Feeling dizzy can be scary. Dizziness can mean different things to different people. However, when dizziness becomes problems with balance including lightheadedness, spinning, foggy headedness, imbalance, unsteadiness or passing out, it’s important to check in with a health care provider.

“Dizziness that is associated with other symptoms such as sudden changes in hearing or vision, headaches or loss of consciousness are certainly some of the more concerning types of dizziness and should be evaluated promptly,” said Joshua Smith, D.O., otolaryngologist with Marshfield Clinic Health System.

Evaluation

When suffering from certain kinds of dizziness, some patients may be referred to an ear, nose and throat provider, like Dr. Smith.

“The main question to be answered is whether or not the symptoms have been caused by a problem with the ear and its connection to the balance system in the brain,” Dr. Smith said.

One of the first tests ordered is a baseline hearing test since some balance problems also may affect certain pitches of hearing. Additionally, Dr. Smith recommends providing a thorough description of the symptoms and some providers may send a questionnaire in the mail to fill out prior to an appointment. This questionnaire covers symptoms and reviews medical problems and medications that could be causing interactions.

A specialized physical examination is almost always a part of this evaluation as well, including the evaluation of reflexes contained within the inner ear that have an effect on movement of the eyes. Smith said some patients may go on to have additional testing of the inner ear balance system at a separate visit or even a CT or MRI of the ear and brain.

Causes

The most common type of dizziness is a sensation of movement or spinning, known as vertigo. Vertigo can be caused by inner ear causes and misinterpretation of information by the brain’s balance center.

Benign Paroxysmal Positional Vertigo (BPPV) is the most common reason someone seeks treatment for dizziness in the United States. Patients with this condition suffer from shorter episodes of a spinning sensation that are typically triggered by certain head movements including looking up, looking down, laying down in bed or turning over in bed.

BPPV is strongly associated with head injuries, an inner ear infection called vestibular neuritis and aging. It is common to experience an unsteadiness that follows and lasts much longer than the vertigo itself, and this condition becomes more and more common as we age.

“There is nothing in particular that can be done to prevent an episode from occurring,” Dr. Smith said. “It is important to note that anyone who has developed positional vertigo has a good chance of developing another episode at some point in the future.”

Treatment

The good news is that once a correct diagnosis is made, there are treatments available.

BPPV is typically treated with canalith repositioning maneuvers. These maneuvers typically involve moving the head, body or both through a series of specific motions in order to move the small calcium crystals back to the inner ear chamber they came from.

“Some patients are able to accomplish these maneuvers on their own at home,” Dr. Smith said. “Others will require a referral to physical therapy and can typically expect resolution of their symptoms after one or two sessions.”

A small percentage of patients who have symptoms that are unable to be resolved with physical therapy may be eligible to undergo a surgical procedure to block the movement of the crystals within the inner ear.

If you are experiencing vertigo or dizziness, talk to your provider to learn the cause and receive treatment.