Causes of Dizziness

Dizziness or loss of balance is the second most common complaint heard in doctor’s offices. The National Institute of Health statistics indicate that dizziness will occur in 70% of the nation’s population at sometime in their lives. Although very common, acute or chronic problems with equilibrium may indicate serious health risks and limit a person’s everyday living.

The first step to getting better is the proper diagnosis. According to the National Institute of Health, 85% of all equilibrium problems can be directly related to an inner ear disorder. The following sections discuss the various inner ear disorders that cause dizziness.

Benign Paroxysmal Positional Vertigo is one of the most common types of peripheral vertigo. This disorder can be seen following head injury, vestibular neuronitis, stapes surgery, Meniere’s disease or can present alone. The disorder is related to an abnormality in the association of the otoconia to the cupula within the membranous labyrinth resulting in abnormal responses to endolymphatic movement with head motion. Symptoms are typically associated therefore, with head movement such as rolling over or getting in or out of bed. the associated vertigo is brief, lasting only seconds in duration and can be seen as an acute form only, or in an intermittent or chronic form. (Please refer to Graphic #1)

Degeneration of the salt-like crystals (otoliths) in the utricle which break free and float into or attach themselves to the semicircular canals. Symptoms include: attacks of vertigo with rapid and pitched head motion (e.g. rolling in or out of bed or simply looking up).

Treatment options include:

1. Canalith Repositioning
2. Semont Liberatory Maneuver
3. Gans Repositioning

Vestibular Neuronitis
Vestibular Neuronitis presents as a sudden episode of vertigo without hearing loss in an otherwise healthy person. The disorder can occur as a single attack or can present as multiple attacks. It occurs more often in spring and early summer and as a result, is often associated with an upper respiratory infection developing two to three weeks afterward. The onset of vertigo is sudden and typically associated with nausea and vomiting and can last for a period of days with gradual improvement over the following weeks. The disorder is often followed by episodes of benign positional vertigo.                 (Please refer to Graphic #2)

A change or reduction in the output of one or both of the balance portions of the inner ear (vestibular system). Causes of Vestibulopathy may be infection, illness, trauma or simply the natural aging process. Symptoms may include positional vertigo, a sense of motion with rapid head movement or visually provoked motion intolerance.

Graphic #2

Treatment options include:

1. Vestibular Rehabilitation
2. Medication

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