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Vertigo (Dizziness)
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Almost everyone has experienced dizziness at some point in their life. Dizziness may be nothing more than a brief lightheaded feeling when you stand up too fast, a loss of balance when trying to walk, or a disabling spinning sensation that can lead to severe nausea and vomiting. Whichever it is, it may be a sign of an underlying inner ear or other condition, and you should consider seeking medical attention.

Many patients will start with their primary care provider or go to the emergency room, where they will usually be given a pill to help control their dizziness.  This is not treating the problem; this is merely covering up or masking the symptoms, and in some cases the medication may actually make the problem worse.  Whatever was causing the dizziness is still there and will usually come back.  It is better to see an ENT or ear specialist like Dr. Paul Shea at the Shea Clinic, who will help determine the specific cause of and best treatment for your dizziness. 

“Dizziness” is a broad or nonspecific term.  It can mean a number of different things.  In order to treat the problem appropriately, it is necessary to make the correct diagnosis about exactly what is causing your dizziness.  The experts at the Shea Clinic have many years of experience as well as the knowledge, training, and testing facilities to pinpoint the nature and cause of your dizziness and recommend the best course of treatment. 

Types of Dizziness

  1. Lightheadedness.  This is what happens when you stand up too fast.  You feel a lightheaded sensation for a few seconds.  It usually passes within a short time, but if it does not, you could faint or fall out.  Common in older patients, dehydration and poor circulation to the brain may contribute to this type of dizziness.  Lightheadedness is not an inner ear problem in most cases.  
  2. Disequilibrium.  Your balance is off.  When you try to walk, you may weave or bump into walls.  In some cases, you may not be able to walk at all and may fall without assistance.  It is worse in a dark environment.  Many things can contribute to disequilibrium. It may be a sign of an inner ear problem and it is also common in older patients.  Medications can also cause or exacerbate this type of dizziness.  
  3. Vertigo.  This is a feeling of motion, which may be spinning, whirling, rocking, floating, or a feeling of falling.  It can range from mild to severe and can lead to nausea and vomiting.  Vertigo can affect patients of any age, though it is more common in older patients.  It may be triggered by motion or may be spontaneous, and is usually, though not always, a sign of an inner ear problem. 

It is possible to have more than one type of dizziness at a time and the symptoms may overlap to some degree, but it is very important for the physician to determine which type a patient is having in order to make the correct diagnosis and recommend the best course of treatment.  Dr. Paul Shea at the Shea Clinic has many years of experience in diagnosing and treating all types of dizziness and balance problems.

Inner Ear Causes of Vertigo

Vertigo may originate from the inner ear or from the central nervous system (vestibular migraine).  There are three disorders of the inner ear which can lead to true vertigo:

  1. Meniere’s Disease.  Caused by a buildup of pressure within the inner ear, the symptoms are (a) dizziness and vertigo (b) fullness, pressure, discomfort, or sensitivity in the ear (c) noise or ringing in the ear (d) hearing loss.  The diagnosis is made based on history and test results.  Treatment involves a low-salt diet, diuretics (water pills), steroids, medications to control the vertigo attacks, and procedures such as intratympanic perfusion.  
  2. Benign Positional Vertigo, aka “BPPV”.  Caused by tiny floating particles in the inner ear, this common problem is triggered by movement or change in position and is common in older patients.  Lack of exercise and sedentary lifestyle are contributing factors.  Medication is usually not helpful, and treatment consists of repositioning maneuvers, i.e. the Epley maneuver, balance exercises, daily walking, a more active lifestyle, and sometimes physical therapy.  
  3. Labyrinthitis/Vestibular Neuronitis.  This is a viral infection or inflammation of the inner ear and/or balance nerve between the inner ear and brain.  It generally resolves within a few weeks and treatment consists of steroids and medication to suppress vertigo and nausea in the acute phase.  

Vestibular Migraine

Common in younger females, migraines can come in different forms.  Considered a migraine variant, vestibular migraine is a condition in which dizziness may be a prominent, or in some cases the only symptom of the migraine disorder.  Most patients with vestibular migraine have a history of typical migraine headaches, which may or may not accompany the dizziness.  Not an inner ear condition though often confused with one, vestibular migraine is diagnosed based on history and by ruling out other causes.  Treatment consists of migraine-preventing medications which are taken daily.

Treatment Options for Dizziness and Vertigo

Treatment options for dizziness and vertigo depend entirely on the underlying cause, which could be an inner ear disorder, central nervous system condition, head trauma, medications, cerebrovascular disease, lack of central compensation, or other causes.  A thorough workup, physical exam, and tests by an ear specialist like Dr. Paul Shea at the Shea Clinic are usually needed to precisely pinpoint the cause of your dizziness or balance problem.

At the Shea Clinic, our physicians specialize in making the correct diagnosis for your dizziness, vertigo, or balance disorder and will recommend the best course of treatment for you or your family member. Treatments are tailored to the individual and may include medications, repositioning maneuvers, dietary or lifestyle changes, physical therapy, and procedures such as intratympanic perfusion.

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