.
• Vestibular Migraine — Vertigo + migraine features (often without the headache being bad). Treatment is migraine-style: triggers, lifestyle, prophylaxis.
• Bilateral Vestibular Hypofunction — Imbalance, oscillopsia (visual world bouncing). Often from ototoxic drugs (gentamicin, cisplatin). Vestibular rehabilitation is the treatment.

If it spins for seconds with head turn — try the EpleyKnow your plan

BPPV is so common, so distinct, and so treatable that anyone with brief positional vertigo should be evaluated for it. The Dix-Hallpike maneuver diagnoses it; the Epley fixes it. Many primary-care offices, ENT clinics, and PTs know how to perform both.

• Classic BPPV pattern — Vertigo lasts seconds to a minute. Triggered by rolling over in bed, looking up, getting out of bed. Often hits in the morning.
• Dix-Hallpike test — Doctor or PT holds your head and lays you back quickly while watching your eyes for the characteristic pattern. Confirms BPPV.
• Epley maneuver — A 1-2 minute series of head positions repositions the crystals. Often resolves BPPV in a single visit.
• Avoid the wrong call — Sudden vertigo + neuro signs (slurred speech, weakness, double vision, severe imbalance) = stroke workup. Vertigo + hearing loss = consider vestibular neuritis vs labyrinthitis vs Meniere's.
• If episodes recur — refer to vestibular PT for repositioning + habituation exercises and balance retraining.

Your daily Force FieldLive It

• Vestibular rehabilitation therapy (VRT) — habituation + balance + gaze stabilization exercises with a vestibular PT. Cuts symptoms and falls dramatically.
• Epley maneuver for BPPV — learn the home version (Brandt-Daroff, half-somersault) for recurrences.
• Hydration + low-salt diet for Meniere's — 1500-2000 mg sodium target; avoid caffeine + alcohol; consider diuretic.
• Migraine prevention for vestibular migraine — sleep, food regularity, stress, caffeine moderation; preventive meds when needed.
• Use meclizine sparingly — helpful for acute spinning, but blunts compensation in chronic cases. Avoid daily use.
• Hearing aids if hearing loss — improves balance and reduces falls.
• Fall prevention — same program as the Falls Prevention page; vestibular disorders amplify fall risk.
• Tell every clinician about your vestibular disorder — affects sedating-medication choices, anesthesia plans, and post-op delirium risk.
• Track triggers + episodes in your Health Passport — patterns guide diagnosis and treatment.

Red flags — call nowAction

• Call your clinic the same day for: new chest discomfort with exertion that goes away with rest (stable spinning sensation worth evaluating); a missed dose of antiplatelet or meclizine (acute) + vestibular therapy; medication side effects (muscle aches, bleeding, GI symptoms).
• Bring up at next visit: any change in exercise tolerance, lipid follow-up timing, BP log review, smoking-cessation support, depression screening, sleep concerns.