Dizziness and balance tests

What is BPPV?

BPPV (Benign Paroxysmal Positional Vertigo) is a condition where small, crystal-like particles (ear stones) become dislodged from their normal position in the inner ear and move to other parts of the ear. This causes sudden episodes of dizziness when the head is moved into certain positions.

Symptoms:

Sudden dizziness or the sensation that the surroundings are spinning.

Dizziness is often triggered by head movements, such as lying down, turning in bed, or looking up.

Nausea associated with dizziness.

Causes:

BPPV occurs when small particles (crystals) in the inner ear become dislodged and move into a canal where they do not belong. This can happen after a head injury, aging, or sometimes for no apparent reason.

Treatment:

Treatment often involves manual maneuvers like the Epley maneuver, which helps move the loose ear stones back to their correct position.

Exercises and head movements can help alleviate symptoms.

When to see a doctor:

If you experience sudden dizziness, it is important to see a doctor for a diagnosis and appropriate treatment.

A virus affecting the balance nerve simply means that the balance nerve (n. vestibulocochlearis) or its associated organ is no longer functioning properly, which can lead to sudden dizziness or loss of balance. This infection is also known as vestibular neuritis or vestibular neuritis.

What happens?

The condition, which is not actually caused by a virus, attacks the part of the balance nerve that sends signals from the inner ear to the brain, affecting the body’s ability to maintain balance. This leads to sudden and persistent severe dizziness.

Symptoms:

Typically, you wake up in the morning feeling unwell and nauseous, but may not necessarily feel that there is something wrong with your ears. Many people interpret the symptoms as a stomach infection, as they consist of nausea and vomiting.

Sudden dizziness or a sensation that the surroundings are spinning.

Balance problems, especially when moving the head.

Nausea and vomiting due to dizziness.

There is usually no hearing loss with vestibular neuritis (if it is a pure balance nerve issue), but some people may experience mild discomfort in the ear.

Causes:

The primary cause is unknown, although there are many theories. The main issue is that one side of the balance nerve or organ is not functioning properly, which disrupts balance function on that side.

In many cases, the exact reason why one balance organ suddenly stops functioning is never determined, but this can be measured precisely by testing the function with advanced video glasses (known as VIHT equipment).

Treatment:

The treatment is primarily symptomatic and may include:

Rehabilitation training (vestibular rehabilitation) to help restore balance and reduce symptoms over time.

Corticosteroids may be used in some cases, but treatment should ideally begin within 48-72 hours to be effective.

Prognosis:

Most people recover from the condition within a few weeks, although there may be a period of balance problems that require rehabilitation. It is not unusual for some symptoms to improve slowly over the course of months.

When should you see a doctor?

If you experience sudden dizziness, balance problems, or nausea, you should contact a specialist for an accurate diagnosis and treatment.

Ménière's Disease is a condition of the inner ear that affects both balance and hearing. It is characterized by sudden episodes of dizziness (vertigo), tinnitus (ringing in the ears), hearing problems, and a feeling of fullness or pressure in the ear.

Causes:

The cause of Ménière's disease is not entirely clear, but it is believed to be related to a buildup of fluid in the inner ear (endolymphatic hydrops). This fluid accumulation can disrupt both balance and hearing. The condition may be linked to genetic factors, infections, trauma, or circulation issues.

Symptoms:

Dizziness (Vertigo):

Sudden and intense episodes of dizziness that can last from minutes to hours.

Hearing Problems:

Temporary or permanent hearing loss, particularly for low-frequency sounds.

Tinnitus:

A constant or intermittent ringing sound in the ears.

Pressure Sensation in the Ear:

A feeling of fullness or pressure in the affected ear.

Course:

The symptoms often come in attacks and can vary in intensity. Some people experience long periods without symptoms, while others have more frequent episodes. Over time, hearing may worsen, and the disease can lead to permanent hearing loss, especially in one ear.

Treatment:

There is no cure for Ménière's disease, but treatment aims to alleviate symptoms and prevent attacks:

Placement of a drainage tube in the affected ear has shown to be effective for many patients.

Medications such as diuretics (to reduce fluid buildup), dizziness medication (e.g., antihistamines or betahistine), and common anti-nausea medications to treat attacks.

Dietary changes: Reducing salt intake to help manage fluid balance.

Vestibular rehabilitation:

 Exercises to help train balance.

Surgery: In rare cases, surgeries such as endolymphatic shunts or balance nerve sectioning may be necessary if symptoms are severe.

Prognosis:

Ménière's disease can be a chronic condition, but many people can live a normal life with treatment. However, it is possible to experience permanent hearing loss in the affected ear over time, and dizziness may be disabling in some cases.

When to see a specialist:

If you experience frequent dizziness, hearing problems, or tinnitus, you should consult a doctor for an accurate diagnosis and guidance on treatment.

Why It Is Important to See an ENT Specialist for Dizziness

Dizziness can be an uncomfortable and frightening experience.

Dizziness can have many harmless causes, but in rare cases, it can also be a sign of a serious condition. Therefore, it is important to get an accurate diagnosis, especially in the case of sudden and severe dizziness, or if dizziness is accompanied by other symptoms such as facial paralysis or other neurological signs. These could indicate a stroke or brain hemorrhage.

Why Should You See an ENT Specialist?

ENT specialists (also known as otorhinolaryngologists or simply ENT doctors) are experts in diseases of the ear, nose, and throat, and they have the necessary expertise to assess and treat dizziness that originates from issues with the balance organs, hearing, or related structures in the brain.

At Charlottenlund Privathospital, we conduct a thorough examination of your symptoms and rule out any serious causes.

Early Diagnosis Is Crucial

Since some forms of dizziness present with identical symptoms, it can be difficult for non-specialists (such as emergency room doctors or general practitioners) to rule out a serious cause of dizziness.

Conclusion

Dizziness can be caused by a variety of factors, and it is important not to ignore the symptoms, especially if they are new, sudden, or persistent.

By being examined by an ENT specialist, you can rule out serious causes of dizziness and receive the proper treatment quickly. If you are unsure of the cause of your dizziness or if you have other concerning symptoms, do not hesitate to seek help.

We are here to assist you and ensure that you receive the best possible treatment.

But Shouldn't I Just Get Scanned?

Large international studies have shown that a thorough examination by a specialist (which includes an advanced assessment of the vestibulo-cochlear reflex using VHIT glasses and following the HINTS principles) can better rule out stroke or brain hemorrhage than both CT and MR scans combined.

Therefore, you should always contact your ENT specialist if you are experiencing dizziness. At Charlottenlund Privathospital, we have no waiting time for dizziness assessments and treatments.