Dizziness and vertigo (neurotology)

Dizziness and vertigo are defined as spatial disorders accompanied by swaying, staggering, or spinning sensations, by nausea or a dazed feeling, and even by blackouts. Dizziness is both very common and an unpleasant sensation. It also is not a diagnosis, but a symptom whose cause may lie in a large number of quite varied conditions.

Causes

Quite specific answers need to be provided by patients to properly diagnose their condition.

If dizziness is systematic (rotary vertigo) , then key causes lie in disturbances to the balance organ of the inner ear (peripheral vertigo) or disturbance to the central nervous system and brain (central vertigo). Unsystematic dizziness can have many causes, though the most common are circulatory problems and the side-effects of medications.

To establish the causes, an examination by a patient's family doctor, by an ear, nose and throat specialist, and by a neurologist is usually necessary.

Diagnostic methods

The specialist will not only conduct a detailed interview with the patient but will also carry out thorough neurotological examinations. The goal is to establish whether the dizziness is the result of damage to the balance organ in the ear or to the balance nerve, or whether its cause lies in a brain disease.

A complete diagnosis can include using tests for the vestibular organ (caloric testing, videonystagmography), hearing and blood tests, and at times, imaging techniques, which can include MRI scans of the petrosal bone (in the inner ear) and of the brain.

Common diagnoses

The most common disturbance to the balance organ in the inner ear or to the vestibular nerve is technically known as benign paroxysmal positional vertigo. Vestibular neuronitis, which affects the balance nerve, is less common, and the condition called Ménière's disease is quite rare.

Treatment possibilities

Therapeutic measures that can be taken are as varied as the causes of dizziness or vertigo itself. They can include medications, postural or position exercises, physiotherapy, and on rare occasions, surgery. However, if dizziness or vertigo persists or is particularly pronounced, it should not be ignored and medical help sought.