Vertigo Patient Reviews, Experiences and Complaints

Vertigo patients’ complaints range from the expression “everything around me is spinning,” which describes an intense sensation of rotation, to a persistent feeling of imbalance such as “I feel drunk” or “the ground is slipping beneath my feet.” These statements indicate more than simple lightheadedness and may be signs of a serious balance problem originating from the inner ear. When combined with additional symptoms such as nausea, tinnitus, and/or blurred vision, each patient’s description provides an audiologist with the most valuable clue for understanding the source of the problem, such as displaced crystals, inflammation of the balance nerve, or Meniere’s disease.

Which Type of Vertigo Does the Complaint “Everything Around Me Is Spinning” Indicate?

One of the most striking and frightening complaints described by patients is a genuine sensation of spinning. It may feel as though the world is rotating around them like a carousel while they remain still or, conversely, as though they themselves are spinning like a top. This condition, called “rotational vertigo” in medical terminology, is generally a sign of a sudden and severe problem in the balance system of the inner ear. It is a highly intense experience that is very different from a simple feeling of lightheadedness and may often be severe enough to confine the person to bed. This type of vertigo usually begins suddenly and causes significant panic. Patients commonly use strong comparisons to describe this intense experience.

Common comparisons used by patients to describe this condition include:

• Feeling as though they are inside a washing machine
• Being caught in the middle of a tornado
• Swaying on the deck of a ship
• Being on a constantly spinning carousel
• The room/surroundings turning upside down

Which Chronic Vertigo Problem Does a Persistent Feeling of Lightheadedness and Imbalance Suggest?

Not every episode of dizziness occurs in the form of severe spinning attacks. Some patients complain of a more subtle, persistent sensation of imbalance and/or lightheadedness that significantly reduces quality of life. This condition is described as feeling as though “the ground is slipping beneath their feet” or “walking as if drunk.” This sensation, which may remain after severe attacks have passed, can become chronic over time. It may occur when the brain is unable to compensate for damage in the inner ear and has to cope with more complex conditions such as Persistent Postural-Perceptual Dizziness (PPPD). This condition undermines the person’s self-confidence and can make even the simplest daily activities difficult.

Typical descriptions of this chronic feeling of imbalance include:

• A constant feeling of drunkenness
• Staggering while walking
• Feeling as though the ground is soft or unstable
• Feeling as though they are on a boat
• A feeling of “fog” or “heaviness” inside the head

Why Are Other Symptoms Accompanying Dizziness Important for the Diagnosis of Vertigo?

Vertigo is only a symptom of a disease and rarely arrives alone. A problem in the balance system may create a domino effect that influences other systems in the body. These accompanying symptoms may be as disturbing as the dizziness itself and play a critical role in establishing the correct diagnosis. Each additional symptom completes one piece of the puzzle and provides important clues about the source of the problem. For example, hearing-related symptoms suggest that the problem originates directly from the inner ear, whereas other symptoms may indicate different causes.

Symptoms that frequently accompany dizziness include:

• Nausea
• Vomiting
• Tinnitus
• A sensation of fullness or pressure in the ear
• Hearing loss
• Blurred vision or a sensation that vision is “jumping” (oscillopsia)
• Difficulty concentrating
• Excessive sweating

Why Do Certain Situations and Movements Trigger Dizziness (Vertigo)?

Understanding what starts or worsens the patient’s symptoms is one of the most valuable pieces of information in the diagnostic process. Patients may often struggle to describe the nature of their dizziness, but they can usually explain very clearly what they were doing when it occurred. These triggers work like a detective in identifying the source of the problem and may directly indicate specific vestibular disorders. Therefore, describing these triggers in detail helps accelerate the diagnosis.

The most common vertigo triggers include:

• Turning from one side to the other in bed
• Getting out of bed or lying down
• Suddenly lifting the head upward, for example to look at a high shelf
• Bending forward
• Making rapid head movements
• Crowded and visually active environments, such as shopping malls
• Watching moving traffic
• Intense stress or fatigue

How Does Dizziness (Vertigo) Cause Anxiety and Panic?

There is a complex and two-way relationship between dizziness and anxiety. Because vertigo creates a feeling of losing control, it naturally causes anxiety. Since the person does not know when the next attack will occur, they remain in a constant state of alertness. This anxiety activates the body’s alarm system, tightens the muscles, and increases sensitivity to balance. As a result, anxiety lowers the threshold at which dizziness is triggered and further worsens existing symptoms. This becomes a vicious cycle in which dizziness triggers anxiety and anxiety triggers dizziness. Breaking this cycle is one of the most important parts of treatment.

The emotional and behavioral consequences created by this vicious cycle may include:

• An intense feeling of panic and fear
• Concern that the attacks will recur
• Fear of being alone or leaving the house
• Avoiding social environments
• A constant feeling of insecurity and helplessness
• Depressive mood

Why Are Vertigo and the Concept of an “Invisible Illness” Not Understood by Society?

One of the most challenging aspects of vestibular disorders is that they produce no visible signs from the outside. Unlike a broken arm or leg, the storm taking place inside a person experiencing vertigo cannot be seen by those around them. This may cause the patient’s struggle to be misunderstood, underestimated, or considered “exaggerated” by family members, friends, and even employers. The patient must cope with both the physical symptoms and the psychological burden of not being understood. This may socially isolate the person and lead to feelings of loneliness.

Common negative reactions patients face because of this “invisible illness” include:

• Being accused with the question “Are you drunk?”
• Being suspected of “pretending”
• Being dismissed with “You are probably just tired; it will pass.”
• Being told “Do not think about it.”
• Having their symptoms not taken seriously
• Being accused of laziness or unwillingness

How Do Patient Narratives Shape the Diagnosis of Vertigo?

The patient’s history is the most important guide on the path to diagnosis. The timing, duration, triggers, and accompanying symptoms help eliminate or confirm possible diagnoses one by one. By listening to these narratives and asking the right questions, an audiologist forms a clinical picture and confirms it with objective tests. Every vestibular disorder has its own unique “story” or “fingerprint”:

Some common vertigo conditions and characteristics that patient narratives may indicate include:

• Benign Paroxysmal Positional Vertigo (BPPV – Displaced Crystals): Brief but severe spinning attacks, usually lasting less than 1 minute. They are triggered by specific head movements. Hearing loss or tinnitus does not accompany them.
• Meniere’s Disease: Spontaneous, severe vertigo attacks that may last for hours. Fluctuating hearing loss, intense tinnitus, and a sensation of fullness in the ear accompany the attack.
• Vestibular Neuritis: Persistent and severe vertigo that usually begins suddenly after a viral infection and lasts for days. Hearing is not affected.
• Labyrinthitis: Severe and prolonged vertigo similar to vestibular neuritis. Unlike vestibular neuritis, unilateral hearing loss and tinnitus also accompany the vertigo.
• Persistent Postural-Perceptual Dizziness (PPPD): Rather than a spinning sensation, there is a persistent feeling of imbalance and lightheadedness. It worsens while standing, with movement, and in visually complex environments. It usually lasts longer than three months. The underlying primary cause must be diagnosed and treated.

Which Tests Does an Audiologist Use to Understand the Cause of Vertigo?

After listening to the patient’s history, a series of objective tests is performed to confirm the suspected diagnosis and understand where the problem is located and how severe it is. These tests are designed to evaluate different parts of the balance system and, although they may appear intimidating to patients, they are essential for clarifying the diagnosis. Each test illuminates a different part of the puzzle and helps determine the most effective treatment approach.

The basic vestibular tests performed by an audiologist include:

• Videonystagmography (VNG): A comprehensive battery of tests that records eye movements through special goggles. In addition to evaluating the neural connections between the balance system and the visual system, it assesses whether there is a functional difference or weakness between the ears, the connections with the central nervous system, and the responses given to different positions.
• Positional Tests: These are the gold standard, especially for diagnosing BPPV (displaced crystals). The patient is placed in a specific position, and it is observed whether symptoms and involuntary eye movements (nystagmus) occur.
• VEMP (Vestibular Evoked Myogenic Potentials): Measures the function of the otolith organs in the inner ear, which are sensors for gravity and linear movement, as well as the related neural pathways. It is a painless test that does not cause dizziness.
• Video Head Impulse Test (v-HIT): Also known as the head impulse test, this is one of the gold-standard measurements for balance disorders. It is important not only for differential diagnosis to understand the origin of the disease but also for understanding the balance difficulties experienced by the individual. It is also necessary for planning vestibular rehabilitation and measuring the success of rehabilitation.
• Computerized Dynamic Posturography: Unlike other tests, this is a highly important and specialized quantitative measurement that enables the individual’s balance ability to be assessed both system by system and collectively. It is essential, particularly for individuals who may require rehabilitation, to understand the difficulties they experience and to create a rehabilitation protocol. It is also frequently used to monitor the progress of rehabilitation.

Is There a Vertigo Treatment That Works Immediately for “Displaced Crystals” (BPPV)?

Yes, when BPPV is diagnosed, treatment is usually rapid and highly effective. This condition occurs when the balance crystals in the inner ear leave their normal location and enter one of the semicircular canals. Rather than dissolving or destroying these crystals with medication, treatment aims to return them to their proper location through a simple mechanical maneuver. Various Canalith Repositioning Procedures are available, including the best-known “Epley Maneuver.” The procedure applied to the patient changes according to the specific BPPV variant. These maneuvers use gravity to move the crystals out of the canal. In most patients, significant improvement or complete recovery may be achieved even after a single session.

It should be remembered that these maneuvers are not exercises. Therefore, they must definitely be performed by audiologists.

The main advantages provided by appropriately and correctly performed maneuvers include:

• Producing a rapid effect
• Being a drug-free treatment
• Being easy to perform in a clinical setting
• Having a high success rate
• Being repeatable when necessary

Is It Possible to Treat Vertigo by Retraining the Brain?

In many chronic dizziness conditions other than BPPV, the problem is functional rather than mechanical. In other words, one of the balance organs may have been permanently damaged or may be sending incorrect signals to the brain. In such cases, treatment aims not to reverse the damage but to help the brain adapt to the new situation. This is the goal of an exercise-based program called “Vestibular Rehabilitation Therapy” (VRT). VRT takes advantage of neuroplasticity, the brain’s ability to reorganize itself and learn new pathways. This therapy teaches the brain to ignore incorrect signals coming from the damaged side, rely more heavily on sensory information from vision and the body, including the feet and joints, to maintain balance, and become less sensitive to movements that trigger dizziness.

The types of exercises that form the basis of a VRT program include:

• Gaze Stabilization Exercises: Improve visual clarity by enabling the eyes to remain fixed on a target while the head moves.
• Postural Control and Balance Exercises: Improve the ability to maintain balance on different surfaces and in different positions.
• Habituation Exercises: Reduce the brain’s sensitivity to dizziness-triggering movements by performing them in a controlled and repetitive manner.

When virtual reality applications are added to all these training methods, the process becomes shorter and patient motivation increases.

What Should Be Considered to Increase Success During the Vertigo Treatment Process?

The success of vertigo treatment does not depend only on the correct diagnosis and the correct maneuver or exercise. The patient’s active participation in the process, motivation, and trusting relationship with the treatment team are equally important. Being patient and having realistic expectations during this process prevents disappointment and enables steady progress toward recovery. Treatment is a team effort, and the most important member of that team is the patient.

Some key points for increasing success during the treatment process include:

• Describing your symptoms and triggers in detail
• Accepting that the treatment process will be gradual
• Knowing that exercises may temporarily increase symptoms at the beginning
• Following the prescribed exercise program regularly
• Understanding that ups and downs are normal during the recovery process
• Not hesitating to seek psychological support when necessary

Dr. Ody. Emel Uğur

Dr. Audiologist Emel Uğur was born in 1982 in Çanakkale. She specialized in Pediatric Audiology, Otologic Disorders, and Vestibular System Disorders, and served for 15 years at the Istanbul Training and Research Hospital. In 2015, she joined the Acıbadem Healthcare Group. She currently works as an Audiologist at the Acıbadem Altunizade Hospital and also serves as a faculty member and program director in the Acıbadem University Vocational School of Health Services Audiometry Program.