Dizziness After COVID

Feeling dizzy after COVID-19 is surprisingly common. Symptoms may develop during the acute infection or appear weeks later as part of "Long COVID." For some people, dizziness resolves quickly, while others experience persistent imbalance, motion sensitivity, or feelings of being disconnected from their surroundings.

Fortunately, there are many possible explanations, and specialist assessment can help determine the cause.

Can COVID Cause Dizziness?

Yes. Dizziness has been recognised as one of the many neurological and vestibular symptoms associated with COVID-19.

People describe post-COVID symptoms in different ways, including:

• Feeling off balance

• Lightheadedness

• Motion sensitivity

• Brain fog

• Floating or rocking sensations

• Feeling disconnected or "not quite right"

• Unsteadiness when walking

• Vertigo or spinning attacks

• Visual motion intolerance

• Fatigue

• Difficulty concentrating

• Symptoms that worsen in busy environments

Some people find that symptoms fluctuate from day to day.

Is Dizziness Part of Long COVID?

Yes. Persistent dizziness and balance problems are recognised symptoms of Long COVID.

Long COVID refers to symptoms that continue for weeks or months after the initial infection. Dizziness may occur alongside:

• Fatigue

• Breathlessness

• Brain fog

• Palpitations

• Exercise intolerance

• Sleep disturbances

• Headaches

For some individuals, dizziness becomes one of the most disabling features of Long COVID.

Conditions That May Develop After COVID

Vestibular Neuritis - Inflammation affecting one of the balance nerves may result in sudden severe vertigo followed by prolonged imbalance.

Benign Paroxysmal Positional Vertigo (BPPV) - Short episodes of spinning dizziness triggered by turning in bed or looking up.

Vestibular Migraine - COVID may trigger migraine-related dizziness in susceptible individuals.

Persistent Postural-Perceptual Dizziness (PPPD) - Persistent sensations of rocking, swaying, or imbalance that are often worse in busy visual environments.

Postural Orthostatic Tachycardia Syndrome (POTS) - Changes in autonomic function can lead to dizziness on standing, palpitations, and fatigue.

Bilateral Vestibular Loss - Although uncommon, viral illnesses may occasionally affect both balance organs.

Why Do I Feel Like I'm Walking on a Boat?

One of the most common complaints after COVID is a sensation of:

• Rocking

• Swaying

• Floating

• Feeling as though you're on a boat

These symptoms are often seen in:

• PPPD

• Vestibular migraine

• Long COVID

• Bilateral vestibular dysfunction

• Mal de Débarquement Syndrome (MdDS)

Although these sensations can be frightening, they are rarely dangerous and often improve with appropriate treatment.

How Is Dizziness After COVID Diagnosed?

A detailed history is essential because symptoms can arise from many different causes.

Assessment may include:

• Hearing tests

• Video Head Impulse Test (vHIT)

• Videonystagmography (VNG)

• Caloric testing

• Vestibular Evoked Myogenic Potentials (VEMP)

• Computerised Dynamic Posturography

• Positional testing for BPPV

• Blood pressure assessment

• Referral to other specialists if necessary

These investigations help distinguish between inner ear disorders, migraine, PPPD, and non-vestibular causes.

Treatment

Treatment depends on the underlying cause.

Vestibular Rehabilitation Therapy - Specialised exercises can help retrain the brain and improve balance.

Treatment for BPPV - Canalith repositioning manoeuvres such as the Epley manoeuvre are often highly effective.

Migraine Management - Lifestyle modifications and medication may help control vestibular migraine.

Managing PPPD - A combination of vestibular rehabilitation, education and, in some cases, medication may be beneficial.

Graded Physical Activity - Slowly rebuilding strength and endurance can improve symptoms caused by deconditioning.

Managing Autonomic Dysfunction - Hydration, compression garments and specialist input may be required for patients with POTS.

When Should I Seek Medical Advice?

You should seek assessment if you experience:

• Persistent dizziness lasting more than a few weeks

• Recurrent vertigo attacks

• Difficulty walking or maintaining balance

• Hearing loss or tinnitus

• Frequent falls

• Symptoms that are affecting your work or daily activities

You should seek urgent medical attention if dizziness is accompanied by:

• Double vision

• Weakness or numbness

• Difficulty speaking

• Severe headache

• Sudden hearing loss

How Can Northern Balance Clinic Help?

At Northern Balance Clinic, we provide specialist assessment for persistent dizziness and balance problems following COVID-19.

Using advanced vestibular testing, we can help identify conditions such as:

• Vestibular neuritis

• Benign Paroxysmal Positional Vertigo (BPPV)

• Vestibular migraine

• Persistent Postural-Perceptual Dizziness (PPPD)

• Bilateral vestibular loss

• Age-related balance disorders

• Functional and visual motion sensitivity disorders

Understanding the cause of your symptoms is the first step towards recovery.