Brett Adams, Au.D.
Humans are able to maintain balance and postural stability through the integration of three sensory systems: the eyes (visual), the legs and extremities (proprioception), and the inner ear (vestibular). When the function or sensory input from any of these is impaired, the individual may experience increased symptoms of imbalance, or may present with a history of falls.
When assessing a patient’s medical history, in relation to balance dysfunction, it is important to differentiate between feelings of the room spinning (vertigo), light-headedness, and feeling unstable. Does the individual experience these symptoms persistently, or intermittently? Does he or she only notice feelings of vertigo when moving into certain positions or rolling over in bed? Or is disequilibrium only noticed while walking in the dark or low-light environments?
Asking one’s self these questions can provide the physician or audiologist with crucial information, which could point to the origin of the problem. Symptoms of dizziness affect approximately 30% of the population, over the age of 65.  Here, we will briefly summarize some of the most common forms of vestibular (inner ear) dysfunction.
- Benign Paroxysmal Positional Vertigo (BPPV)
For those who suddenly notice feelings of short-duration positional vertigo (room spinning) only when bending over, looking upwards, lying down, or rolling over in bed, these symptoms may be caused by a condition called BPPV. Accounting for approximately 20-30% of diagnosis of dizziness-related cases, BPPV is the most common cause of vertigo.  Usually the symptoms of spinning last less than one minute, at a time, and suppress when the patient maintains a stable head position. BPPV is caused by displaced otoconia (inner ear crystals), that provide the brain information about the body’s position in relationship to gravity. When these crystals become dislodged from their original position and migrate into the semi-circular canals of the vestibular system, severe positional-triggered vertigo can be induced, until the condition is treated by an audiologist or physical therapist. At Southwestern Ear, Nose & Throat, we offer treatments for BPPV, performed in the Santa Fe office. However, in some cases, symptoms can spontaneously resolve without treatment.
- Ménière’s Syndrome
According to the National Institute on Deafness and Other Communication Disorders (NIDCD), approximately 615,000 individuals are currently diagnosed with Ménière’s in the United States, with 45,500 new cases each ear.  Ménière’s syndrome can also be referred to as endolymphatic hydrops, which refers to an abnormal regulation or buildup of inner ear fluid (endolymph). Because both the hearing (cochlear) and balance (vestibular) portions of the inner ear share this fluid, those with Ménière’s may have symptoms of abnormal hearing and balance function. Most commonly, this dysfunction is first observed in one ear with episodes of “room spinning” vertigo, “muffled” or decreased hearing in one ear, accompanied by “roaring” or “buzzing” sounds in the affected ear, as well. This disturbance of sensory signals between the inner ear and the brain can result in debilitating symptoms of imbalance.
- Vestibular neuritis and labrynthitis
While its origin may not be identified in each case, often a viral insult to the inner ear or auditory/vestibular nerve pathways (cranial nerve VIII) can cause a sudden decrease or complete loss in balance or hearing and balance function. These events most often affect one ear and can be accompanied by persistent “ringing,” also called, tinnitus. When this occurs, the individual may experience severe symptoms of vertigo, which often dissipates within several days, but may result in residual feelings of imbalance.
The treatment options for these common causes of vertigo vary between medical intervention and BPPV treatments, which can be performed at our Santa Fe facility. If you are experiencing symptoms of dizziness or imbalance, and would like to know more, please contact Southwestern Ear, Nose & Throat for a consultation.
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Neuhauser, H. (2007). Epidemiology Of Benign Paroxysmal Positional Vertigo: A Population Based Study. Journal of Neurology, Neurosurgery & Psychiatry, 710-715.
- Ménière’s Disease. Retrieved November 22, 2014, from