Doctor please help, I'm dizzy! Mr Wale Olarinde explains the common causes....
Mr Wale Olarinde, Consultant ENT/Head & Neck Surgeon
Claremont Clinics: Monday PM, Thursday AM and Friday EVE.
Feeling dizzy can be very distressing as most of the time it comes out of the blue and leaves the affected person feeling worried and drained. Mr Olarinde outlines the key points about this symptom and its commonest causes.
Many people may describe dizziness as:
- Feeling off balance
- Feeling their surroundings moving
- Feeling of actually moving
- Not being to walk straight
- Feeling light headed
- Just not feeing right
There may be associated symptoms such as ringing or hissing sounds in one or both ears (Tinnitus), hearing loss, nausea, vomiting, headaches, ear fullness or ear discharge. Our balance is maintained by our eyes, inner ear and joint position sense constantly relaying information to our brains to keep us in the position we want to be in.
The most important thing during any consultation is to find out the cause for the dizziness rather than trying various treatments/medications without a diagnosis. This usually requires a careful history of the symptoms since they first started to determine what examination(s) are required. The commonest inner ear causes of dizziness include Benign Positional Paroxysmal Vertigo (BPPV), Labyrinthitis, Vestibular Neuronitis, Meniere’s syndrome, head injuries, vestibular migraine or very rarely small brain tumours. Neurological conditions such as Parkinson’s disease and Multiple Sclerosis (MS) may also cause dizziness. Other causes of dizziness may be hormonal or cardiac related and some people may need further investigations to find the cause usually involving a hearing test. The commonest inner ear causes of dizziness include;
Benign Positional Paroxysmal Vertigo (BPPV)
BPPV is a condition that produces brief attacks of dizziness commonly brought on by head movements. It is caused by tiny crystals moving in the inner ear stimulating balance receptors which help to maintain our balance. Treatment is with an Epley’s Manoeuvre to reposition those crystals, which must be carried out someone trained to perform this manoeuvre.
This is a more severe form of dizziness as it lasts up 24 hours and can be very disabling. It is more appropriately called Vestibular Neuronitis as most sufferers do not experience hearing loss. The labyrinth refers to the part of the inner ear that controls our hearing, i.e. the cochlea. The dizziness is continuous during this period and often associated with vomiting. Most people tend to lie still and close their eyes while the dizziness is present as that seems to be the only thing that helps. Labyrinthitis usually gets better spontaneously but it is important to be sure this is the condition that has caused the dizziness.
Meniere’s syndrome is a triad of dizziness, hearing loss and hearing noises in one ear. The dizzy spells last from a few minutes but typically goes on for hours with associated vomiting. Treatment is in a step-ladder fashion starting with dietary changes, through to medication and finally to surgery. Surgery is only required in extreme situations that cannot be controlled with medication.
Diagnosing the Cause of your Dizziness
Your specialist will ask you very detailed questions about your dizziness such as asking you to describe precisely what happens, the duration of each dizzy spell, the regularity and associated symptoms. You should come prepared for this as the cause of the dizziness in most people is obtained by taking a careful history. Your ears will be examined and a hearing test is very likely to be required. The examination also comprises of a number of positional tests and procedures such as Epley’s Manoeuvre which can be done during your consultation.
A private consultation with Mr Olarinde costs £200 if you don't have health insurance and a hearing test ranges between £75-£125. Mr Olarinde is a recognised health provider by all health insurers. To book an appointment, call our friendly Private Patient Team on 0114 263 2114. It is helpful to have a referral from your GP or one of our Private GPs but Mr Olarinde will happily see you without one if necessary.
Copyright Wale Olarinde, 2016.