Causes of Dizziness
Dizziness or vertigo can be caused by a disturbance in a particular part of the inner ear - the vestibular system. This is the part of your balance system that provides your brain with information about changes in head movement with respect to the pull of gravity. When your vestibular system is not working properly, the result may be dizziness, vertigo, imbalance, disorientation and possibly nausea and vomiting.
Some specific disorders known to cause dizziness and/or vertigo are listed below in alphabetical order:
Acoustic neuroma is loosely defined as a tumor on the nerve from the inner ear to the brain. Patients with this disorder may experience a gradual hearing loss, ringing or buzzing in the ears and dizziness. A sensation of pressure and fullness may also be present.
Arteriosclerosis, a hardening or narrowing of blood vessels that supply blood to the brain, may cause decreased blood flow, resulting in dizziness.
Benign Paroxysmal Positional Vertigo (BPPV) is a balance and dizziness disorder caused by a problem in the vestibular system of the inner ear which forms part of the balance organs. Small particles or crystals become detached from their normal location in the inner ear and interfere with the normal function of the vestibular system. As the name indicates, the vertigo, which can be intense, comes on suddenly following certain movements of the head. This type of vertigo comes and goes and, if left untreated, may be recur for years.
'Central' or neurological vertigo refers to dizziness that results from problems in the balance centers of the brain, rather than the ear. This type of dizziness is generally much less common than dizziness caused by inner ear problems. Strokes, multiple sclerosis, brain tumors or cysts and deformities of the upper spine or the back of the brain are all possible causes.
Hyperventilation can cause temporary dizziness and sometimes occurs when you are exercising strenuously or if you hold your breath when you are under stress.
Labyrinthitis is an inflammation, usually caused by a virus, of the labyrinth, the part of the inner ear that contains the organs of balance.
Meniere's disease is a condition in which repetitive attacks of vertigo are accompanied by pressure in the ears, buzzing or ringing, and partial hearing loss that can fluctuate during an episode.
Osteoarthritis, a joint disease, can affect the neck or cervical area of the spine. Openings in the neck vertebrae contain arteries, which supply the brain with blood. When these openings narrow as a result of osteoarthritis, blood flow to the brain is restricted, resulting in dizziness.
Ototoxicity is caused by exposure to, or ingestion of a particular substance which damages the auditory and inner ear system. Ototoxicity may result in irreversible damage to hair cells in the inner ear and/or vestibular system, which may cause vertigo, vision problems, hearing loss, gait unsteadiness and imbalance.
Peripheral fistula is a leakage of inner ear fluid to the middle ear. It can occur after a head injury or physical exertion or without a known cause (rarely).
Peripheral vestibular disorders refers to all forms of dizziness caused by inner ear problems, including BPPV, labyrinthitis and Meniere's disease. The term is commonly used when a doctor knows the problem is in the inner ear, but is unable to be more specific.
Post-traumatic vertigo is dizziness resulting from a head injury, concussion or whiplash.
Postural hypotension is indicated by symptoms of lightheadedness or blackouts, and is typically experienced when rising from a lying or sitting position.
Tinnitus is buzzing or ringing in the ears and can occur with dizziness or may be a symptom by itself.
Vascular vertigo is dizziness caused by problems with the blood supply to the inner ear or the balance centers of the brain. This can occur in people who suffer from migraine or those who are overweight, smoke, have high blood pressure or don't get enough exercise.
Vestibular neuronitis is an infection of the vestibular nerve, generally viral.
Viral labyrinthitis is a viral inflammation of the inner ear. It causes dizziness/vertigo which may last days or weeks, usually following a cold or flu.
Types of Therapy
Self Directed programs are most commonly used with patients who do not require supervision during their exercises, are not in an acute state, or whose lives do not allow weekly visits.
Clinic Directed programs are designed for patients whose symptoms may be acute and who may require supervision during their exercises.
Balance Retraining Therapy is for individuals who have a loss of balance and unsteadiness. Most of these patients do not report dizziness or vertigo. There is an emphasis on practical solutions to common problems, i.e. difficulty getting around in the dark, walking on uneven surfaces, and negotiating steps and curbs. Fall prevention, movement coordination, and improved participation in everyday activities are all high priorities of the program.
Canalith Repositioning is a technique used to reposition the otoconia back into the utricle, from which they have been dislodged. This is the treatment of choice for BPPV.