Why Most Vertigo Is Undertreated in India
Vertigo is one of the commonest reasons people visit a doctor — and one of the most poorly handled. The typical experience across India is depressingly familiar: a patient describes spinning or dizziness, is handed a strip of betahistine or a vestibular sedative, and is sent home with no test and no diagnosis. When the vertigo returns, the dose is increased. Years can pass this way.
The problem is not the medicines themselves but the missing step before them — the diagnosis. Roughly 80% of true vertigo is BPPV (benign paroxysmal positional vertigo), a mechanical inner-ear problem that is immediately curable with a physical manoeuvre and needs no long-term medication at all. Yet BPPV is repeatedly treated with tablets that do nothing for it and, taken long term, actually slow recovery.
The other side of the coin is more serious. A small proportion of vertigo comes from the brain — a stroke in the brainstem or cerebellum can present as vertigo and nothing else. Without the right bedside examination, this is easily mistaken for a harmless inner-ear upset and sent home. Undertreatment, then, cuts both ways: curable vertigo is left to recur, while dangerous vertigo is occasionally missed.
There are practical reasons this happens so often. Vertigo consultations are frequently rushed, the specific tests that confirm a diagnosis take training and a few unhurried minutes to perform, and both patients and doctors sometimes reach too quickly for a scan when a bedside examination would answer the question better. Meanwhile many patients, understandably, stop looking for answers once the tablets take the edge off — even though the underlying problem has never been named. The result across the Tricity, and across India, is a large number of people quietly limiting their lives around a symptom that could, in most cases, be diagnosed and often cured in a single proper visit.
What a Proper Vertigo Assessment Includes (Dix-Hallpike, HINTS, Neurological Exam)
A genuine vertigo assessment is a hands-on clinical examination, not a five-minute chat and a prescription. It rests on three pillars.
The Dix-Hallpike test
This two-minute bedside manoeuvre confirms BPPV without any scan. The neurologist moves you from sitting to lying with your head turned and slightly extended; if BPPV is present, that position triggers a brief burst of vertigo and a characteristic pattern of eye movement called nystagmus. The direction and timing show exactly which ear and canal are affected — and that guides the corrective Epley manoeuvre.
The HINTS examination
HINTS (Head Impulse, Nystagmus, Test of Skew) is a focused set of eye-movement tests that, in trained hands, distinguishes peripheral (inner-ear) vertigo from central (brain) vertigo. Used correctly, it is more sensitive than an early MRI for detecting a small brainstem stroke — which is precisely why it needs a specialist who performs it regularly.
The full neurological examination
Beyond the ears, the neurologist checks gait, coordination, cranial nerves, limb strength and sensation. This is how central causes reveal themselves and how contributing factors — blood pressure, blood sugar, medication side-effects — are picked up. Only after this examination does treatment make sense.
Why a DM Neurology Specialist Matters for Accurate Diagnosis
Vertigo sits at the crossroads of the ear and the brain, and the single most important clinical decision is whether the cause is peripheral (inner ear — usually benign) or central (brain — potentially serious). Getting that decision right is the core skill of a neurologist.
A DM in Neurology is a super-specialist qualification earned after MBBS, a full MD in Medicine, and then three further years of intensive neurology training. That training is built around exactly this kind of pattern recognition — reading nystagmus, interpreting a head-impulse test, weighing red flags, and deciding when a scan is truly needed and when it is not. General practitioners and even many specialists rarely perform Dix-Hallpike or HINTS routinely, which is why so much vertigo goes untested.
The practical benefit for you is confidence: a curable BPPV is treated on the spot, a benign neuritis is managed correctly with rehabilitation rather than endless sedatives, and a dangerous central cause is caught early. Accurate diagnosis is not a luxury in vertigo — it is the whole game.
Dr. Iqbal Singh — Training and Expertise
Dr. Iqbal Singh is the consultant neurologist at Gini Advanced Care Hospital, Mohali. He completed his DM in Neurology at Dayanand Medical College (DMC), Ludhiana, one of the region's most respected centres for neurology training, after his foundational MBBS and MD in Medicine.
Vertigo and balance disorders are a core part of his day-to-day practice. He performs Dix-Hallpike testing, HINTS examination and the Epley and other repositioning manoeuvres as routine bedside procedures — the kind of hands-on skills that come only from doing them regularly. Alongside vertigo, he manages the full range of neurological conditions including epilepsy, Parkinson's disease, dementia, stroke, headache and neuropathy.
Because Gini is a multi-speciality hospital, Dr. Singh also works closely with the endocrinology and internal-medicine teams — valuable when vertigo overlaps with diabetes, blood-pressure problems or vascular risk, all of which are common in patients from this region. You can read more on his profile page.
What a Vertigo Consultation at Gini Covers
A vertigo consultation with Dr. Iqbal Singh is structured to reach an answer, not just to reassure. It typically includes:
- A careful history — what exactly you feel (true spinning versus light-headedness), what triggers it, how long each episode lasts, and whether there is any hearing change, headache or double vision.
- A Dix-Hallpike test if positional vertigo is suspected, to confirm or exclude BPPV.
- A HINTS examination and neurological exam to separate peripheral from central causes and check for red flags.
- Same-visit treatment where appropriate — most BPPV is treated with the Epley manoeuvre in the same appointment, often with dramatic relief.
- A clear plan — whether that is repositioning, vestibular rehabilitation exercises, a short medication course, control of blood pressure or sugar, or, occasionally, urgent imaging.
The aim is that you leave with a named diagnosis and a specific plan, rather than another vague prescription. Where vertigo is caused by BPPV, many patients feel substantially better before they even leave the room.
Because Gini is a multi-speciality hospital, anything the consultation uncovers can be followed up under one roof. If your dizziness turns out to be driven by blood-pressure swings, poorly controlled diabetes, an ear condition needing an ENT opinion, or a medication that is making you light-headed, the relevant team is on hand rather than a separate journey away. For older patients in particular, where vertigo, unsteadiness and fear of falling often overlap, this joined-up approach matters — the goal is not just to settle the spinning but to make you steady and confident on your feet again.
How to Book — and How to Reach Us
Gini Advanced Care Hospital is in Sector 69, Mohali, within easy reach of the wider Tricity area. It is roughly 15 minutes from most of Chandigarh and about 20 minutes from Panchkula, with straightforward road access and parking on site — often quicker to reach than a large city hospital.
To book a vertigo assessment with Dr. Iqbal Singh, call 0172 4120100 or message us on WhatsApp at +91 82889 44490. Same-day and next-day appointments are usually available. If your vertigo comes with any red-flag symptoms — sudden severe headache, double vision, slurred speech, facial or limb weakness, or an inability to walk — do not wait for an appointment: call our 24/7 emergency line on +91 82888 43800 or go straight to the nearest emergency department.
For more on the condition and its treatment, see our vertigo treatment page and the wider neurology services at Gini.