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Vertigo
Vestibular Balance Disorders

Medical Author: James K. Bredenkamp, MD, FACS
Medical Editor: Leslie J. Schoenfield, M.D., Ph.D.
Doctor to Patient

Vertigo, Not an Easy Diagnosis

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Vertigo is a Difficult DiagnosisThe 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.


Doctor to Patient

Introduction

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.

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.



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

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How was the diagnosis as to the cause of your vertigo (dizziness and vestibular balance disorders)?

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