Vertigo and Dizziness

Vertigo is not a disease, but a symptom.  It refers to the sensation that the environment around or the patient him/herself is moving.  If you often feel like the world around you is literally spinning, contact otolaryngologist and neurotologist Ricardo Cristobal, MD, PhD, FACS, at Texas Ear Clinic in Fort Worth, Texas. The practice has the expertise and state of the art equipment to perform vestibular testing to help determine the root cause of these dizzy spells and provide treatment to help you find relief. Call the office today or use the online tool to schedule your visit.

What are the symptoms of vertigo?

People describe vertigo as a feeling of spinning, swaying, tilting, or feeling unbalanced. Along with these sensations, you may experience:

• Nausea
• Vomiting
• Abnormal jerking eye movements
• Headache
• Ringing in the ears
• Fullness in the ears
• Sensitivity to head motion
• Difficulty placing your head in certain positions

Vertigo can make it challenging to complete daily tasks.

What causes vertigo?

Some causes of vertigo include: 

Benign paroxysmal positional vertigo (BPPV)

When tiny calcium particles are moved from their normal location in the organs of balance in the inner year, it can cause BPPV. The loose particles make the inner ear send erroneous information to the brain about head and body movements and their relationship to gravity. 

Ménière’s disease

Ménière’s disease is likely caused by a buildup of fluid and the resulting changes in pressure in the inner ear. You may also experience ringing in the ears, as well as fluctuating fullness and hearing loss. 

Superior Semicircular Canal Dehiscence

Patients with superior semicircular canal dehiscence have a defect in the bone that surrounds the inner ear.  This causes them to experience symptoms such as dizziness and sensitivity to loud sounds and to pressure changes, mental fog, ear fullness, hearing their internal sounds (voice, breathing, heartbeat, stomach sounds, joints moving), unsteadiness and fatigue.

Vestibular neuritis or labyrinthitis

When a viral infection has caused inflammation in the inner ear around the nerves important to the body’s sense of balance, your inner ear is affected, causing vertigo.

Vertigo can also result from neurological or vascular problems, certain medications, or migraines.

What is vestibular testing?

Vestibular testing helps identify the cause of vertigo. Offerings include: 

Rotational chair

This test evaluates how the inner ear balance system responds to movement. You sit in a dark room, resting in a chair that rotates at different speeds. 

Videonystagmography

This test measures response of the balance system to head movement and to temperature change stimulation. It includes recording eye movements during head positioning and positions and while putting air in the ears. It provides an accurate diagnosis of which ear and which part of the ear is causing benign paroxysmal positional vertigo (BPPV) among other conditions.

Vestibular evoked myogenic potentials (VEMP)

This test assesses balance function of the inner ear by recording neck muscle contraction as you hold your neck in certain positions and listen to a clicking sound. It helps diagnose conditions such as superior semicircular canal dehiscence syndrome, where the bone around the inner ear membranes has a gap patients experience dizziness with sound exposure.

VHIT

VHIT tests your function in response to an abrupt head rotation in the plane of the canals of balance in the inner ear. This test can help diagnose a reduction in vestibular function in one ear versus the other. 

Electrophysiologic tests such as electrocochleography help diagnose Meniere's disease.

Other tests help establish changes in the brain's ability to process balance information following traumatic brain injury.

How do you treat vertigo?

Treatment for vertigo depends on the cause. Vertigo may go away on its own as your brain adapts to inner ear changes. 

Treatment may include vestibular rehabilitation through physical therapy. You may also benefit from a canalith repositioning maneuver (CRP), which helps remove calcium deposits from the inner ear. 

Anti-nausea medications, steroids, or antibiotics may also help resolve infections or inflammation that cause vertigo. 

For Ménière's disease, Dr. Cristobal may recommend water pills to reduce excess fluid or other medications.  In rare cases, surgery may be required, including endolymphatic sac decompression procedure, labyrinthectomy, vestibular nerve section or reinforcement of the round and oval window.

Superior semicircular canal dehiscence may require surgery to place a plug in the portion of the inner ear missing bone.

Call Texas Ear Clinic or use the online tool to set up an appointment if you’re struggling with vertigo.