Labyrinthine positional nystagmus: when to get help
Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Call emergency services for dizziness or nystagmus accompanied by:
New facial drooping, arm or leg weakness, or numbness
Trouble speaking, understanding speech, or swallowing
New double vision or loss of vision
A sudden severe headache
Inability to stand or walk, especially without brief positional attacks
Collapse, loss of consciousness, or new confusion
These features can occur with stroke or another serious neurological problem.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Seek urgent medical assessment for sudden hearing loss, especially in one ear.
Sudden hearing loss is not typical of BPPV and may need time-sensitive treatment.
Continuous severe vertigo that is not tied to head position also needs prompt assessment, particularly when it is new.
3
Does any of this apply?
Book an appointment
Arrange a routine appointment if positional dizziness is new, keeps returning, interferes with daily activities, or has not improved after a repositioning maneuver.
You should also be assessed if you develop ear pain, ongoing imbalance, ringing in one ear, or a change in hearing.
Every sign above is quoted from the sofidex article on Labyrinthine positional nystagmus. If you are not sure, err upward — it is always reasonable to be checked.