Balance and Dizziness
Good balance is dependent on nerve signals from healthy inner ears, eyes, legs being organized by the brain.
Dizziness is the disturbing sensation when balance goes wrong and can be due to abnormalities of inner ears, eyes, leg sensation or brain.
With over 20 years practice in the field of ENT, specialising in the treatment of dizziness and balance problems in Central London, I can help to determine why you are feeling dizzy and offer the best possible treatment. For details of my specialist ENT clinics at The London Clinic at 5 Devonshire Place and The BUPA London Hospital, please click here, or contact me to schedule an appointment.
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.
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.
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.
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.
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
VP is a rare condition in which an artery presses against a nerve of the inner ear – either on the right or left side.
This is a common cause of severe prolonged dizziness due to injury of the inner ear.
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.
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.
Advice and Medication
Advice and Medication for Acute Vertigo and Nausea for all conditions other than BPPV.
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.
Bilateral vestibulopathy (syn. bilateral vestibular areflexia) is a consequence of significant injury to the balance portions of both inner ears.
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.
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.
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.