How Balance Works
The main function of the balance or vestibular portion of the inner ear is to detect head motions and transmit this information to the brain via balance (vestibular) nerve. Both the right and left inner ears work in tandem to provide the brain the proper information regarding your motion and position. Dizziness can occur if one or both inner ears start sending inaccurate signals to the brain. This can occur as a result of numerous inner ear conditions such as labyrinthitis (inner ear inflammation) and Meniere’s disease (inner ear fluid imbalance).
What is Dizziness?
Dizziness is a condition in which the patient’s ability to orient him or herself in space is altered. This condition can lead to symptoms of vertigo (spinning or abnormal sense of motion), imbalance, or sense of lightheadedness. This can occur as a result of inner ear, brain or a combination of these and other disorders.
Symptoms Associated with Vestibular Disease
Most patients with vestibular disorders will have several or all of the following symptoms: vertigo (dizziness characterized by an abnormal sense of motion such as spinning), imbalance, or sense of lightheadedness. There can also be hearing loss on one or both sides and tinnitus (ringing, buzzing, or other abnormal internal sound sensations). The symptoms may occur only for a short time or the symptoms may be chronic, depending on the particular condition present. In some cases, the symptoms resolve but recur in the future. Symptoms can also be triggered by various factors. Examples of possible triggers include: stress, allergy attacks, dietary changes, hormonal changes, sleep disturbances, certain visual or motion stimuli, and weather changes.
What is the Evaluation Process?
Patients with dizziness with or without hearing loss undergo a full ear, nose and throat evaluation. In addition, they may be given a hearing test to produce an audiogram, a balance (vestibular) test such as an ENG or VEMP or image test such as a MRI or CT scan. Based on the medical evaluation, the treatment options for the dizziness and hearing loss will be presented to you.
Peripheral (Inner Ear) Disorders
Peripheral disorders are typically caused by a problem that occurs in the inner ear. A very common condition is acute inflammations (labyrinthitis or vestibular neuronitis) that may be due to a virus such as the common cold. The condition typically resolves over time without treatment, but various medical treatments may be helpful to alleviate the symptoms.
Benign paroxysmal positional vertigo is caused by loose particles floating in your balance (semicircular) canal in the inner ear. This condition typically resolves over time but can be treated with an office procedure called the particle (or canalith) repositioning maneuver.
Meniere’s disease is caused by a fluid imbalance in the inner ear. This condition can cause vertigo (spinning sensation), hearing loss, tinnitus (abnormal sounds in the ear), and fullness in the ear. The symptoms can be recurrent thoughout the patient’s lifetime. Fortunately, there are various medical and surgical treatments available for this condition.
Superior semicircular canal dehiscence syndrome is due to the presence of an abnormal opening in one of the balance canals. This condition can cause many symptoms including dizziness and hearing loss. There is a surgical treatment for this condition in which the abnormal opening can be closed. However, most patients with this condition do not need surgical treatment.
Central (Brain) Disorders
Acoustic neuromas can cause both dizziness and hearing loss. There are various treatment options available for this condition as explained on the acoustic neuroma web page.
Migraine vestibulopathy is a common cause of dizziness. It is thought to be due to a chemical disorder that is related to migraine headaches. However, not all patients with migraine vestibulopathy have migraine headaches. This condition is typically treated with a daily medication that controls the various symptoms.
Other Vestibular Disorders
There are many other vestibular disorders that are too numerous to show. If you have dizziness, you should see a physician such as an otolaryngologist so that a proper diagnosis and treatment plan can be formulated for you.