If you tend to get lightheaded when you stand up, avoid sudden changes in posture.

If you are thirsty or lightheaded, drink fluids. If you are unable to keep fluids down from nausea or vomiting, you may need intravenous fluids. These are delivered to you at the hospital.

Most times, benign positional vertigo and labyrinthitis go away on their own within a few weeks. During attacks of vertigo from any cause, try to rest and lie still. Avoid sudden changes in your position as well as bright lights. Be cautious about driving or using machinery.

Some vertigo can be reduced by working with a physical therapist. Medications from your doctor may help you feel better.

Such medications include antihistamines, sedatives, or pills for nausea. For Meniere's disease, surgery may be necessary.

Call 911 or go to an emergency room if someone with dizziness also has:

• A head injury
• Fever over 101°F, headache, or very stiff neck
• Convulsions or ongoing vomiting
• Chest pain, heart palpitations, shortness of breath, weakness, inability to move an arm or leg, or change in vision or speech
• Fainting and losing consciousness for more than a few minutes

Call your doctor if:

• You have never had dizziness before.
• Symptoms you have had in the past are different (for example, last longer than usual, are worse than before, or are interfering with your daily activities).
• Medication is the suspected cause. Talk to your health care provider before making any changes to your medication.
• You have any hearing loss.

Your doctor will perform a physical exam, focusing on your heart, head, ears, and nervous system, and ask question such as:

• Does your dizziness feel like lightheadedness, vertigo, or imbalance?
• Does your dizziness occur with a change in body position?
• What other symptoms occur when you feel dizzy?
• When did your dizziness begin?
• Are you always dizzy or does the dizziness come and go?
• How long does the dizziness last (minutes, hours)?
• Did another illness develop before or after the dizziness began? How much later?
• Have you had any nausea and vomiting?
• Do you have a significant amount of stress or anxiety?

• Blood pressure measurements and tests
• ECG
• Hearing tests
• Neurological tests
• Balance testing (ENG) may be required.
• MRI

Promptly treat ear infections, colds, flus, sinus congestion, and other respiratory infections. This may help prevent labyrinthitis and Meniere's disease.

If you have a cold, the flu, or other viral illness, drink plenty of fluids to prevent getting dehydrated.

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Tusa RJ. Dizziness. Med Clin North Am. 2003; 87(3): 609-641, vii.

Swartz R. Treatment of vertigo. Am Fam Physician. 2005; 71(6): 1115-1122.