Private dizziness clinic in London, same-day specialist medicine.

Which kind is it?

• Vertigo — a false sense of movement, usually the room spinning. Points to the inner ear or, less often, the brain.
• Presyncope — feeling faint, light-headed, about to black out, often with greying vision and clamminess. Points to blood pressure, heart rhythm or anaemia.
• Disequilibrium — unsteadiness on the feet without spinning or faintness. Points to nerves, joints, vision, medication or neurological conditions.
• Non-specific dizziness — a floating, foggy or detached feeling, often associated with anxiety or hyperventilation.

Vertigo — the common causes

• BPPV — brief, intense spinning triggered by turning over in bed, looking up or bending down. Lasts seconds to a minute. The commonest cause, and it is cured in one appointment with a repositioning manoeuvre.
• Vestibular neuritis — sudden severe vertigo lasting days, often after a viral illness, with nausea and unsteadiness but normal hearing.
• Ménière's disease — attacks lasting 20 minutes to hours, with hearing loss, tinnitus and a sense of fullness in one ear.
• Vestibular migraine — vertigo with or without headache, often light and sound sensitivity. Commonly missed.

Feeling faint — the common causes

• Postural hypotension — blood pressure dropping on standing. Very common, especially with age, dehydration and blood pressure medication.
• Medicines — antihypertensives, diuretics, antidepressants, prostate tablets, opioids.
• Anaemia, low blood sugar, and dehydration.
• Heart rhythm problems — particularly if it happens without warning, while sitting or lying, or during exertion. This combination needs prompt cardiac assessment.
• Vasovagal episodes — triggered by standing for a long time, heat, pain or the sight of blood.

What assessment involves

• Lying and standing blood pressure — simple, and frequently diagnostic
• ECG, particularly for faintness or if episodes occur without warning
• Examination of the ears, eyes and balance, including specific positional tests
• Blood tests — full blood count, ferritin, glucose, kidney function, thyroid
• Medication review, which is one of the highest-yield steps
• Imaging only where the history or examination suggests a central cause

Staying safe meanwhile