BPPV · Vestibular Neuritis · Ménière's · Dix-Hallpike Test · Epley Manoeuvre
Gini Advanced Care Hospital, Sector 69, SAS Nagar (Mohali), Punjab
80% of vertigo cases are caused by BPPV — a completely mechanical problem with the inner ear that can be corrected in a single 10-minute procedure called the Epley manoeuvre. No medication. No surgery. Immediate relief in most cases. If your vertigo hasn't been assessed and treated with the Epley manoeuvre, you may have been suffering unnecessarily.
Vertigo is not the same as light-headedness or feeling faint. Vertigo is the specific false sensation that you or the room is spinning or moving when it is not. True vertigo points to a problem in the balance (vestibular) system — either the inner ear or the brain. Distinguishing vertigo from general dizziness is the first and most important step, because it changes the entire diagnostic pathway.
BPPV — displaced inner-ear crystals; brief, position-triggered spinning; the most common and most curable. Vestibular neuritis — viral inflammation of the balance nerve; severe constant vertigo for days. Labyrinthitis — inner-ear inflammation affecting both balance and hearing. Ménière's disease — episodic vertigo with hearing loss, tinnitus and ear fullness from inner-ear fluid pressure. Central vertigo — from the brain (stroke, tumour, MS); potentially serious and requiring urgent assessment.
The Dix-Hallpike test is a simple two-minute bedside manoeuvre. The neurologist rapidly moves you from sitting to lying with your head turned and slightly extended over the edge of the couch. In BPPV, this triggers a characteristic burst of eye movements (nystagmus) and brief vertigo — confirming the diagnosis and identifying which ear and canal is affected, without any scan.
Once the affected canal is identified, the Epley manoeuvre guides your head through a specific sequence of positions, using gravity to roll the displaced crystals out of the canal and back to where they belong. It takes about 10 minutes, is painless, and resolves 80–90% of BPPV in one session — often with immediate relief. No medication is required.
Vertigo accompanied by double vision, slurred speech, facial droop, limb weakness or numbness, severe headache, or inability to walk may indicate a stroke and is an emergency. Sudden, severe, unremitting vertigo — especially in someone with vascular risk factors — should never be dismissed as 'just the ears'. A DM Neurology assessment reliably distinguishes benign inner-ear vertigo from dangerous central causes.
CGHS patients can be assessed and treated for vertigo at Gini with a wellness-centre referral. The Dix-Hallpike test and Epley manoeuvre are performed in the OPD; any required audiometry or imaging is arranged, and the CGHS desk handles the paperwork. Call 0172 4120100.
The most common cause of sudden spinning vertigo is BPPV (benign paroxysmal positional vertigo) — tiny calcium crystals dislodged inside the inner ear, triggered by head movements. Other causes include vestibular neuritis (viral inflammation of the balance nerve), labyrinthitis, Ménière's disease, migraine, and — less commonly but seriously — a stroke affecting the brainstem or cerebellum.
Most vertigo (inner-ear/peripheral) is benign and treatable. However, vertigo can occasionally be the only sign of a stroke. Warning signs of dangerous (central) vertigo include double vision, slurred speech, facial or limb weakness, severe headache, or difficulty walking. Any vertigo with these features is an emergency — call +91 82888 43800 or go to the nearest emergency department.
BPPV is the most common cause of vertigo. Calcium carbonate crystals (otoconia) that normally sit in one part of the inner ear become displaced into the semicircular canals, sending false movement signals to the brain. This causes brief, intense spinning triggered by head position changes — turning in bed, looking up, or bending down. It is mechanical, not dangerous, and usually curable in one visit.
The Epley manoeuvre is a sequence of slow, guided head and body positions that use gravity to move the displaced crystals out of the semicircular canal and back to where they belong. It takes about 10 minutes, causes no pain, requires no medication, and resolves 80–90% of BPPV cases in a single treatment.
BPPV is often cured in one Epley manoeuvre, though it can recur and be re-treated. Vestibular neuritis usually resolves over weeks with rehabilitation. Ménière's disease is managed rather than cured, with diet and medication controlling attacks. The key is an accurate diagnosis — which requires a proper neurological and vestibular assessment.
BPPV episodes last seconds to a couple of minutes with each head movement, but can recur for days or weeks until treated. Vestibular neuritis causes severe constant vertigo for 1–3 days, easing over weeks. Ménière's attacks last 20 minutes to several hours. Vertigo that is constant and unremitting, or accompanied by neurological signs, needs urgent assessment.
Go to emergency if vertigo comes with any of: sudden severe headache, double or lost vision, slurred speech, facial droop, weakness or numbness in an arm or leg, inability to walk or stand, or chest pain. These can indicate a stroke. Call +91 82888 43800 (Gini 24/7 emergency).
Gini Advanced Care Hospital, Sector 69 (Mohali) · OPD Mon–Sat, 9 AM–5 PM · Emergency 24/7: +91 82888 43800
Our team will reach out via WhatsApp or call within 2 hours.
Most vertigo is curable. Book a Dix-Hallpike assessment with Dr. Iqbal Singh — many patients walk out better the same day.