Vertigo and Balance Disorders

Vertigo is a feeling of the environment moving while you are stationary. It can be described as feeling as if the room is spinning while you are sitting, standing or laying still. Some estimates place the number of adults that experience vertigo as high as 40 percent.

Sometimes vertigo is accompanied by other symptoms such as tinnitus, hearing loss, anxiety, nausea or a feeling of fullness in one or more ears.

Since balance begins in the ears, the ENT is the doctor you should see for treatment of vertigo, dizziness and balance disorders.

Vertigo as a symptom

Vertigo and problems with balance are symptoms of other disorders. These include such disorders as:

• Problems with the inner ear
• High blood pressure
• Anemia
• Central nervous system problems
• Viral or bacterial infection

Diagnosing the problem

The ENT will begin with a complete medical history. Be sure to let the ENT know any medications you have been taking prior to the onset of the symptoms. A physical examination will also be part of the diagnosis. The ENT will check your ears for any signs of infection or abnormalities. The ENT may also request certain tests to help in the diagnosis. This can include electronystagmogram (ENG) and videonystagmogram (VNG) as well as the more familiar CT and MRI scans. The ENT may also ask for an audiological exam to determine if you have experienced any hearing loss.

• ENG. The ears send signals to the brain regarding your position; the eyes send signals as well. If the eyes and ears are coordinated properly you are balanced. ENTs use a test of the involuntary eye movements associated with the balance system to test for problems with the inner ear. As part of this test checking side-to-side eye movements and the ability of your eyes to follow moving targets will test your balance system. You will also be moved into different positions to test for motion-induced dizziness. Finally, your ear canals will be tested with cold and warm air or water while checking the involuntary eye movements. While these tests are being performed, you will have electrodes connected to your face to measure the movements of your eyes.
• VNG. This is a newer test than the ENG. Instead of using electrodes around the eyes, this test uses infrared cameras to directly measure the movements of the eyes. You will still perform that same tests for ocular mobility and nystagmus, it is just the method of measurement that is different.

Treating vertigo and balance disorders

Once the ENT has determined the cause of the vertigo they can begin a course of treatment. Depending on the underlying cause, treatment can range from changes in diet, medication or therapy such as Epley maneuvers.