Dizziness: Lightheadedness, Imbalance or Vertigo?
Your ears do more than just help you to hear. The Vestibular System is also useful for maintaining balance. Part of the inner ear contains three semi-circular canals. These are full of fluid that react whenever you move your head. As the fluid shifts within the canals, small cilia (or hair-like protuberances from a cell) are activated and send messages to the brain. These messages tell your brain which direction the body is moving.
You know that feeling of dizziness after you have been spinning around? Well, the fluid in your inner ears was also spinning. That made the cilia move in all different directions and briefly confused your brain. When a person has a vestibular disorder, disruptions somewhere within the inner ear structures or along the nerve or brain pathways may occur. We offer many ear services, including these that help with dizziness, lightheadedness, and vertigo.
What Is the Difference?
Dizziness is often used to describe either lightheadedness, Imbalance or vertigo, so it is important to know the difference in symptoms to help narrow down the list of possible problems.
Vertigo is the illusion that you or your surroundings are moving (rotating, spinning, leaning, falling) without actual movement. Vertigo describes a symptom, but is not a final diagnosis. Severe vertigo can cause nausea or even lead to vomiting. You may physically lose your balance or even have trouble walking. Vertigo is not the same as motion sickness, though, as this feeling is not actually triggered by repeated motion. When patients present with vertigo, our goal is to determine if it is ear related or not.
Imbalance is a state of being off centered or loss of spatial awareness. It can be caused by your ears, headaches, neuropathies, muscle weakness among other things. It could be side-stepping, veering, or running into walls.
Lightheadedness is the sensation of almost fainting or passing out, but without the feeling that your surroundings are moving. It often disappears when you lie down. When lightheadedness gets worse, it can feel like almost fainting and may sometimes cause nausea to the point of vomiting. It is not uncommon for people to get a bit lightheaded, and it usually is not caused by an inner ear problem (i.e. it could be a momentary drop in blood pressure caused by getting up too quickly).
At Midwest ENT Centre, we work with patients who may be experiencing dizziness, imbalance or vertigo episodes. Depending on the patient’s symptoms, the doctor may request further assessment of the inner ear balance system, called the Vestibular System. An outpatient test that can be performed is Videonystagmography (VNG).
What Exactly Is VNG Testing All About?
VNG is composed of a series of tests used to determine the cause of a patient’s dizziness or balance problems, and whether or not it is due to inner ear disease. It is one of the only tests available today that can decipher between a unilateral (one ear) and bilateral (both ears) vestibular problem. If dizziness is not caused by the vestibular portion of the inner ear, it might be caused by the brain, by medical disorders such as low blood pressure, or by psychological problems such as anxiety. The list of possible causes of dizziness is long, which includes inner ear disorders, neurologic disorders, blood pressure/cardiac problems, reactions to medications, diabetes or other causes.
What Is BPPV?
Here at Midwest ENT Centre, we assess and diagnose patients with many inner ear and balance disorders. One of the most common causes of dizziness in patients is called Benign Paroxysmal Positional Vertigo, or BPPV. It is present in about 20% of all dizzy patients, but is more likely found in older individuals. This is a condition caused by small calcium crystals floating in the fluids of the inner ear. When a person turns their head, the movement of fluids in the semi-circular canals send a signal to the brain, indicating direction. Loose crystals in the fluid disrupts normal responses, and are interpreted by the brain as dizziness or vertigo.
In addition to these, signs of BPPV can include lightheadedness, imbalance or unsteadiness, difficulty concentrating, and nausea. Although abrupt and sometimes frightening, these sensations usually last for only brief periods of time (usually 30-60 seconds), although unsteadiness may continue for longer.
Activities that bring on symptoms vary in each person, but are precipitated by changes in head position. Rolling over, getting out of bed, bending over, and tilting the head to look up are common triggers of BPPV.
What Can Be Done for BPPV?
During a visit to our clinic, the physician may order further testing of the inner ear balance system to determine the source of a person’s dizziness. The doctor may recommend specific exercises intended to reposition the floating crystals so that they are no longer interfering with normal inner ear functions. Physical therapy may also be necessary, to help in developing long-term strategies for patients with balance disorders.
Symptoms usually decrease over time as the inner ear system recovers and crystals are reabsorbed or return to their original placement. However, those who develop BPPV once are very likely to experience it again in the future.
Sources: The National Dizziness and Balance Center
Vestibular Function: Evaluation and Treatment (2004) Alan Desmond, AuD
Vestibular Disorders Association and American Speech-Language-Hearing Association
Call Midwest ENT Centre at (636) 685-8250 for more information or to schedule an appointment.