Dizziness, a blanket term used to describe any feeling of unsteadiness, is one of the leading health complaints in the United States, affecting an estimated nine million people annually. For those over the age of 70, it’s the top reason for a visit to the doctor’s office.
Causes
Dizziness is the result of your brain receiving false signals from the balance system (comprised of the inner ear, eyes and sensory nerves). It senses movement and overcompensates, leading to a spinning sensation, lightheadedness or faintness. There are many possible causes of dizziness including low blood pressure, anemia, dehydration, heat-related disorders, endocrine system disorders (e.g., diabetes, thyroid disease), heart conditions, high blood pressure, viral and bacterial infections, head trauma, hyperventilation, neurological disorders and certain medications.
Several balance disorders are commonly associated with dizziness and/or vertigo. Benign Paroxysmal Positional Vertigo (BPPV) involves brief but intense periods of vertigo that are triggered by specific changes in head position. It occurs when tiny crystals in the otolith organs become dislodged and migrate to the semicircular canals. Meniere’s disease is a chronic condition that causes vertigo, tinnitus, fullness in the ear and fluctuating hearing loss that may eventually become permanent. Meniere’s is usually confined to one ear and though its cause is unknown, it may be the result of abnormal fluid buildup in the inner ear. Labyrinthitis is an inflammation of the inner ear usually caused by an infection. Its symptoms include vertigo, temporary hearing loss and tinnitus.
Symptoms
Patients who experience dizziness report a variety of symptoms depending on the exact nature of their disorder. These include:
- Lightheadedness
- Fainting
- Unsteadiness
- Weakness
- Vertigo (the sensation of movement in your surroundings)
- Confusion
- Disorientation
- Blurred vision
Treatment
Treatment for dizziness takes many forms, depending on the cause. Your doctor will try to target the underlying condition in order to reduce or eliminate the symptoms. Options include medications (antihistamines, sedatives, antibiotics, steroids), physical or occupational therapy, surgery, repositioning exercises, vestibular retraining programs and lifestyle modifications such as dietary changes and elimination of alcohol, nicotine, caffeine, and/or sodium.
Vertigo
Vertigo is a form of dizziness characterized by the feeling that you or your environment is moving or spinning, despite the lack of any actual movement. This sensation is brought on by disturbances in the inner ear or the brain.
Types of Vertigo
Peripheral vertigo is associated with problems in the inner ear. The vestibular system sends signals to the brain about the position of the head in relation to movement, enabling us to keep our balance and maintain equilibrium. When these signals are disrupted, vertigo results. This can often be caused by inflammation related to a viral infection and is commonly associated with two conditions: labyrinthitis (inflammation of the inner ear and vestibular nerve), and vestibular neuronitis (inflammation of the vestibular nerve). Other causes of peripheral vertigo include benign paroxysmal positional vertigo (BPPV), which occurs when tiny pieces of calcium break off and float in the tube of the inner ear, sending confusing messages to the brain, and Meniere’s disease, which involves excess fluid in the inner ear.
Central vertigo occurs when there is a problem in the brain, usually affecting the brainstem or the cerebellum. These parts of the brain are responsible for interactions between the visual and balance systems; any disturbance can lead to vertigo. The most common cause of central vertigo is a migraine headache. Other less common conditions that can trigger central vertigo include stroke, tumors, acoustic neuroma, multiple sclerosis, alcohol and certain drugs.
Symptoms & Treatment
Technically speaking, vertigo is a symptom itself and not a diagnosis. It’s characterized by the sensation that you or the room is moving or spinning. This may be accompanied by additional symptoms such as nausea, vomiting, hearing loss, tinnitus, difficulty focusing or moving the eyes, double vision and a feeling of fullness in the ear. If you’re suffering from vertigo, your doctor will give you a thorough physical examination and may order a CT scan or MRI.
Treatment varies depending on the type and severity of vertigo. Some forms disappear without treatment. The most common type, BPPV, responds well to head maneuvers, while other types are successfully treated with medication. When the condition persists, physical therapy can help.
Call Comprehensive ENT at (804) 228-4480 for more information or to schedule an appointment.