Vertigo vs. Dizziness: A Quick Guide

Reviewed by Dr. Khalili | August 25th 2025

Feeling “off” can mean two different things:

• Dizziness: light-headed, faint, woozy, or unsteady.
• Vertigo: a false sense that you or the room is spinning.

Common reasons you might feel this way

• BPPV (benign paroxysmal positional vertigo): brief spinning when you roll over in bed, look up, or turn your head.
• Inner-ear irritation after a virus: sudden vertigo with nausea; sometimes (but not always) there’s hearing loss.
• Migraine: vertigo or dizziness with or without headache; often linked to specific triggers and motion sickness.
• Ménière’s disease: episodes of vertigo with ear fullness, ringing (often a roaring sound), and fluctuating hearing.

Not just the ear

Dehydration, low blood pressure, poor sleep, some medicines, anxiety, or low blood sugar cancause light-headedness or imbalance.

Less common causes

• Mal de Débarquement syndrome: feeling like you’re still on a boat (rocking/swaying) after travel by sea, air, or other passive motion.
• Cerebellopontine angle (CPA) tumors: growths near the brainstem that can cause imbalance and hearing loss.

Red flags — get urgent help (call 911)

•  Face drooping, arm weakness, or slurred speech
• Severe headache or new double vision
• Trouble walking, fainting, or chest pain
•  Sudden hearing loss in one ear

What you can try at home (if symptoms are mild)

• Sit or lie down until it passes; don’t drive during active vertigo.
• Hydrate and stand up slowly.
• Limit triggers like alcohol and high caffeine.

If you’ve been told you have BPPV, ask about a simple head-movement treatment
(the Epley maneuver).

How clinicians evaluate it

Our first step is to decide whether symptoms are coming from the inner ear or the brain/central nervous system(sometimes it’s a mix). At an ENT/neurology visit, we may:

• Ask when it started, what triggers it, and how long episodes last.
• Do head-position tests, a full neurologic and head/neck exam, and check hearing and balance (a complete audiogram and videonystagmography [VNG]).
• Order an MRI when symptoms suggest a central cause.

Treatment — targeted to the cause

Examples include:

• BPPV: canal-repositioning maneuvers
• Nausea: short-term anti-nausea medication
• Vestibular hypofunction: vestibular (balance) therapy
• Migraine: migraine-focused plan and trigger management
• Ménière’s/other otologic issues: salt-intake management and, when appropriate, office-based ear treatments (e.g., intratympanic injections)

When to seek care: If symptoms are new, severe, or not improving, contact your primary care clinician or an ENT specialist. Call 911 for any of the red flags above.