When a patient is sent to be evaluated for complaints of dizziness it is often helpful to break the symptoms into different categories.
Vertigo is a term that is commonly used to describe dizziness and generally means that there is a sensation of motion. The sensation of motion that is experienced is often described as a spinning sensation which is known as rotatory vertigo. Vertigo can also be described as a sensation of motion without true spinning. Whether you feel that you are moving or spinning or that your environment is moving or spinning, both situations are consistent with vertigo. It is important to understand that the term vertigo is not a diagnosis or a disease. It is a symptom and might be the result of numerous conditions.
Imbalance or disequilibrium, refers to the inability to maintain balance especially when standing or walking.
Lightheadedness is most similar to a feeling of nearly passing out or a head rush that can sometimes be experienced when rising too quickly from a sitting or lying position to a standing position.
Many patients are evaluated by an Ear, Nose & Throat physician (otolaryngologist) due to complaints of dizziness. The inner ear provides both a hearing and a balance function. The balance portion of the inner ear, called the vestibule or labyrinth, communicates with the eyes and brain, as well as the muscles of your body, to help maintain balance.
There are a variety of inner ear conditions that can cause dizziness, but not all dizziness is inner ear related. The type of symptoms, along with a physical examination, can determine the necessary testing to be scheduled. From an Â otolaryngology standpoint the most common test that is ordered is called a VNG or video- nystagmography. This is a test that is done in the office by doctors of audiology at CornerStone Ear, Nose & Throat, PA, that allows measurement of the strength and function of each inner ear balance system as well as testing the coordination of eye movements. During certain portions of this testing it is normal to experience dizziness. Once this testing is performed, further information about the underlying function of the inner ear balance system is obtained which can help determine whether or not the symptoms of dizziness are potentially inner ear related.
Some of the more common causes of dizziness related to the inner ear are benign paroxysmal positional vertigo (BPPV), Ménière disease, and infections of the inner ear, which are most commonly viral in nature. In more rare cases there are tumors that can be the cause of dizziness. The most common types of these tumors are not cancerous, but may cause significant problems if not detected and removed early.
Benign paroxysmal positional vertigo is a fancy term that basically describes a sensation of spinning vertigo that is triggered by certain head positions such as rolling over in bed or tilting the head backwards or forwards. It is thought to be caused by small crystals in the inner ear fluid that become lodged in a certain part of the balance system causing the sensation of spinning when they shift position in the inner ear as the head is moved. This type of vertigo can occur without any precipitating event, but can also occur after head trauma. It can usually be diagnosed in the office or when having VNG testing performed, and can most effectively be treated with a re-positioning maneuver performed by qualified clinicians in an otolaryngology office.
Ménière’s disease is a disorder of the inner ear that is related to excess fluid in the inner ear. This condition is complex in its origin and may respond to treatments which can be both medical and surgical.
Viral infections of the inner ear can occur when a virus infects the inner ear balance system causing a sensation of vertigo. Usually these conditions are self-limited, meaning they will resolve on their own, but certain medications can help improve the symptoms and at times balance exercises can speed the recovery. If hearing loss, facial paralysis, or facial paralysis accompanied by blisters of the external ear is associated with the sensation of vertigo, immediate medical attention by an Ear, Nose & Throat doctor is strongly recommended.
A tumor referred to as a vestibular schwannoma , or acoustic neuroma, is a rare benign tumor of the balance nerve that can affect the balance system as well as causing hearing loss, facial weakness, and ringing in the ears known as tinnitus.
If symptoms of dizziness are also associated with facial paralysis, facial weakness, sudden or significant loss of hearing in one ear more than the other, recent trauma to the ear, purulent drainage from the ear or vesicles (blisters) on the external ear, care from an otolaryngologist should be sought as soon as possible. Otherwise, general symptoms of dizziness should be evaluated by a general practitioner, who can determine if evaluation by an tolaryngologist is warranted. CornerStone Ear, Nose & Throat physicians and doctors of audiology work together closely to assess and treat various causes of dizziness, allowing patients the convenience of proficient comprehensive care and treatment in one location.