Vertigo related services we provide
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A guide to vestibular disorders
There are various conditions that affect the vestibular system, a very important system when it comes to maintaining balance and spatial orientation. Understanding these disorders is crucial for individuals who are experiencing symptoms of vertigo, dizziness, and imbalance. Let’s explore each condition briefly:
Peripheral Vestibular Disorders
BPPV (Benign Paroxysmal Positional Vertigo)
BPPV is one of the most common causes of vertigo. It occurs when small calcium carbonate crystals become dislodged from the otolith organs of the inner ear and migrate into the semicircular canals.
This displacement disrupts the normal flow of fluid in the canals, leading to brief episodes of vertigo triggered by changes in head position. Typically, vertigo related to BPPV feels like the world is spinning, occurs for less than a minute, and happens when one rolls in bed, gets up from lying or sitting, bends over, or tips the head backwards.
Luckily, this form of vertigo can be easily diagnosed and treated by an experienced therapist. Often, only one visit is required for this type of vertigo.
Meniere’s Disease
Meniere’s Disease is a relatively rare disorder of the inner ear characterized by recurrent episodes of vertigo, fluctuating hearing loss, tinnitus (ringing in the ear), and a feeling of fullness or pressure in the affected ear. It is believed to result from an abnormal buildup of fluid in the inner ear, although the exact cause is still unclear.
Diagnosis of Meniere’s Disease is primarily achieved through accurate history taking, and by undergoing hearing tests to assess for unilateral hearing loss, a key component of Meniere’s Disease. Once diagnosed correctly, management strategies and medication can be extremely effective.
Vestibular Neuritis or Labyrinthitis (Inner Ear Infections)
Vestibular neuritis and labyrinthitis are conditions caused by inflammation of the vestibular nerve or the labyrinth (the inner ear structures responsible for balance and hearing), typically due to a viral or bacterial infection.
Symptoms include severe vertigo, nausea, vomiting, and imbalance, and in labyrinthitis, this is accompanied by hearing loss and ringing in one ear. Symptoms tends to be very severe for 2-3 days – at this time, even sitting still results in the world feeling like it is moving or spinning.
After this time, vertigo symptoms ease, but movement, especially fast head movements, can make one very dizzy. It can take weeks or even months to recover from a Vestibular Neuritis or Labyrinthitis. Vestibular rehabilitation exercises can help speed up the recovery from this condition.
Migraine & Other Central
Vestibular Disorders
Vestibular Migraine
Migraine is the second most debilitating chronic condition in the world, second only to back pain and it is the most common “neurological” cause of vertigo among adults (as opposed to BPPV which is the most common cause of peripheral vertigo). Migraine affects people - women more than men - in their prime years, and more than half of all migraineurs experience dizziness at one time or another.
Vestibular migraine is a form of migraine, often not associated with headache, but instead dizziness, imbalance, and vertigo are the most prominent presenting symptoms. It tends to arise between the ages of 40 and 65, typically in those who have a current or previous migraine history. Vestibular migraines can be triggered by typical migraine triggers such as stress, hormone changes, sleep irregularities, dehydration, certain foods or drinks, barometric pressure changes, bright lights or motion.
PPPD (Persistent Postural-Perceptual Dizziness)
PPPD is a chronic dizziness disorder characterized by persistent sensations of rocking, swaying, or floating, often triggered or exacerbated by visual stimuli or changes in posture. Individuals with PPPD may also experience anxiety, difficulty concentrating, and fatigue.
PPPD usually starts following an acute period of vertigo, such as after an episode of BPPV, vestibular neuritis, vestibular migraine or even a whiplash or concussion injury.
Mal de Debarquement Syndrome
Mal de Debarquement Syndrome, or MdDS, is a rare vestibular disorder characterised by a persistent sensation of rocking or swaying, typically following a period of travel on water or by air. Symptoms can last for months or even years after the motion stimulus has ceased, significantly impacting quality of life.
Learn more about assessment and treatment for headaches and migraines associated with vestibular and neck-related conditions.
Other Conditions Causing Balance Dysfunction
Acoustic Neuroma
Acoustic neuroma, also known as vestibular schwannoma, is a (usually) benign/non-cancerous tumor that develops on the vestibulocochlear nerve, which connects the inner ear to the brain. As the tumor grows, it can compress the nerve, leading to symptoms such as vertigo, hearing loss, tinnitus, imbalance, and in some cases, facial numbness or weakness. This can be suspected during a routine vestibular assessment but needs to be confirmed by MRI imaging of the inner ear.
Age-related balance dysfunction
As we age, unfortunately our vision becomes poorer, our hearing gets worse, our bodies weaken. We may have hip or knee operations which affect muscle strength and nerve function. Maybe we have poorer sensation due to conditions such as Diabetes Mellitus, or peripheral neuropathy. Similarly, our vestibular system also deteriorates as we age. By the age of 75, we have lost about 20% of the hair cells of the inner ear, reducing the efficiency of the vestibular end organs.
The good news is that the brain is adaptable, meaning we can make changes to retrain it, we can teach ourselves to balance better and we can improve our strength through exercise. Aging is NOT synonymous to falls and immobility. There is always room for improvement.
Bilateral Vestibular Loss (BVL)
Bilateral vestibular loss can occur from a number of conditions, ototoxicity being one of them. Ototoxicity refers to damage to the inner ears or auditory nerves caused by exposure to certain medications or chemicals. When ototoxicity affects the vestibular system, it can result in bilateral vestibular loss causing chronic unsteadiness, difficulty walking (especially in the dark), and visual disturbances - vision feels like it bounces or blurs with head movement.
It can be very debilitating, and make the world appear like it is being watched on an old home movie camera due to the visual disturbance experienced during head movements. Balance is usually severely impacted.
Cervicogenic Dizziness
Cervicogenic dizziness refers to dizziness that originates from a problem in the neck (cervical spine) rather than the inner ear or brain. The cervical spine has many “proprioceptors” – sensors that tell your brain where your head is in space. If the neck joints or muscles are injured or dysfunctional, they can send incorrect signals to your brain about your head position. This creates a sensory mismatch between the three systems that your brain relies upon for balance – vision (eyes), the vestibular system (inner ears) and neck proprioception (cervical spine), leading to a sense of unsteadiness, imbalance, light-headedness or disorientation.
Symptoms are often worse with movement or when upright, and better when sitting still or lying down. Sometimes neck pain, stiffness, poor posture and headaches occur in combination with dizziness.
What is Vertigo?
People often use the words “dizziness” and “vertigo” synonymously, but “true” vertigo is characterised by the sensation that you or your surroundings are moving or spinning when there is no actual movement.
Understanding what is causing your dizziness or balance problems is the first step towards effective management and treatment. If you or someone you know is experiencing symptoms suggestive of a vestibular disorder, seeking evaluation at the Vertigo Clinic is recommended. With proper diagnosis and treatment, many individuals can regain control over their balance and improve their quality of life. Dizziness and vertigo is not something you have to live with!
To discuss your symptoms and possible cause, call us on 0508 837 844 to book an appointment.
Ph 0508 VERTIGO
0508 837 844
344 Otumoetai Road, Tauranga