Dizziness & Imbalance
Dizziness and vertigo are the most common symptoms that will prompt a person to seek medical care (as common as back pain and headaches). The more specific you can be with your physician and your audiologist about the symptoms you are experiencing, the better we will be able to pinpoint the cause of your dizziness or imbalance and get you on the road to feeling and functioning better. Falling can be a direct consequence of dizziness, and we certainly want to help prevent that.
The inner ear is very involved in your balance, or your perception of where you are in space. Disturbances of the inner ear and the balance centers of the brain can cause vertigo and imbalance, and this is why your physician may refer you to us to evaluate your vestibular system (the part of the inner ear which helps to control your balance).
The evaluation includes a hearing test and videonystagmography, or VNG for short. Because certain medications can interfere with the test results, you will be asked to cooperate with restricting those medications for 48 hours prior to testing.
Click Here if you would like to learn more about how the inner ear is involved with balance and what types of problems can occur to cause dizziness / imbalance.
The following information is for those of you who would like to learn more about how the inner ear is involved with balance and what types of problems can occur to cause dizziness/imbalance:
The inner ear has two parts that help the body determine its position in space relative to gravity; 1) the semicircular canals and 2) the vestibule.
There are three semicircular canals that are aligned at right angles to each other. These canals are filled with fluid and are lined with a nerve-filled, crystal-encrusted membrane that transmits information to the cerebellum (the part of the brain that controls balance and coordination). The cerebellum collects information from the eyes (visual stimuli) and the nerve endings in muscles associated with proprioception (the perception of movement), to assist the brain in assessing where the body is in relationship to gravity every time one part of it moves.
Normally, when the head moves, fluid in the semicircular canals shifts, and that information is relayed to the brain. When the head stops moving, the fluid stops as well, and that information is relayed to the brain.
In some cases there may be a short delay in the transmission of this information to the brain. For example, when a person rides on a merry-go-round or spins quickly around in circles, the fluid in the canals develops momentum and though the body stops spinning, the fluid in the semicircular canals may continue to move. This causes vertigo, or a sensation of spinning, and may cause the person to fall or stumble. It also may be associated with nausea and/or vomiting. While kids try to provoke these symptoms in play, they can be debilitating for an adult.
These are some of the problems that can occur in the inner ear and create dizziness/imbalance:
• Inflammation: In patients with vertigo, inflammation of the fluid or irritation of the crystals on the membrane that lines the walls of the semicircular canals may cause the spinning sensation even without much head movement. Often, only one canal is involved and the patient may be symptom-free if they don't move.
• Benign paroxysmal positional vertigo (BPPV): Symptoms of BPPV include dizziness or vertigo, lightheadedness, imbalance, and nausea. BPPV occurs because of changes in the vestibular system of the inner ear. With BPPV, calcium carbonate crystals (which the ear uses as a gravity and movement sensor) can move from the utricle of the vestibular system into one or more of the semicircular canals. Moving the head in certain directions may cause these crystals to move through the fluid in the canals, causing hair like sensors to send information to the brain triggering the symptoms of BPPV. Activities which bring on symptoms will vary in each person, but symptoms are almost always precipitated by a position change of the head with respect to gravity. Getting in/out of bed, rolling over in bed, tilting the head back to look up, bending over, or making quick head movements are common “problem” motions. Although it may occur at any age, by age 70, approximately 50% of all individuals will have experienced BPPV.