Dizziness and balance studies

What is BPPV?

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

Symptoms:

Sudden dizziness or feeling that the surroundings are spinning.

The dizziness is often triggered by head movements, e.g. by lying down, turning in bed or looking up.

Nausea associated with the dizziness.

Reasons:

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

Treatment:

Treatment often involves manual maneuvers such as the Epley maneuver to help move the loose ear stones back into their proper position.

Exercises and head movements can help relieve the symptoms.

When should you see a doctor?

If you experience sudden dizziness, you should contact a doctor to get a diagnosis and get the right treatment.

A virus on the balance nerve simply means that the balance nerve (n. vestibulocochlearis) no longer functions as it should, which can cause sudden dizziness or loss of balance. This infection is also called vestibular neuritis or vestibulitis.

What is happening?

The disease - which is far from always 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. It causes sudden and often very strong episodes of dizziness.

Symptoms:

You typically wake up in the morning feeling uncomfortable and stuffy, but may not necessarily have the impression that there is something wrong with your ears. Many interpret the symptoms as a stomach infection, as the symptoms consist of nausea and vomiting. Sudden dizziness or a feeling that the surroundings are spinning.

Balance problems, especially when moving the head. Nausea and vomiting as a result of the dizziness.

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

Reasons:

The primary cause is often a viral infection, which may be related to respiratory infections, colds or herpes viruses. Viruses can affect the balance nerve and disrupt its function. In many cases, you have no idea why one balance organ suddenly does not work, but this can be measured by testing the function with advanced video glasses (so-called VIHT equipment)

Treatment:

Treatment is primarily symptomatic and may include:

Medicines for dizziness (eg antihistamines or benzodiazepines) to relieve the dizziness.

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

Corticosteroids may be used in some cases to reduce inflammation of the balance nerve.

Prognosis:

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

When should you see a doctor?

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

Ménière's disease is a disease 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.

Reasons:

The cause of Ménière's disease is not entirely clear, but it is thought to be due to a build-up of fluid in the inner ear (endolymphatic hydrops). This fluid retention can disrupt balance and hearing. It may be related to genetic factors, infections, trauma or problems with blood circulation.

Symptoms:

Dizziness (vertigo): Sudden and intense episodes of dizziness that can last from minutes to hours.

Hearing problems: Temporary or permanent hearing loss, especially in low-frequency sounds.

Tinnitus:

 A constant or periodic ringing sound in the ears.

Ear pressure: A feeling of fullness or pressure in the affected ear.

Progress:

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

Why it is important to be seen by an ear doctor for vertigo

Dizziness can be an unpleasant and frightening experience, and it is something many people experience at some point in their lives. Dizziness can be caused by a wide variety of causes, so it is important to get a proper diagnosis, especially if the dizziness is persistent or severe. In some cases, dizziness can be a symptom of a serious underlying condition, such as a blood clot in the brain or a brain tumor.

What can cause dizziness?

Dizziness can stem from many different causes. Often it is associated with problems in the balance organ of the inner ear or in the nervous system. But it is important to remember that dizziness can also be a symptom of more serious conditions such as:

Blood clot in the brain (cerebrovascular event): A blood clot can block the blood supply to parts of the brain, which can lead to dizziness, balance problems or other neurological symptoms.

Brain tumor: Tumors affecting the balance centers of the brain or ear can also cause dizziness as an early symptom.

Why should you see an ear doctor?

Otorhinolaryngologists (also called otorhinolaryngologists) specialize in diseases of the ear, nose, and throat, and have the expertise to assess and treat vertigo that stems from problems in the balance organ, hearing, or related structures in the brain.

When you consult an ear doctor, we will thoroughly examine your symptoms and rule out any serious causes. This includes:

A thorough clinical examination: The ear doctor will assess your dizziness in relation to your other symptoms and medical history. We will ask how the dizziness feels, how often it occurs, and whether there are other symptoms such as headaches, vision problems or sensory disturbances.

Balance and hearing tests: Dizziness can be caused by a disturbance in the balance organ in the inner ear, and therefore the ear doctor can carry out specific tests to assess whether your balance functions are working normally.

Referral for further investigations: If we suspect that the dizziness is due to a more serious condition, such as a blood clot or brain tumor, we will refer you to further examinations, such as an MRI scan or CT scan, to obtain an accurate diagnosis.

Early diagnosis is essential

An early and correct diagnosis is essential to get the right treatment and prevent any complications. If the dizziness is due to a serious condition such as a blood clot in the brain or a brain tumor, early treatment can make a big difference to your recovery and prognosis.

Conclusion

Dizziness can be caused by many different factors and it is important not to ignore the symptoms, especially if they are new, sudden or persistent. By being examined by an ear doctor, you can rule out serious causes of vertigo and get the right treatment quickly. If you're unsure what's causing your dizziness, or if you have other worrying symptoms, don't hesitate to seek help.

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

But shouldn't I just be scanned?

Large international studies have shown that a thorough examination by a specialist doctor (which involves an advanced examination of the vestibulo-cochlear reflex with so-called VHIT glasses and which is carried out according to the so-called HINTS principles) can rule out blood clots in the brain and cerebral haemorrhage BETTER than both a CT and an MRI scan together. 

You should therefore always consult your ear, nose and throat doctor if you feel dizzy - and at Charlottenlund Private Hospital we have no waiting time for examination and treatment of Dizziness.