Acute symptoms · Berlin
Acute vertigo
Acute vertigo is an acute medical condition that RAB Arztbesuche treats with a licensed physician on a home visit anywhere in Berlin — daily from 6 am to midnight, usually within 60 to 90 minutes.
Sudden vertigo is frightening — the room spins, every move makes it worse, nausea and vomiting follow. Getting up, let alone travelling to a clinic, seems impossible. Our specialist physicians come daily from 6 am to midnight, perform a structured neurological exam and classify the symptoms.
Medically reviewed by Susanne Reiche · Last reviewed
Acute vertigo in Berlin — the central question: peripheral or central
Vertigo is not a uniform symptom. The most important clinical question in the first minutes is: peripheral (inner ear, vestibular nerve) or central (brainstem, cerebellum)? This distinction shapes everything else. Peripheral vertigo — benign positional vertigo or vestibular neuritis — is unpleasant but usually treatable. Central vertigo can signal a stroke and belongs immediately in hospital.
On the house call we have time to examine carefully — something often impossible in a crowded ER. We use the Frenzel goggles or a hand lens, check nystagmus, perform the Dix-Hallpike test where positional vertigo is suspected and use the HINTS triad (Head Impulse, Nystagmus, Test of Skew) to separate peripheral from central causes.
Common causes and their therapy
Benign paroxysmal positional vertigo (BPPV) is the most common cause of acute rotatory vertigo — second-long, position-triggered attacks. The treatment of choice is the Epley manoeuvre, which we can perform directly on site at a success rate above 80 percent. Vestibular neuritis presents as continuous rotatory vertigo over days without hearing loss; we prescribe antiemetics and a short steroid course alongside vestibular rehabilitation. Ménière's disease combines vertigo attacks, tinnitus and unilateral hearing loss — ENT involvement is essential here.
Why careful history-taking does half the work
Three questions decide much: Is the sensation spinning (rotatory), swaying (imbalance) or near-fainting (presyncope)? How long does an attack last — seconds, minutes, hours, days? What triggers it — position change, stress, movement or nothing? The answers narrow the differential more precisely than most equipment-based tests. The house call gives us the time to take that history.
How the house call works
On first contact we screen for red flags (speech disturbance, weakness, new severe headache, hearing loss). With suspected stroke we direct you to a stroke unit; otherwise we dispatch the next available specialist — typically a 60- to 90-minute arrival.
On site we perform a structured neurological exam focused on cranial nerves, coordination, stand and gait, plus targeted vestibular testing. For classical BPPV we perform the Epley manoeuvre on site, explain the diagnosis and provide a written exercise programme. Antiemetics are administered as needed.
Billing and insurance
We bill according to the German private medical fee schedule (GOÄ) via our Privatärztliche Verrechnungsstelle. House call, neurological exam, administered medication and the Epley manoeuvre are itemised separately. German private health insurance and Beihilfe schemes typically reimburse these positions in full.
We can issue an English invoice on request and remain reachable by phone for billing questions after the visit.
Emergency? Dial the emergency number
If unconscious, with severe chest pain, breathlessness or heavy bleeding, dial 112 immediately. Our service complements the emergency services — it does not replace them.
Case profiles
Typical scenarios
Older patient with positional vertigo
A 72-year-old in Zehlendorf is hit by brief, intense rotatory attacks on turning in bed. We confirm BPPV with the Dix-Hallpike test and perform the Epley manoeuvre directly in the bedroom.
Vestibular neuritis
A patient in Mitte has continuous rotatory vertigo with nausea over two days; hearing is normal. We confirm clinically, administer antiemetics and start a steroid course.
Hotel guest after long-haul flight
A traveller in a Mitte hotel feels dizzy with nausea after a long flight. We clarify whether this is harmless adaptation or whether further work-up is needed.
Suspected stroke — 112 right away
Sudden vertigo with speech disturbance or one-sided weakness belongs to the ambulance service. We help by phone to triage the picture and structure the transport.
Frequently asked questions
What is the difference between rotatory vertigo and imbalance?
Rotatory vertigo feels like a carousel — typical for an inner-ear cause. Imbalance feels like standing on a ship — more common with neurological or psychogenic causes. The distinction matters diagnostically.
Can the doctor perform the Epley manoeuvre at my home?
Yes. With confirmed BPPV we perform the Epley manoeuvre on site. Success rates are above 80 percent — many patients are symptom-free after a few manoeuvres.
Do I need an MRI?
Not necessarily. Classical BPPV or vestibular neuritis can be diagnosed clinically. We recommend MRI with red flags, an unclear course or suspected central cause.
Can you give me something for the nausea?
Yes. An injection of dimenhydrinate or metoclopramide typically takes effect within 10 to 20 minutes.
Book now or call
Get in touch — we will arrange a doctor for your house call regarding Acute vertigo.