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 is the top reason for a visit to the doctor’s office.
What Are the Causes of Dizziness?
Dizziness is the result of your brain receiving false signals from the balance system (comprised of the inner ear, eyes and sensory nerves).
There are many possible causes of dizziness that are not part of the balance system 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. The cause of Meniere’s disease is unknown, but 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.
What Other Symptoms Are Associated with Dizziness?
Patients who experience dizziness report a variety of symptoms depending on the exact nature of their balance disorder. These include:
- Vertigo (the sensation of movement in your surroundings).
- Blurred vision.
Diagnostic Tests for the Vestibular System
The vestibular system is complex and responsible for many of the body’s functions. In order to narrow down the exact cause of dizziness, it is necessary to administer a variety of tests. These measure eye movements, head movements, hearing, function, stability, vestibular and more.
Studies indicate vestibular testing is extremely thorough and accurate in identifying inner ear disorders. Vestibular testing is also helpful in determining whether additional diagnostic testing, such as an MRI, is needed. A battery of tests is administered in most cases. The most common ones include:
- Acoustic Immittance Measures. These tests evaluate the eardrum and middle ear.
- Audiometry. This hearing exam measures your ability to hear different sounds, pitches, and frequencies. It can determine the nature and extent of your hearing loss. It can also help determine what further testing is needed.
- Electrocochleography. This test is used to determine whether there is excess fluid in the inner ear by measuring the electrical currents generated by sound stimulation, and can help with the diagnosis of Meniere’s disease and other balance and hearing disorders.
- VHIT. This is a new test that uses video goggles to measure ear specific disorders of the vestibulo ocular reflex.
- cVEMP & oVEMP. These tests measure the saccula and utricle through neck and eye muscles. This test can screen for Superior Canal Dehiscence.
- Videonystagmography (VNG). This is similar to ENG testing, but an infrared video camera attached to a pair of goggles is used in place of electrodes. VNG is used to record eye movements in multiple different sub-tests.
- Computerized Dynamic Posturography (CDP). CDP tests measure how well the visual, vestibular and sensory systems work together to maintain balance. It includes an Adaptation Test in which the platform moves up and down and a Motor Control Test where the platform moves forward and backward. These are used to measure reflexive responses to unexpected movement. This test uses a platform to measure body sway and it can compare balance to same aged peers.
These tests may be combined with additional hearing or diagnostic tests depending on the results.
How Is Dizziness Treated?
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 and nicotine.
Call Southwest Idaho ENT at (208) 367-3320 for more information or to schedule an appointment.