Vertigo, Balance, & Dizziness

Common Causes of Dizziness and Vertigo

 

Disorders of the inner ear that cause dizziness and balance problems are miserable to experience and often quite frightening. Keeping balanced is an incredibly intricate and complicated task. It involves multilple inputs to the brain from all over the body. In order to maintain balance we must have clear and accurate information from the body (regarding the position of the trunk, legs, and arms, what you are touching, whether you are standing or sitting, and whether you are still or moving), the eyes (to keep track of our surroundings and the horizon, floor, and other visual clues), and our inner ears (mainly informing us about and confirming the position of the head relative to the rest of the body). All of this input comes in constantly, letting us adjust rapidly to keep us from falling over. Therefore, you might imagine there are lots of different places in that chain of command where information could potentially be mixed up. When the signals are crossed people feel out of whack and dizzy.  

Vertigo, which is commonly used to describe dizziness of any sort, is actually defined as the feeling of motion when there is none. It is a typical reaction to an inner ear problem. People report room spins, feeling drunk, sea motions, bouncing sensations, and many other variations. Very often these feelings are associated with nausea and vomiting.

When we see people with dizziness we try to determine if the source is the inner ears or elsewhere. We ask about associated complaints and do a good exam of the ears and hearing, nervous system, and head and neck in general. We want to find out if the dizziness is a symptom of a more serious medical problem; high or low blood pressure, heart problems, stroke, brain tumor, mulitole sclerosis, or medication side effects, among others. 

 


Benign Paroxysmal Positional Vertigo (BPPV)

This is a disorder which leads to dizziness that occurs sporadically with certain positions. It is usually short lived and resolves on its own. Sometimes we need to try some special testing in the office (Hallpike and particle repositioning maneuvers) to help resolve the symptoms. 

Vestibular Neuritis

This is a common cause of dizziness that may last for a few days and may occasionally be severe. It is often associated with viral infections, and it usually improves with time.

Meniere’s Disease

Meniere’s Syndrome is characterized by episodic dizziness associated with low tone hearing loss, buzzing, and fullness in the offending ear. These events are difficult to predict and can be very severe, usually lasting several hours. Over time, hearing loss may progress and worsen. There is no known cause or cure for Meniere’s Disease. However, there are medications and dietary adjustments that may help stabilize symptoms and may prevent flare ups. Our office offers special testing to confirm this diagnosis, when your providor suspects taht you have this disease.

Migraines

Some migraines can cause a feeling of imbalance and vertigo. This may be accompanied by ringing in the ears or hearing loss. Migraine-related vertigo may occur in conjunction with or separate from the migraine headache.  When we have determined that your inner ear is not the source of your vertigo, we may refer you to a neurologist for further evaluation.

Acoustic Neuroma

Acoustic neuroma is a rare benign growth on the auditory  nerve that connects the inner ear to the brain. Symptoms include one-sided hearing loss (asymmetrical hearing loss), one-sided ringing or buzzing, and occasionally facial numbness, facial weakness, and visual problems. Your providor will order an MRI scan when he or she wants to rule this diagnosis out.

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