Dizziness

Problems affecting the equilibrium system often present with issues related to dizziness and imbalance. The term dizziness can mean many things. Patients often describe symptoms including, lightheadedness, blurred vision, a feeling of faintness, spinning (vertigo), weakness, and general unsteadiness. Those individuals with imbalance often express a history or fear of falls. This imbalance is often made worse when walking in the dark or on uneven surfaces. Interestingly, this list is not comprehensive and patients with equilibrium disorders can experience a wide variety of less common symptoms.

Common Conditions

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is the most common cause of vertigo. In fact, this condition will affect approximately 50% of those persons over 70 years of age at least once. BPPV is caused by small calcium carbonate particles (otoconia), which are normally found in the inner ear. These particles can become displaced and migrate into one of the ear’s semi-circular canals, where they do not belong. This condition is characterized by brief and intense episodes of vertigo that occur with a change in position. BPPV may be the result of the natural aging process, illness, a change in medication, or head trauma. BPPV is often idiopathic (no known cause can be identified).

Vestibular Neuronitis/Neuritis

Vestibular neuronitis is the second leading cause of vertigo. This condition is typically characterized by a rapid-onset vertigo that is not accompanied by hearing loss. Patients may experience an intense spinning sensation with nausea and vomiting. These intense symptoms typically improve over the course of several days, with gradual improvement over the next few months. Vestibular neoronitis can occur as a single or in multiple attacks. This condition is related to inflammation of the inner ear and may be related to a viral infection.

Migraine

When many individuals think of migraine, headache immediately comes to mind. It is important for patients to understand that migraines can present with a number of different symptoms. One of these symptoms is related to the perception of dizziness or vertigo. Interestingly, research has shown us that as many as 25-30% of migraineurs experience vertigo as an aura. Many of those with vestibular migraines do not experience headaches at the same time as their dizziness.

Loss of balance and unsteadiness

Issues affecting the equilibrium system of the inner ear can result in a feeling of unsteadiness, a loss of balance, and/or falls. We use three primary systems to maintain our balance (vision, touch, inner ear) and a disruption to any of these systems can result in imbalance. It is important for individuals who are off balance to be appropriately evaluated so the contribution of each system can be closely observed.