Vertigo and Dizziness
Vestibular Balance Disorders

• How do patients describe the symptoms caused by balance disorders?
  • Dizziness
  • Vertigo
  • Lightheadedness
  • Motion sickness
• What problems cause balance disorders?
  • Visual
  • Inner ear (vestibular)
  • General sensory
  • Brain
• How are patients with balance disorders evaluated?
• What general advice can be given to patients with balance disorders?
• How are balance disorders treated?
• What are vestibular rehabilitation exercises?
• What are the specific balance disorders and their treatments?
  • Meniere disease
  • Motion sickness syndrome
  • Vestibular migraines
  • Inner ear trauma
  • Perilymphatic fistula
  • Medication damage to inner ear (ototoxicity)
  • Acoustic neuromas and other cerebellopontine angle (CPA) tumors
  • Benign paroxysmal positional vertigo (cupulolithiasis)
  • Vertebral basilar insufficiency
  • Labyrinthitis
  • Multiple sclerosis
  • Disequilibrium of aging
• Vestibular Balance Disorders At A Glance

Ponder this: if a cat is dropped upside down, it will land right side up on all four paws. If a newborn infant is tilted backward, its eyes will roll downward so that its gaze remains fixed on the same point. If, as you read this article, you shake your head rapidly from side to side, the print nonetheless will stand still. Each of these scenarios is an example of how a healthy balance (vestibular) system compensates for daily changes in our spatial orientation.

Balance is a state of body equilibrium or stability. We often take for granted how dependent we are on a healthy balance system. When the system breaks down, however, patients will describe symptoms such as dizziness, vertigo, lightheadedness, or motion sickness.

Vertigo, Not an Easy Diagnosis Medical Author: Benjamin C. Wedro, MD, FAAEM Medical Editor: Melissa Conrad Stöppler, MD The room spins wildly around, and you become intensely nauseous. No, it's a ride at your local amusement park, not the residual of an all night party, but instead, you are challenged with vertigo. The symptoms are highly unpleasant and incapacitating, and the illness has a variety of causes including: trauma to the inner ear, stroke, or the most common cause, idiopathic, meaning we just don't know. Balance is complicated. The labyrinth system (the inner ear, see diagram below) has a gyroscope mechanism that tells the brain where the body is in relation to the world. To be in tune with your surroundings, the gyroscope needs to work, and the brain needs to interpret the signals. The labyrinth can get confused (for example, from viral infections or repeated head movements - like using a computer to enter data or cleaning cupboards above your head), or - just because. The cerebellum (the back part of the brain), can misinterpret the signals (for example, due to a tumor or stroke), so vertigo is not a symptom to be taken lightly. Fortunately, with a detailed medical history and physical exam, the doctor should be able to distinguish loss of balance due to an inner ear problem - from incoordination resulting from a brain problem. Read more about causes and diagnosis of vertigo. » Top Searched Vertigo Terms: causes, dizziness, symptoms, treatment, exercises, inner ear, benign paroxysmal positional vertigo , cure, define, inner ear infection, vestibular disorders, medications, Lipitor, cervical, inner ear disorder

How do patients describe the symptoms caused by balance disorders?

More than two million people per year visit their doctor for vestibular balance disorders.

These disorders are the ninth most common complaint that leads patients to visit their primary care physicians. Furthermore, it is one of the most common reasons elderly people seek medical advice.

Patients often describe balance problems in terms of vertigo, dizziness, lightheadedness, and motion sickness. But, not all of these symptoms are always caused by disorders of the vestibular system. Moreover, although one person may describe a balance problem using one or more of these terms, another person may use a different combination of these terms to describe the very same condition. In fact, some people will even use the word dizziness to indicate that they simply do not feel well. It is important, therefore, for patients to not use general terms when describing their balance problems. Put another way, it is best for patients to simply describe the sensation they feel without using general terms like dizziness or vertigo.

Dizziness

In general, physicians refer to dizziness as a feeling of being woozy, drunk, unsteady, or giddy. There is often a feeling of imbalance (disequilibrium) without a true sensation of turning or spinning. Dizziness is a general-purpose, rather imprecise term used to describe the sensation of imbalance (sensory disorientation). Although patients often use the word dizziness to describe balance or inner ear problems, it is typically not caused by a disorder of the inner ear.

Vertigo

Vertigo refers to an hallucination of motion that can be linear (straight ahead), falling, or rocking. It is often described as a spinning, turning, or whirling sensation. What's more, the spinning may be one of self-rotation (subjective vertigo) or rotation of the surrounding environment (objective vertigo). In most cases, the symptom of vertigo implies a disorder of the inner ear or vestibular system.

Lightheadedness

Lightheadedness refers to the typical sensation one experiences prior to a fainting episode. Associated symptoms can include sweating, feeling cold, shortness of breath, numbness around the mouth or of the fingers, and a dimming or tunneling of vision. Lightheadedness is caused by a momentary decrease in blood flow to the brain. This sensation can occur for a number of reasons including medication side effects and heart (cardiac) and blood vessel (vascular) problems. For instance, orthostatic hypotension is low blood pressure that occurs upon standing. In this condition, the low blood pressure decreases blood flow to the brain, and thereby, causes lightheadedness.

Contrary to popular belief, high blood pressure (hypertension) itself does not cause lightheadedness. Hypertensive patients may experience lightheadedness, however, when their blood pressure drops for any reason. It happens that the most common reason for such a drop in blood pressure is a response to their blood pressure medications. Lightheadedness is usually not a common complaint from patients with vestibular problems.

Motion sickness

Whereas vertigo, lightheadedness, and dizziness are symptoms of diseases, motion sickness is a normal response to an abnormal situation. It is a general term that includes such conditions as seasickness, airsickness, carsickness, and even space sickness. Motion sickness is caused by a real or perceived motion stimulus to which a person has not yet adapted. It occurs when conflicting information is fed into the vestibular and other sensory systems.

Individual thresholds (the amount of motion it takes) to trigger motion sickness differ. Eventually, however, anyone will develop motion sickness if placed in a situation that provides enough motion. The symptoms of motion sickness include nausea, vomiting, spinning, sweating, and headache. In fact, motion sickness has ruined many a vacation, and has limited the activities or even incapacitated those who are prone to it. (Motion sickness is discussed in more detail below.)

Vertigo (Dizziness And Vestibular Balance Disorders) - Describe Your Experience

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