Dizziness and vertigo

Vertigo is often inner-ear related (BPPV, vestibular neuritis); lightheadedness can be dehydration, low blood sugar, or medication side effects. A provider can evaluate online.

Also called: room spinning · lightheaded · BPPV

Medically reviewed by Dr. Ikechukwu Ogbu, MD
MD · Board-Certified, Internal Medicine · Last reviewed

Seek urgent care or the ER if you have:

  • Symptoms that are sudden, severe, or rapidly worsening
  • High fever (over 103°F / 39.4°C) that doesn't respond to treatment
  • Chest pain, trouble breathing, fainting, or confusion
  • Signs of dehydration — dizziness, dark urine, unable to keep fluids down
  • Symptoms in someone who is pregnant, immunocompromised, or over 65

What dizziness and vertigo could be

The most common causes a clinician considers. This isn't a diagnosis — it's the differential a provider works through with you.

Ear infection (otitis)

Ear infection (otitis) is one of the more common causes of dizziness and vertigo. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Anxiety

Anxiety is one of the more common causes of dizziness and vertigo. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Hypoglycemia / low blood sugar

Hypoglycemia / low blood sugar is one of the more common causes of dizziness and vertigo. A provider can confirm with the right history, exam, or labs — and start treatment the same day when appropriate.

Typical workup

What a clinician usually orders or asks about when someone presents with dizziness and vertigo.

  • Focused history: timing, triggers, severity, and prior treatments related to "dizziness and vertigo"
  • Targeted physical exam of the involved system
  • Rule-in / rule-out workup for the most likely causes: Ear infection (otitis), Anxiety, Hypoglycemia / low blood sugar
  • Labs, imaging, or referral only when the answer will change management

When to see a clinician

  • Symptoms have lasted more than a few days without improving, or keep coming back
  • You're not sure if this needs antibiotics, prescription treatment, or watchful waiting
  • You have a chronic condition (diabetes, heart disease, immunocompromised) that raises the stakes
  • You want a same-day plan without a trip to urgent care

Common questions