The feeling of spinning (called Vertigo or dizziness) is a neurological condition that makes the patient unable to control their balance in a normal manner. Symptoms are caused by the rotation upsetting the equilibrium of the balance of the body and which has many causes.
Loss of balance can be divided into two major categories:
- The loss of balance may be related to the inner ear balance system, which includes diseases of the ear, such as otitis, disease of the inner ear, which affects the balance organ in the inner ear, or exposure to toxic or harmful drugs, and even a tumor in the nervous system, which may spread to the brain.
- The loss of balance may be related to the central nervous system, including brain tumors and nerves supplying the brain, the balance center is affected by a lack of blood to the brain stem, and it can be caused from concussion of the brain stem, or a head injury.
Common cause of dizziness:
- Otitis Media is infection through bacteria that may spread to the inner ear (Toxic Labyrinthitis).
- Disorders of the middle ear due to the common cold (Eustachian Tube Dysfunction). A cold can cause the bacteria to spread to the middle ear or may produce swelling of the Eustachian duct.
- Certain drugs or toxic substances can affect the nerve (Toxic Labyrinthitis). These can include antibiotics. These drugs may be toxic to the nervous balance system and the hearing nerve in the inner ear and may lead to destruction of nerve endings which may impair hearing.
- Head Injury can cause skull fracture through the balance organ in the inner ear or bleeding in the inner ear or bleeding in the brain. In addition, severe coughing or sneezing can cause perforation of the ear drum, causing harm to the nerve endings in the inner ear and can cause numbness, as well as loss of balance.
Diseases that cause dizziness and tinnitus
- Meniere ‘s disease is a disorder of the inner ear where the causes are not fully understood. The causes may be due to water in the inner ear or allergic conditions of the inner ear.
- Dizziness while changing posture (Positional Vertigo) generally comes from small concretions moving in the semi-circular canals in the inner ear or may be defects in blood flow to the inner ear and brain. In the case of ischemic causes (Vertebrobasilar Arterial Insufficiency) the treatment will be different from Positional Vertigo.
- Neuro-degeneration and balance perception (CNS Degenerative Change).
- Inflammation of nerves (Vestibular neuronitis) but this will not cause loss of hearing.
- Tumors of the nervous system (Vestibular schwannoma).
- Disorders of the brain and central nervous system from other causes, such as diabetes, blood pressure, obesity, infectious diseases, kidney disease, heart and thyroid disorders.
Diagnosis for treatments following to the causes of disease
- History of dizziness.
Getting accurate information about the history of symptoms is important and must not be neglected. The diagnosis may be made from 90 percent history. The history should include whether the patient had a history of ear disease or not, check if they have had concussion or is taking any drugs or medication, checking for symptoms such as dizziness, numbness, staggering or falling.
- Physical examination.
While checking the history, observing the patient’s walking is also important. Poor blood circulation is often seen in the elderly. Physical examination should cover the ear, nose, and other body systems which may be the cause of dizziness.
- Special hearing (Bekesy). Walking, posture and balance (Posturography).
- Checking the nerves of the inner ear with Positioning testing.
- Abnormal movements of the eyes with VNG testing.
- The function of the brain stem with Brainstem Electrical Response Audiometer (BERA).
Please ask for more details at the Hearing, Speech, Balance and Tinnitus Center