Dizziness is a condition related to spatial orientation. A room one is in seems to be turning or swaying, one feels dazed, sick, or it can even go black before one’s eyes. Dizziness is both an unpleasant sensation as well as quite common. When diagnosed, dizziness may turn out to be due to a wide variety of treatable conditions.
For the purpose of making a diagnosis, patients need to be asked quite specific questions.
In the case of a spinning sensation (rotary vertigo), its cause can often be found in disturbances to the vestibular system of the inner ear. This system controls balance. Problems may also lie in a disturbance of the central nervous system or in the brain. Other types of dizziness may have other causes, the most common of which are circulatory problems or the side effects of drugs.
To determine the exact cause, examination by a primary care physician is the first step, usually followed by consultation with an ENT specialist or with a neurologist.
In addition to obtaining more detailed information from the patient, an ENT specialist will conduct a thorough examination. The goal is to determine whether the cause of the dizziness might be the result of inner ear damage that affects balance or the vestibular nerve, or by a brain condition.
For a full diagnosis, in addition to examining the ears, other diagnostic tools are used. Some are to examine the condition of the balance system, such as the caloric reflex test or (video-based) nystagmus tests. Tests of hearing, blood tests, or imaging procedures such as an MRI scan of the petrous bone and the brain, may also be indicated.
Most common diagnoses
The most common disturbance of the inner ear’s balance organ or the vestibular nerve is called benign paroxysmal positional vertigo – a readily treatable condition. Less common are vestibular nerve malfunctions. Méniere’s disease is, by contrast, quite rare.
Treatments are as varied as the causes of dizziness itself. They may include medication, positional exercises, or physiotherapy; surgery itself is only rarely indicated or recommended. Strong or persistent dizziness, however, calls for medical evaluation.
Throat and pharynx