Understanding Your Dizziness

The sensation of dizziness is due to a disturbance in nervous signals in either the
inner ears, eyes, leg joints, feet and brain.

Patients have a primary cause of their dizziness and a secondary response to their
dizziness.

The Primary Cause.

The primary cause generates a sensation “dizziness” (either a spinning sensation
“vertigo” or an imbalance “unsteadiness” sensation).

Examples of specific primary causes are as follows: –

Inner ear
Benign Paroxysmal Positional Vertigo (BPPV) – “Crystals in the inner ear”
Ménière’s Disease
Vestibular Paroxysmia
Vestibular Neuritis
Superior Canal Dehiscence
Middle Ear Perilymph Fistula
Bilateral Vestibulopathy
Herpes Zoster Oticus (HZO) and Ramsey Hunt Syndrome

Brain
Central Positional Vertigo
Vestibular Migraine
Chiari Malformation in Adults
Motion Sickness and Persistent Dizziness

Spinal Cord and Leg nerves
Peripheral neuropathy

Eyes
Poorly fitted glasses
binocular vision dysfunction

The primary cause once identified can be effectively treated.

The Secondary Response.

The brain is not passive; it tries to handle the new troubling situation by using the
frontal lobes of the brain to suppress the disturbances created by primary cause.
This secondary response initially stabilises the situation but often, paradoxically,
leads to further imbalance symptoms which are typically a continuous rocking
sensation and brain exhaustion. In many patients this can become the dominant
problem.

This secondary response it is called Persistent Postural-Perceptual Dizziness
(PPPD) and once recognised can be treated effectively.

The Diagnostic Challenge
The patient’s symptoms are often a mixture of the symptoms of the primary cause
and the secondary response. These need to be untangled so as to get a clear
understanding of the initial cause and the extent of the secondary response.

 

 

Possible Causes of Dizziness

 

Benign Paroxysmal Positional Vertigo (BPPV) – “Crystals in the inner ear”

This is a very common cause of dizziness.

The typical experience is a sudden sensation of spinning, either when turning over in bed, bending over or looking up.

 

Read More

 

 

 

 

Ménière’s Disease

Ménière’s disease (pronounced “many-ears”) is rare problem of the inner ear.

It is a repeating problem of the inner ear in which there is a build-up of fluid in the membranes of the inner ear giving a feeling of pressure or fullness in the ears. These membranes then suddenly burst making you feel very dizzy.  

 

Read More

 

 

 

 

What is Central Positional Vertigo and What Causes it? 

A simplistic way of thinking about this condition is to regard it as a “dangerous and abnormal benign positional paroxysmal vertigo (BPPV)” because it can be caused by disease in the brainstem or cerebellum.

 

Read More

 

 

 

 

Persistent Postural-Perceptual Dizziness (PPPD)

This is an important common cause of “dizziness” with three key features:

i)A long-standing complaint** of non-spinning “dizziness” on most days.

ii)Associated with anxiety and low mood.

iii)Normal clinical examination.

 

 

Read More

 

 

 

 

Vestibular Migraine

Dizziness due to migraine/ vestibular migraine is quite common. The diagnosis is based on the patient’s story as there are no clinical findings except when the patient is having an attack and there is no blood test or scan that can make the diagnosis

 

Read More

 

 

 

 

Vestibular Paroxysmia 

VP is a rare condition in which an artery presses against a nerve of the inner ear – either on the right or left side. 

 

Read More

 

 

 

 

Vestibular Neuritis

This is a common cause of severe prolonged dizziness due to injury of the inner ear. 

 

Read More

 

 

 

 

Superior Canal Dehiscence

This is a rare condition and is one of a group of diseases caused by a “third mobile window”. It is due to an abnormal connection between the inner ear and the brain cavity.

 

 

Read More

 

 

 

 

 

Middle Ear Perilymph Fistula

This is a rare condition in which there is a tear between the middle and inner ear. Let us explain further. 

 

 

Read More

 

 

 

 

Advice and Medication

Advice and Medication for Acute Vertigo and Nausea for all conditions other than BPPV.

 

 

Read More

 

 

 

 

Chiari Malformation in Adults

 

The fundamental cause of this condition is that the cerebellum is too big for the posterior fossa and is pushed down through the foramen magnum.

 

 

Read More

 

 

 

 

 

Bilateral Vestibulopathy

Bilateral vestibulopathy (syn. bilateral vestibular areflexia) is a consequence of significant injury to the balance portions of both inner ears.

 

 

Read More

 

 

 

 

Herpes Zoster Oticus (HZO) and Ramsey Hunt Syndrome

These conditions are two forms of the same disease process where Ramsey Hunt Syndrome is Herpes Zoster Oticus with a facial nerve weakness.

 

 

Read More

 

 

 

 

Motion Sickness and Persistent Dizziness 

Motion sickness, often called sea sickness, occurs when your brain receives conflicting signals from your eyes, inner ears, skin and joints about your state of motion. 

 

 

 

Read More

 

 

 

 

The First Attack of Vertigo – Is it a Stroke or is it Inner Ear Disease? 

If a first episode of vertigo occurs without any pre existing history of dizziness both the patient and clinician are concerned whether this represents a Transient Ischaemic Attack (TIA/ Mini Stroke) which may herald a more serious stroke with its devastating consequences. 

 

 

 

Read More

 

 

 

 

 

 

 

 

×

Make an appointment and we’ll contact you.