Balance Center FAQs
What are dizziness, vertigo, and imbalance?
The terms dizziness, vertigo and imbalance are basically descriptions of symptoms that an individual may have that are affecting his or her normal ability to stay balanced. These symptoms can include a lightheaded sensation, spinning and difficulty walking without falling. They may be continuous or may come and go. Many different ailments can cause dizziness, vertigo and imbalance. Balance testing can help determine what the cause of the symptoms may be and how to best treat them.
What are some possible causes of severe dizziness, vertigo or imbalance problems?
There are many possible causes for these types of symptoms. Some of the more serious causes include:
- Meniere's Disease
- Benign Paroxysmal Positional Vertigo (BPPV) (see more below)
- Aging of Balance System
- Vertigo of Central (brain) Origin
- Migrainous Dizziness
- Vestibular Neuritis
- Vestibular Schwannoma
- Motor or Visual Disturbances
What is Benign Paroxysmal Positional Vertigo?
Benign paroxysmal positional vertigo, also known as positional vertigo, benign positional vertigo, canalithiasis, cupulolithiasis and BPPV is the most common cause of peripheral vertigo. It is characterized by brief spinning vertigo lasting several seconds to a few minutes usually occurring with turning of the head, tilting the head back or leaning forward. Individuals with BPPV often complain of symptoms with rolling over in bed, getting in or out of bed as well as symptoms throughout the day with head movement. Turning to the affected side will make symptoms worse. In addition to the spinning sensation with head turning, some patients will have dizziness, or lightheaded sensation throughout the day, nausea and rarely vomiting, and sensation of imbalance. Often the symptoms will resolve with in a few days. However, many patients have symptoms that if left untreated will last for weeks to months.
BPPV is caused by free floating crystals (otoliths) in the balance canals. Otoliths are tiny calcium carbonate crystals that normally are positioned in another part of the inner ear known as the utricle. When they get displaced into a balance canal, symptoms of BPPV occur. The problem occurs in older children and adults of any age, but there is an increased incidence with age. There is an increased frequency of BPPV after head trauma. In addition, individuals with other diagnoses affecting dizziness and balance can have benign positional vertigo including; meniere's disease, vestibular neuritis, and migrainous dizziness.
BPPV can be diagnosed by examination by a physician who specializes in diagnoses of the inner ear (neurotology). Sometimes, specialized testing using VNG/ENG equipment is needed to confirm the diagnosis of BPPV.
Relief from persistent symptoms for most patients can be achieved by treatment in the office using an Epley Maneuver, also known as canalith repositioning maneuver. This treatment can be performed by a Balance Therapist or by a physician. Some patients with persistent dizziness and balance symptoms may require longer term Vestibular and Balance Therapy to resolve all of their symptoms. Rarely surgery may be required to treat BPPV.