How is vertigo diagnosed?
Nov 27, 2025
Source: Cainiu Health
Dr. Lu Cheng
Introduction
Diagnosing vertigo requires combining symptom evaluation with professional examinations, generally achieved through detailed medical history inquiry, physical examination, vestibular function tests, imaging studies, blood tests, and hearing assessments. Detailed medical history inquiry: The physician will ask about specific details of the vertigo episodes, including frequency, duration, and triggering factors.
Diagnosing vertigo requires a combination of symptom evaluation and professional examinations, which can generally be achieved through detailed medical history inquiry, physical examination, vestibular function tests, imaging studies, blood tests, and hearing assessments. The specific analysis is as follows:
1. Detailed Medical History Inquiry: The doctor will ask about the specifics of the vertigo episodes, including frequency, duration, triggering factors, and whether symptoms such as nausea, vomiting, tinnitus, hearing loss, or limb numbness are present. This helps to preliminarily identify potential causes of vertigo and provides direction for further testing.
2. Physical Examination: Focuses on neurological and ear evaluations, observing gait stability, presence of abnormal eye movements, palpating around the ears for abnormalities, and assessing balance function (e.g., standing with eyes closed, walking in a straight line). This basic physical examination helps rule out vertigo caused by neurological disorders or ear diseases.
3. Vestibular Function Tests: Utilize tests such as electronystagmography (ENG) and vestibular evoked myogenic potentials (VEMP) to evaluate the function of the inner ear's vestibular system. These tests measure the vestibular organs' response to stimuli, identifying any vestibular dysfunction and helping determine whether vertigo is related to inner ear problems.
4. Imaging Studies: Based on initial assessment, cranial CT or magnetic resonance imaging (MRI) may be selected to examine brain structures for abnormalities such as cerebral infarction, tumors, or cerebrovascular malformations. Ear structures may also be evaluated to rule out inner ear inflammation, benign paroxysmal positional vertigo (BPPV), or other ear-related conditions, thereby excluding organic causes of vertigo.
5. Blood and Hearing Tests: Blood tests assess glucose, lipid, and electrolyte levels to identify metabolic disturbances or infections that could cause vertigo. Hearing tests are conducted simultaneously to detect hearing loss and determine whether auditory system involvement accompanies the vertigo, aiding in accurate diagnosis.
Patients experiencing vertigo should seek medical attention promptly to avoid delays in diagnosis and treatment due to self-diagnosis. When visiting a doctor, it is important to accurately describe symptom details and cooperate fully with all recommended examinations. If vertigo
