Dizziness is one of the most common reasons patients come to primary care and neurology, and it is also one of the most under-diagnosed because 'dizzy' means different things to different people. Some patients feel the room spinning (true vertigo). Others feel lightheaded, unsteady, or about to faint. The right treatment depends entirely on the correct diagnosis, which is why the first visit focuses on sorting out what kind of dizziness you have. Most causes are benign and treatable — BPPV resolves within minutes of the right repositioning maneuver — but some causes need urgent evaluation. At Viva Medical Center in Doral, FL, we distinguish peripheral (inner ear) from central (brain or vascular) causes and plan treatment accordingly. Call (305) 209-0001.
Types of Vertigo and Dizziness We Treat
- Benign Paroxysmal Positional Vertigo (BPPV) — the most common cause, often treated same-day with repositioning maneuvers
- Vestibular neuritis and labyrinthitis — usually post-viral, typically improves over weeks with vestibular rehab
- Vestibular migraine — recurrent vertigo with migraine features, treated with migraine prevention strategies
- Ménière disease — episodic vertigo with hearing change, treated with dietary and medical management
- Orthostatic dizziness — lightheadedness on standing, workup includes heart rate and blood pressure review
- Persistent Postural-Perceptual Dizziness (PPPD) — chronic unsteadiness managed with vestibular therapy and counseling
- Central causes — when exam findings suggest brain or vascular origin, urgent imaging and neurology referral
What the First Visit Looks Like
The hardest part of evaluating dizziness is getting the story right. The first visit is a careful conversation plus specific bedside tests.
- Detailed history — what 'dizzy' means to you, what triggers it, how long episodes last, hearing changes
- Bedside exam — eye movements, Dix-Hallpike maneuver, head impulse test, gait and balance testing
- Orthostatic vital signs when lightheadedness is the main complaint
- Cardiac and medication review for orthostatic or syncope-like symptoms
- MRI referral when exam findings suggest a central cause
- Coordinated referral to ENT when the picture suggests peripheral ear disease
Treatment — Matching the Cause
- Epley and other repositioning maneuvers for BPPV — often relief within one visit
- Vestibular rehabilitation referral for neuritis, PPPD, and post-concussive dizziness
- Vestibular migraine prevention with migraine-class medications and trigger management
- Low-salt diet and medical management for Ménière disease, with ENT co-management when needed
- Medication review to stop or substitute agents that cause orthostatic drops
- Fall-prevention plan for older adults with recurrent dizziness or balance issues
When Dizziness Is an Emergency
Most vertigo is benign, but these patterns need emergency evaluation, not a clinic visit.
- Sudden-onset vertigo with weakness, numbness, trouble speaking, or vision loss
- Vertigo with severe headache unlike anything you have had before
- Vertigo with trouble walking straight, even when not spinning
- Hearing loss in one ear that appears suddenly with vertigo
- Dizziness after a head injury within the last 7 days
Long-Term Management
- Follow-up at 2-4 weeks after the first visit to check response to treatment
- Vestibular therapy progress review every 4-6 weeks
- Preventive medication adjustments for vestibular migraine based on episode frequency
- Coordination with ENT, cardiology, or physical therapy as the picture evolves
- Balance and fall-risk assessment for patients over 65 with recurrent episodes
- Mental health screening — chronic dizziness commonly coexists with anxiety, and we treat both
Insurance and Scheduling
- In-network with Oscar Health, Aetna, Cigna, Humana, Medicare Advantage, Ambetter, UnitedHealthcare
- Same-day appointments for new-onset vertigo when scheduling allows
- Telehealth follow-ups for medication review and vestibular therapy progress
- Bilingual English and Spanish staff
- Self-pay rates published for patients without insurance
Frequently Asked Questions
How do I know if it is vertigo or regular dizziness?
Vertigo is the specific feeling that you or the room is spinning. Regular dizziness is usually described as lightheaded, foggy, or unsteady without spinning. The distinction matters because the causes and treatments differ. When you book, our team asks a few screening questions so the visit is structured around the likely category.
Can BPPV be treated in one visit?
Often yes. If the bedside exam confirms BPPV, we can perform the Epley maneuver (or a variant) during the same visit. Most patients feel significantly better within 24-48 hours. A small percentage need a second round of repositioning. We send you home with instructions and a plan in case symptoms return.
Do I need an MRI for vertigo?
Not routinely. MRI is ordered when the history or exam suggests a central cause — for example, new neurological findings, sudden onset with stroke-like features, or an atypical presentation. Most BPPV, vestibular neuritis, and vestibular migraine cases are diagnosed clinically without imaging.
What is vestibular migraine?
A form of migraine where the main symptom is vertigo or dizziness instead of (or alongside) headache. Episodes can last minutes to days. Treatment combines acute migraine strategies during attacks with preventive medication to reduce frequency. Many patients with vestibular migraine were previously told they had Ménière or 'inner ear issues' without improvement, which is why the diagnosis matters.
Can telehealth work for vertigo follow-up?
Yes for follow-ups and medication adjustments. The first visit is in-person because we need to perform positional testing that cannot be done over video. Once we have a diagnosis and treatment plan, follow-ups work well by video, especially for vestibular migraine and PPPD.
Is vertigo treatment covered by insurance?
Yes for our in-network carriers. Evaluation, bedside maneuvers, vestibular rehab referral, and follow-up visits are covered under your primary care or neurology benefit. Call (305) 209-0001 with your plan and we verify the copay before you book.