What is the likelihood that scuba diving (or flying) brings on a vertigo attack?

Low: Vertigo from flying is very rare, vertigo from scuba diving is not as rare (but still rare). It is more likely that pressure change from being under water can lead to rupture of the inner ear causing something called a perilymph leak. When fluid from the inner ear leaks into the middle ear patients get severe vertigo, hearing loss and tinnitus. This is a true ear emergency.

Very likely: Sudden changes in air pressure will cause severe stress at the level of the ear components. Diving raises external pressure rapidly, and the inner ear has to equilibrate rapidly or structures may rupture or bleed. Same occurs with sudden changes in altitude with flying. Rupture of the ear drum, round window, and bleeding into the semi-circular canals can occur.

Eval.: Vertigo that develops during a dive or shortly thereafter warrants medical evaluation.