TARRYTOWN, N.Y. -- Dizziness is a common problem experienced by most people at some point during their lifetime.
Even though the sensation of dizziness is quite common, it can be associated with many different disorders, and determining the cause of dizzy symptoms can be complicated and often frustrating for the patient.
The sensation of dizziness can arise from problems in the vestibular system (in the inner ear), sensory abilities in the feet and spine, or vision, or when the brain is unable to correctly interpret the information it receives from the ear, sensory system or vision.
Different disorders of the inner ear can cause dizziness. The most common one is benign paroxysmal positional vertigo, or BPPV. This disorder occurs when small crystals called otoconia become displaced from their normal location in the inner ear.
Individuals with BPPV have episodes of intense spinning vertigo, often accompanied by nausea and vomiting, that lasts for a number of seconds and occurs whenever the patient moves a certain way.
BPPV most often resolves on its own in a few weeks. However, it can be treated more quickly using positioning maneuvers performed by a physician or occupational or physical therapist.
Labyrinthitis is an infection or inflammation of the inner ear that leads to severe spinning vertigo lasting from a few hours to a few days. This condition is accompanied by hearing loss in one ear that is often permanent.
Vestibular neuritis, which is similar to labyrinthitis, is related to infection or inflammation of the balance (vestibular) nerve. Initial treatment for both of these conditions may include steroids and/or short-term medications to reduce the sensation of vertigo.
Two common causes of dizziness unrelated to the inner ear are anxiety and vestibular migraine, which may involve dizziness without a headache. With both, symptoms can vary considerably in terms of severity, duration and character of the dizziness.
Comprehensive evaluation and management of a patient with dizziness often include visiting a physician who specializes in balance disorders, a hearing evaluation, balance function testing and vestibular therapy.
Many patients have improvement or resolution of their symptoms with a combination of vestibular therapy and medical management. Surgery is rarely recommended, but when necessary typically leads to significant relief of symptoms.
Cameron Budenz, MD, is Medical Director of the Balance Center at Phelps. She is also an assistant professor in the department of otolaryngology at New York Medical College and has served as an instructor for courses attended by surgeons from around the world.