WhatsAppExpert Diagnosis and Treatment for Spinning Sensations and Balance Problems
The Vertigo and Balance Disorders Unit is a multidisciplinary unit in which ENT, neurology and physical medicine and rehabilitation specialists work together to find and treat the cause of dizziness, spinning sensations and unsteadiness. In our unit, vertigo arising from the inner ear, of neurological origin or related to systemic diseases is addressed with detailed assessment protocols, and personalised treatment aimed at the cause is planned. Academic Hospital's advanced diagnostic technologies and experienced staff deliver reliable results across a wide clinical spectrum, from acute vertigo attacks to chronic balance disorders.
Contents
What Is the Vertigo and Balance Disorders Unit?
The Vertigo and Balance Disorders Unit is a specialised unit that systematically investigates, diagnoses and treats the underlying cause of dizziness and unsteadiness. Vertigo describes the sensation that you or your surroundings are spinning; unlike simple dizziness, it points to a dysfunction in one of the components of the balance system. The balance system combines, in the brainstem, information from three sources: the inner ear (vestibular system), vision and the sense of muscle and joint position (proprioception). When a problem occurs in any of these three components, vertigo and a risk of falling may arise. In our unit, benign paroxysmal positional vertigo (BPPV), Meniere's disease, vestibular neuritis, labyrinthitis and central vertigo are assessed with a detailed clinical protocol.
Which Diseases and Conditions Are Treated?
The Vertigo and Balance Disorders Unit covers all forms of dizziness of peripheral and central origin.
- Benign paroxysmal positional vertigo (BPPV): Brief spinning attacks linked to head position; the most common vestibular disorder
- Meniere's disease: Characterised by recurrent spinning attacks, a feeling of fullness in the ear, tinnitus (ringing in the ear) and fluctuating hearing loss
- Vestibular neuritis: Inflammation of the inner ear nerve of viral origin; characterised by a sudden, severe spinning sensation
- Labyrinthitis: Inflammation of the inner ear labyrinth; affects both balance and hearing
- Vestibular migraine: Balance disturbance and vertigo attacks associated with migraine
- Perilymphatic fistula: Tears in the inner ear membranes caused by head trauma or forceful straining
- Drug-induced vestibular toxicity: Loss of balance caused by aminoglycoside antibiotics and other ototoxic drugs
- Central vertigo: Dizziness originating from the brainstem or cerebellum (stroke, tumour, multiple sclerosis)
- Posturographic balance disorders: Chronic unsteadiness in older patients at high risk of falling
- Cervical dizziness: Unsteadiness complaints originating from the neck
When Should You Seek Medical Advice?
The following situations are sufficient reason to consult the Vertigo and Balance Disorders Unit.
- If you experience sudden and recurrent attacks of a spinning sensation
- If the spinning sensation is accompanied by nausea and vomiting
- If you have noticed ringing, a feeling of fullness or reduced hearing in your ear
- If you are afraid of falling or feel the need to hold on to something while walking
- If you experience short spinning attacks triggered by head movements
- If difficulty concentrating and fatigue have become persistent after vertigo
The following symptoms require emergency medical assessment: facial drooping or paralysis, speech disturbance, sudden weakness in an arm or leg, double vision, a severe headache of sudden onset. These findings may indicate central vertigo or a stroke.
Diagnostic Methods
In the vertigo unit, the diagnostic process is carried out by combining a detailed clinical examination with targeted tests.
| Method | What it is used for |
|---|---|
| Assessment of nystagmus (involuntary eye movements), balance and coordination | |
| A positional test used in the diagnosis of BPPV; it reveals displaced crystals originating from the posterior semicircular canal | |
| Used in the diagnosis of horizontal semicircular canal BPPV | |
| Records eye movements with a video camera to measure vestibular reflexes objectively; it is the key test for distinguishing peripheral from central causes | |
| Assessment of hearing and inner ear function with pure-tone audiometry, tympanometry and auditory brainstem response (ABR) testing | |
| Supports the diagnosis of endolymphatic hydrops in Meniere's disease | |
| A computerised balance test that measures the contributions of vision, the vestibular system and proprioception separately | |
| Performed to rule out acoustic neuroma, brainstem lesions and demyelinating diseases | |
| Used particularly when a central cause is suspected and in acute vertigo presentations | |
| Tests to rule out thyroid disease, anaemia, hypoglycaemia, and autoimmune and infectious causes |
Treatment Approaches
Vertigo treatment begins with correctly identifying the cause; each condition has its own specific treatment protocol.
| Treatment | Scope and application |
|---|---|
| Highly effective physical manoeuvres for the treatment of BPPV that require no medication. Performed with the correct technique, the Epley manoeuvre achieves success in 85 to 90 per cent of cases of posterior canal BPPV. | |
| During an acute attack, vestibular suppressant drugs, antiemetics and, in suitable patients, short-term corticosteroids are used to relieve nausea and the spinning sensation. Long-term use of vestibular suppressant drugs is avoided, as they are known to delay central compensation. | |
| Salt restriction, diuretic therapy, medication aimed at controlling attacks and, where necessary, intratympanic corticosteroid or gentamicin injection are used. | |
| An exercise programme carried out under the supervision of a physical medicine and rehabilitation specialist that helps the brain recalibrate the balance system. Gaze stabilisation, balance and postural stability exercises reduce the risk of falling. It is the main treatment option in chronic vestibular insufficiency, impaired compensation after vestibular neuritis and chronic unsteadiness in older people. | |
| Identifying and controlling factors that make attacks more likely, such as stress, irregular sleep, and caffeine and salt intake. | |
| In Meniere's disease that does not respond to medical treatment, options such as endolymphatic sac surgery, labyrinthectomy or vestibular nerve section are considered. |
Appointments for the Academic Hospital Vertigo and Balance Disorders Unit: 444 0 353
Book an AppointmentVertigo and Balance Disorders at Academic Hospital
At the Academic Hospital Vertigo and Balance Disorders Unit, dizziness and unsteadiness complaints are addressed through an assessment carried out jointly by ENT, neurology and physical medicine and rehabilitation specialists. The unit works with the following departments:
- Ear, Nose and Throat: ENT examination in inner ear vertigo, BPPV and Meniere's disease, and surgical options in resistant cases
- Neurology: distinguishing central vertigo and other neurological causes
- Audiology: audiological tests assessing hearing and inner ear function
- Physical Medicine and Rehabilitation: planning and delivering the vestibular rehabilitation programme
- Migraine Treatment: joint management of vestibular migraine
- Radiology: MRI and brain CT examinations to rule out central causes
- Emergency Department: urgent assessment of dizziness accompanied by signs that may indicate a stroke
Frequently Asked Questions
References
The general information given on this page about vertigo and balance disorders, diagnostic methods and treatment approaches is supported by the reliable health sources listed below.
- National Institute on Deafness and Other Communication Disorders (NIDCD), "Balance Disorders", nidcd.nih.gov
- NHS, "Vertigo: Causes, Symptoms and Treatment", nhs.uk
- Bhattacharyya N et al., "Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)", Otolaryngol Head Neck Surg. 2017, pubmed.ncbi.nlm.nih.gov
- Mayo Clinic, "Meniere's Disease: Symptoms and Causes", mayoclinic.org
The information on this page is for informational purposes only; it does not replace medical examination, diagnosis or treatment. Please consult a healthcare institution regarding your complaints.
