While the inner ear is a critical part of the body’s balance system, the brain remains “command central,” and other senses such as vision and proprioception are more commonly the underlying cause of balance problems. Distinguishing the source of the balance problem or dizziness can be difficult and often requires the expertise of a physician with particular training in that area. The ear, nose and throat specialists, also known as otolaryngologists, at CornerStone Ear, Nose & Throat can help determine if dizziness is the result of an inner ear disorder or more likely from another cause. Our doctors will evaluate your specific situation, and if your inner ear is the cause, they will recommend a treatment plan to help you feel like you are back on solid ground.
Causes Of Dizziness
Lightheadedness can result from the brain or inner ear not getting proper blood flow. This condition can be due to multiple factors associated with aging, hardening of the arteries, high blood pressure, diabetes or high levels of cholesterol. Circulation can also be affected by inadequate cardiac (heart) function, hypoglycemia (low blood sugar), anemia (low iron), nicotine, caffeine or excess salt in the diet. Poor blood flow to the inner ear can result in symptoms of vertigo, a particularly debilitating type of dizziness that involves a feeling of rotation or movement when there is none.
While not common, diseases of the nervous system, such as multiple sclerosis, syphilis, Parkinson’s disease, Alzheimer’s, dementia, neuropathy, spinal stenosis and even tumors, can cause dizziness or adversely affect balance.
Anxiety and panic attacks can also lead to episodes of dizziness, hyperventilation and tingling in the hands, feet or face. Breathing techniques can often help in these situations.
Vertigo is a specific form of dizziness that can be directly related to an issue with the inner ear. People with this condition feel that they are moving or that the environment around them is moving, when neither is actually happening. For a person with vertigo, the world feels like it is constantly spinning or moving during the attack. Vertigo is usually accompanied by nausea and vomiting as the brain struggles to make sense of the competing and conflicting information it receives.
Common Causes Of Vertigo
Benign Paroxysmal Positional Vertigo (BPPV) – Individuals with BPPV experience vertigo when they put their head in a certain position. Symptoms most commonly arise suddenly when lying down, turning over to the affected ear’s side in bed, or looking up. Symptoms last for about 40-50 seconds when the attack hits, but episodes will likely recur over time. The sensation is caused by a dislodged otololith crystal entering one of the semicircular canals in the inner ear and stimulating a hair cell there, essentially tricking your ear into thinking you are spinning when you are not. BPPV episodes can persist for days, weeks or months. As the name implies, the condition is benign and usually self-limited, though treatment can rapidly eradicate the condition once it is correctly diagnosed.
Meniere’s Disease – This inner-ear disorder is the result of a buildup of too much inner-ear fluid, which can cause a sudden rupturing of the inner-ear membranes. The result is sudden, severe vertigo often lasting hours. The initial attacks are often the worst. The classic syndrome or combination of signs and symptoms includes bouts of vertigo with associated nausea or vomiting, tinnitus (loud ringing) in the ear, a sensation of fullness or pressure in the affected ear often preceding the attack, and fluctuating nerve damage hearing loss, which is often worse after the attack but which may improve with healing. Typically, the hearing loss is in the low frequencies, which distinguishes it from many other causes of nerve damage hearing loss.
Migraine – People with a history of migraine headaches can experience vertigo attacks that include bouts of nausea or vomiting, and tinnitus (loud ringing) in the ear. As such, distinguishing migraine from Meniere’s disease is a true clinical challenge. Points of consideration include family history of migraine, female gender, other associated symptoms such as photophobia (discomfort from bright lights) and altered thinking and processing of information during the attack, and the absence of nerve damage hearing loss, all of which would suggest a migraine cause.
Viral And Bacterial Infections – Vestibular neuritis is a viral infection that attacks the inner ear, causing acute vertigo (lasting days), but that normally does not affect hearing. Acute suppurative labyrinthitis is a bacterial infection of the inner ear that can completely destroy both the hearing and equilibrium function of that ear.
Injuries To The Head And Skull – It is common for vertigo to occur after a head injury. Incapacitating vertigo, nausea and hearing loss can result from a skull fracture that damages the inner ear. Less severe injuries such as concussion or labyrinthine concussion can result in temporary or even permanent balance difficulties, especially in situations where the ability to fixate visually on nearby objects is impaired.
Allergies – Both food and airborne allergens can trigger dizziness.
Diagnosing And Treating Dizziness And Vertigo
If dizziness is a problem for you, the physicians at CornerStone Ear, Nose & Throat can help. Our diagnostic evaluation will include a physical examination of your ears, nose and throat, as well as a check of your blood pressure, nerve and balance function, and hearing. Additional tests to determine the source of your dizziness may include a CT or an MRI scan of your head, or tests to evaluate the function of the inner ear. These tests usually include VNG with positional, caloric and oculomotor testing (videonystagmography). In most instances, inner ear-related dizziness is treatable. Based on the results of the examination and testing, recommended care may include medications, therapeutic maneuvers, balance exercises or vestibular rehabilitation if permanent damage has been done.
When To See A Doctor Regarding Dizziness
If you have a severe case of dizziness or vertigo, it is important to seek the care of a specialist. It’s also important to seek immediate medical help if your dizziness is accompanied by any of the following:
- High fever
- Severe headache
- Ongoing vomiting
- Chest pain
- Heart palpitations
- Shortness of breath
- Inability to move an arm or a leg
- Change in vision or speech
- Hearing loss
- Blisters on the outer ear
- Facial weakness
- Stiff neck