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Dizziness is often referred to as vertigo, or the sensation that the room or environment around you is moving or not staying still.  Symptoms may include a headache, spinning, tilting, nausea, and rapid eye movements, sweating, and ringing in the ears (tinnitus).

Dizziness can be caused by the following:

BPPV (Benign Paroxysmal Positional Vertigo)

Causes

  • BPPV occurs when tiny particles (canaliths)clump together in the canals of the inner ear, sending mixed signals to the brain that the body is in motion.  This results in dizziness that comes and goes (paroxysmal).  The dizziness is usually caused by positional changes such as: rolling over in bed, moving from a sitting to a standing position, turning the head left to right or up and down.

Diagnosis   

  • A Dix-hallpike test is performed in the office and is easy to do.  This is a simple test that has the patient move from a seated to a lying position in order to recreate the dizziness and confirm the diagnosis 

Treatment

  • Your physician may perform an Epley maneuver in the office, which helps to reposition the canaliths and improve your dizziness.
  • Specialized exercises can be done at home or with the aid of a physical therapist.

Vestibular Neuritis

Causes

  • This form of dizziness occurs when a specific part of the inner ear nerve that controls balance becomes swollen due to infection.  This results in severe dizziness that makes it difficult to stand or walk without the using something for support.  Severe symptoms usually last a few days, but full recovery may take several weeks to months.  Hearing loss does not usually accompany this form of dizziness.

Diagnosis  

  • Diagnosis is usually made by an Ear, Nose, Throat specialist in the office.  Further testing with a hearing test (audiogram), as well as a specialized dizzy study called a vestibulonystagmography (VNG), can also be done to confirm the diagnosis.

Treatment  

  • The use of oral anti-inflammatory steroids, antiviral medications, and special medication to treat the symptoms of dizziness are routinely used for treatment.

Labyrinthitis

Causes

  • Labyrinthitis is similar to vestibular neuritis, but also includes inflammation and swelling of both the balance nerve and hearing nerve.  In addition to the symptoms of vestibular neuritis, hearing loss will accompany labyrinthitis.

Diagnosis:

  • Diagnosis is similar to vestibular neuritis, and a hearing test will confirm the presence of hearing loss.

Treatment:

  • Treatment is similar to vestibular neuritis.  However, because a hearing loss occurs with labyrinthitis, it is important to seek help promptly in order to begin appropriate medication that can help reduce or eliminate long-term hearing loss.

Head & Neck Injury

Causes:

  • Head and neck trauma can damage the inner ear structure, nerve, or hearing center in the brain causing dizziness.  Some injuries may cause permanent damage to hearing or balance, while others may cause temporary or reversible damage that can be treated medically, surgically, or with observation.

Diagnosis:

  • Diagnosis is made by history, physical examination, and special radiographic studies such as a CT scan or MRI.  Neurologic testing in the office can be done to help identify specific deficits, or weaknesses, that might be present secondary to the trauma.

Treatment:

  • Treating the underlying traumatic injury takes precedence.  Many injuries may cause permanent or long-lasting dizziness that requires a special surgery that can help improve symptoms.  Many times, medication and observation are the best choices of treatment as they pose less risk of further injury after a traumatic accident.
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