Dizziness and Vertigo

Dizziness and vertigo are common symptoms reported during office visits. They can result from an inner ear peripheral vestibular disorder or a central vestibular disorder involving the brain. It is important to differentiate the between them so as to make an accurate diagnosis and recommend appropriate treatment. Dizziness is a sensation of feeling faint, unsteady, or being lightheaded. Vertigo is more specific and refers to a frank spinning rotational perception of movement.

Vestibular dysfunction can be caused by head injury, aging, viral inflammation, autoimmune disease, loose crystals within the inner ear, etc. Below is a short list with appropriate description:

  1. Vestibular neuronitis – This is typically caused by a viral infection. There is inflammation of the inner ear sometimes also associated with hearing impairment. Patients can be severely ill for days with severe imbalance, nausea, and vomiting.
  2. Cholesteatoma – A skin tumor within the middle ear that can erode into the inner ear and temporal bone.
  3. Benign positional vertigo – Related to loose crystals (otoconia). This can occur following a head injury but sometimes occurs simply to aging and degeneration within the inner ear.
  4. Autoimmune disease – Diseases such as Cogan’s syndrome, lupus, rheumatoid arthritis, or Wegener’s granulomatosis can sometimes harm the inner ear due to an over aggressive immune system.
  5. Acoustic neuroma arising from the vestibular cochlear (hearing) nerve – Although this is benign in pathology, it can enlarge in size and lead to severe hearing impairment, dizziness, hydrocephalus, and brain compression.
  6. Meniere’s disease – This is a common, sometimes progressive condition. There is abnormality involving the pressure and composition of the inner ear fluid. Patients can have an aura with roaring tinnitus followed by severe vertigo, nausea, and vomiting. Milder forms as well can occur with ear pressure and fullness associated with lightheadedness. Middle ear space appears clear on evaluation. Disease is bilateral in 25% of patients.
  7. Otosclerosis – Involves improper bony growth within the middle ear that can lead to mixed or conductive hearing loss as well as dysfunction within the inner ear.
  8. Migraine and vertigo are fairly common – Patients will typically have an aura, sensitivity to light and sound, dizziness, and severe headaches. This condition is typically treated by a neurologist.

Non vestibular causes of dizziness include a cardiac condition (e.g., arrhythmia), aneurysm, aging with atherosclerosis and limited blood supply to the brain, dehydration, degenerative arthritis of the cervical spine interfering with blood supply to the brain, heart attack, hyperventilation, anxiety, stroke, medications, multiple sclerosis, orthostatic hypertension, brain tumor, etc.

Featured

Related Posts

Taming Tinnitus

Ringing, buzzing, roaring, crickets, hissing, static, pulsing, screeching, ocean waves, sizzling, cicadas, dial tones, whooshing……  Tinnitus can be described as many sounds. Many annoying sounds.   And for those afflicted with this unwelcome...

read more

Sudden Hearing Loss

The incidence of sudden sensorineural hearing loss is 1 per 5000 every year. This refers to nerve damage versus an ear infection with middle ear fluid. It is likely to strike adults in their 40s and 50s, although we have seen it in much younger and older individuals....

read more

Need Help?

Get In Touch

Follow Us

About the Authors

Kari Kingsley, MSN, CRNP

Kari works as an otolaryngology nurse practitioner in collaboration with Dr. Neeta Kohli-Dang. Together they share nearly forty years of ENT experience. They treat dizziness, ear infections, hearing loss, nasal congestion, sinus infections, thyroid nodules, tonsillitis, neck masses, hoarseness, trouble swallowing, and a multitude of other ear nose and throat conditions.

Neeta Kohli-Dang, M.D., F.R.C.S. (C)

Dr. Neeta Dang has had a successful and busy practice since 1987 with vast experience in the treatment of ear, nose and throat disorders, both pediatric and adult.

Related Posts

Taming Tinnitus

Taming Tinnitus

Ringing, buzzing, roaring, crickets, hissing, static, pulsing, screeching, ocean waves, sizzling, cicadas, dial tones, whooshing……  Tinnitus can be described as many sounds. Many annoying sounds.   And for those afflicted with this unwelcome...

Sudden Hearing Loss

Sudden Hearing Loss

The incidence of sudden sensorineural hearing loss is 1 per 5000 every year. This refers to nerve damage versus an ear infection with middle ear fluid. It is likely to strike adults in their 40s and 50s, although we have seen it in much younger and older individuals....

Dizziness and Benign Positional Vertigo

Dizziness and Benign Positional Vertigo

Benign positional vertigo refers to small displaced crystals of calcium carbonate which called otoconia, otoliths, or canaliths. These crystals are typically attached to the otolithic membrane within the utricle of the inner ear. Sometimes due to trauma or aging, the...