Vertigo and Dizziness in London. Telling the Common, Treatable Causes Apart From the Rare, Serious Ones
The Wellness is the best place in London to have vertigo and dizziness properly assessed, because the word dizziness means genuinely different things to different people, a spinning sensation, lightheadedness, unsteadiness, or a sense of impending faint, and each of those points toward a completely different set of causes, so the single most useful thing a proper assessment does is work out precisely which kind of dizziness is actually present before considering what might be causing it. True vertigo, the specific sensation that either you or the world around you is spinning, is most often caused by a problem in the inner ear rather than the brain, and the single commonest cause, benign paroxysmal positional vertigo, produces brief, intense spinning triggered by specific head movements and is both easily diagnosed and, in a genuinely satisfying twist for a medical condition, treatable with a specific repositioning manoeuvre performed in a single appointment rather than with medication at all. Alongside the common, benign causes sit a small number of red flags, a first, severe episode with new hearing loss, a headache, double vision, slurred speech, weakness or numbness on one side of the body, or difficulty walking, that need to be identified quickly because they raise the possibility of a stroke or another neurological cause rather than an inner ear problem. A proper assessment takes a structured history to establish exactly what kind of dizziness is present, examines you specifically for the causes that fit that pattern, and treats the common causes properly rather than reaching for a generic anti-sickness tablet and hoping it settles. Consultations from £150 by video and £220 in person, extended assessment from £395. Fees appear further down this page.
Reviewed by the medical team at The Wellness. Last updated August 2026.
Get your dizziness assessed on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
What kind of dizziness do you actually have
This single question does more diagnostic work than almost anything else in the assessment, because dizziness is not one condition but a description covering several genuinely different experiences, and each points toward a different group of causes entirely. True vertigo is a specific spinning sensation, either you feel like you are spinning or the environment around you is, and it points strongly toward the inner ear or, less commonly, the brainstem or cerebellum, rather than toward the heart or blood pressure.
Presyncope, a feeling of lightheadedness or being about to faint, often with vision greying or narrowing, points toward the cardiovascular system, blood pressure, heart rhythm, or blood sugar, rather than the inner ear, and needs an entirely different set of tests. Disequilibrium, a sense of unsteadiness or imbalance particularly on standing or walking without the room actually spinning, often relates to problems with vision, sensation in the feet, joints, or coordination, and is more common in older adults, sometimes from several mild contributing factors rather than one single cause. And a vague, non-specific lightheadedness that does not fit neatly into any of the above is very often linked to anxiety or hyperventilation, which is a genuine and treatable cause in its own right rather than a diagnosis of exclusion to be reached only once everything else has been ruled out. Establishing which of these 4 patterns actually fits your experience is the first and most important step, because treating vertigo as though it were presyncope, or the reverse, wastes time investigating the wrong system entirely.
What causes true vertigo
Benign paroxysmal positional vertigo, BPPV, is the commonest cause by a wide margin and is genuinely one of the more satisfying diagnoses in medicine to make and treat, because it has a specific, recognisable pattern, brief episodes of intense spinning, typically lasting under a minute, triggered by turning over in bed, looking up, or bending down, caused by small calcium crystals that have become dislodged within the inner ear's balance canals. It is diagnosed with a specific positional test that reproduces the vertigo and the characteristic eye movement that goes with it, and, remarkably for a condition causing such distressing symptoms, it is treated in a single appointment with a repositioning manoeuvre that physically moves the dislodged crystals back to where they belong, working for the substantial majority of people, often in one session.
Vestibular neuritis or labyrinthitis, inflammation of the inner ear or its nerve, often following a viral infection, causes a more prolonged, severe episode of vertigo, typically lasting days rather than seconds, sometimes with hearing loss and ringing in the ear if the labyrinth itself is involved, and it settles gradually, sometimes helped by specific exercises that retrain the balance system once the acute phase has passed. Ménière's disease produces recurrent episodes of vertigo lasting hours, together with fluctuating hearing loss, tinnitus and a sensation of fullness in the ear, and it needs its own specific long-term management plan since it tends to recur over years. Migraine can cause vertigo as a genuine feature in its own right, sometimes without a headache accompanying it at all, which is a pattern that surprises many people and is easily missed if migraine is not specifically considered as a cause of vertigo.
Ask what might be causing your vertigo on WhatsApp or email team@thewellnesslondon.com.
When is dizziness a medical emergency
A small but genuinely important group of presentations need urgent assessment rather than a routine appointment, and knowing them is worth doing regardless of how the current episode feels. Sudden, severe dizziness or vertigo together with any of the following needs emergency assessment, double vision, slurred speech, difficulty swallowing, new weakness or numbness on one side of the face, arm or leg, a severe headache unlike any before, or difficulty walking or a new, marked loss of coordination, because this combination raises the possibility of a stroke affecting the back of the brain, which can present with vertigo as a prominent feature rather than the more classically recognised one-sided weakness alone.
Sudden hearing loss accompanying vertigo, chest pain, palpitations or fainting alongside dizziness, and dizziness following a head injury all warrant prompt assessment too. It is worth being explicit that the great majority of vertigo and dizziness is due to benign, treatable causes rather than anything of this nature, but the pattern above is specifically screened for at every assessment precisely so that the rare, serious cause is not missed among the many benign ones.
How vertigo and dizziness are properly investigated
The history does most of the work, precisely what the sensation feels like, how long each episode lasts, what triggers it, whether hearing is affected, and whether any of the red flag features above are present, and a structured, physical examination follows, including specific positional testing where BPPV is suspected, an assessment of eye movements, hearing, balance and coordination, and a neurological examination where anything in the history raises concern.
Blood pressure, checked both lying and standing, identifies orthostatic hypotension, a drop in blood pressure on standing that is a common and often overlooked cause of lightheadedness, particularly in older adults or those on certain medications. Bloods, including a full blood count, glucose and thyroid function, are checked where the pattern suggests a metabolic or cardiovascular contributor rather than an inner ear problem, and an ECG is arranged where the pattern suggests presyncope rather than true vertigo. Imaging, typically MRI, is reserved for cases with red flag features, an unclear diagnosis despite thorough assessment, or vertigo accompanied by hearing loss or other neurological signs that need to be characterised, rather than ordered reflexively for every dizzy patient, since the majority of vertigo is diagnosed clinically without needing a scan at all.
What actually treats vertigo and dizziness
Matched precisely to the cause, because a generic anti-sickness tablet, while it can take the edge off acute symptoms, does nothing to actually treat most of the underlying conditions and, used for more than a short period, can occasionally slow the brain's own natural compensation for an inner ear problem. BPPV responds to the specific repositioning manoeuvre described above, performed in the consultation, working for the substantial majority of people often within a single session, which is a markedly better outcome than medication alone would achieve.
Vestibular rehabilitation, a specific set of exercises that retrain the brain's balance system, is genuinely effective for a range of inner ear causes, including the aftermath of vestibular neuritis and some cases of persistent unsteadiness, and is arranged with a specialist physiotherapist where indicated. Ménière's disease is managed with a combination of dietary measures, specific medication and, in some cases, specialist procedures, tailored to how often and how severely it is recurring. Where anxiety or hyperventilation is the genuine driver, treating that directly, rather than continuing to search for an inner ear cause that is not actually present, is what resolves the symptoms. And where orthostatic hypotension or a medication side effect is found, adjusting the contributing factor often improves symptoms considerably without needing any further specific dizziness treatment at all.
What does vertigo and dizziness assessment cost in London
Consultant ENT or neurology appointments in the Harley Street district run £250 to £450 for a first consultation before any test, with specialist vestibular testing, hearing assessment and imaging charged separately, and comprehensive imaging and executive programmes at the top of the London market exceed £32,000. Below all of it sits a tier defined by its conditions rather than its price, a brief remote consultation that prescribes an anti-sickness tablet without ever establishing what kind of dizziness is actually present, let alone performing the repositioning manoeuvre that would resolve BPPV in a single visit.
At The Wellness the assessment, the specific diagnosis and, where appropriate, same-appointment treatment are 1 fee, and all figures are from prices. The Executive Health Programme, the most comprehensive assessment with full biomarker profiling and coordinated imaging, is from £11,995. The Comprehensive Blood Panel, including full blood count, glucose, thyroid function and the relevant markers, with consultation and interpretation, is from £495, and a Targeted Blood Panel from £295. An extended 45-minute consultation for a full vertigo and dizziness assessment, including positional testing and, where appropriate, the repositioning manoeuvre for BPPV performed in the same appointment, is from £395. An in-person consultation with examination in Marylebone is from £220, a same-day video consultation from £150 and telephone follow-up from £59. A home, hotel or office visit is from £495 daytime and £695 evenings and weekends. MRI, vestibular rehabilitation and referral to a named ENT specialist or neurologist are arranged at specialist centres with the appointment booked.
Same-day appointments 7 days a week in Marylebone, 3 minutes from Baker Street.
Why The Wellness is the best place in London for vertigo and dizziness
Because the first and most important question, precisely what kind of dizziness this actually is, is worked through properly rather than assumed, and the red flags for the rare, serious causes are checked deliberately at every assessment, so the small but important minority needing urgent attention is not missed among the far larger number of benign, treatable cases.
Because BPPV, the commonest cause of true vertigo, is treated properly rather than medicated. The specific positional test confirms the diagnosis and the repositioning manoeuvre is performed in the same appointment, resolving symptoms for the substantial majority of people, which is a fundamentally different and better outcome than being sent away with an anti-sickness tablet and told to wait it out.
And because the other causes, Ménière's disease, vestibular neuritis, migraine-associated vertigo, orthostatic hypotension, a medication side effect, or anxiety, are each properly identified and treated on their own terms, with vestibular rehabilitation and specialist referral arranged where they are the right next step, rather than every dizzy patient being funnelled toward the same generic treatment regardless of what is actually causing their symptoms.
Book a vertigo assessment on WhatsApp or call 020 3951 3429.
Frequently asked questions
What is the most common cause of vertigo
Benign paroxysmal positional vertigo, BPPV, caused by small calcium crystals becoming dislodged within the inner ear's balance canals. It produces brief, intense spinning triggered by specific head movements such as turning over in bed or looking up, and it is treated in a single appointment with a repositioning manoeuvre.
How do I know if my dizziness is serious
Sudden, severe dizziness with double vision, slurred speech, weakness or numbness on one side, a severe headache unlike any before, or difficulty walking needs emergency assessment, since this pattern raises the possibility of a stroke. Sudden hearing loss, chest pain, palpitations, fainting or dizziness after a head injury also warrant prompt assessment.
What is the difference between vertigo and just feeling dizzy
Vertigo is a specific spinning sensation, either you or the environment feels like it is spinning, and points toward the inner ear or brain. Lightheadedness or feeling about to faint points toward blood pressure or the heart, and unsteadiness without spinning points toward vision, sensation or coordination. Establishing which one you have changes the entire assessment.
Can vertigo be treated without medication
Yes, and often better than with medication. BPPV, the commonest cause, is treated with a specific repositioning manoeuvre performed in the appointment, working for the majority of people in a single session, and vestibular rehabilitation exercises effectively treat several other inner ear causes without needing ongoing medication.
Can anxiety cause dizziness
Yes, and it is a genuine, treatable cause in its own right rather than a diagnosis reached only once everything else has been excluded. Non-specific lightheadedness linked to anxiety or hyperventilation should be identified and treated directly rather than continuing to search for an inner ear cause that may not be present.
Do I need a scan for vertigo
Not usually. Most vertigo is diagnosed clinically through history and examination without needing imaging. MRI is reserved for cases with red flag features, an unclear diagnosis despite thorough assessment, or vertigo accompanied by hearing loss or other neurological signs that need further characterisation.
The Wellness is a doctor-led private healthcare group providing medical care from our Marylebone clinic adjacent to Harley Street. All doctors are GMC-registered. Imaging, vestibular rehabilitation and specialist care are arranged at specialist centres and reported by consultants, and blood analysis is performed by accredited laboratories. Sudden severe dizziness with weakness, slurred speech, double vision or a severe headache needs emergency assessment, and in an emergency call 999. This article is general information and not a substitute for medical advice about your own health.
Enquire now on WhatsApp or email team@thewellnesslondon.com or call 020 3951 3429.
References. NICE Clinical Knowledge Summaries on vertigo, dizziness and BPPV, including the Epley repositioning manoeuvre. NICE guideline NG128 on stroke and transient ischaemic attack, including recognition of posterior circulation stroke presenting with vertigo. British Society of Otology and British Academy of Audiology guidance on vestibular assessment and Ménière's disease. Published evidence on vestibular rehabilitation therapy. Published evidence on migraine-associated vertigo. Published 2026 London private ENT, neurology and vestibular assessment market pricing.
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