How Do I Know If I Have A Vestibular Disorder?

Dizziness is Common

Dizziness is a common problem that affects nearly 37 million individuals in the US each year.  Approximately 2 million of these individuals initially seek care at an emergency department. 

Many conditions that result in dizziness and imbalance are caused by dysfunction of the vestibular system, which comprises the inner ear and parts of the brain that regulate balance and equilibrium. It is necessary to undergo a vestibular evaluation to determine if symptoms are a result of a vestibular dysfunction or if there is a different underlying cause. 

A vestibular evaluation should be performed by a trained healthcare provider and/or a multidisciplinary team of healthcare providers. When receiving an assessment, it is essential for the individual to describe their symptoms accurately. The term “dizziness” has various meanings and is described differently among individuals. “Dizziness” is often used interchangeably with terms such as “vertigo,” “imbalance,” “lightheadedness,” “fogginess,” and “swaying.”  Symptom description plays a crucial role in the evaluation and diagnostic process; therefore, it is best for the patient to provide as much detail as possible when describing their symptoms. 

Symptom Definitions

The following are definitions that will help with obtaining an accurate diagnosis:

• Dizziness: sensation of lightheadedness, faintness, or unsteadiness.
• Vertigo: sensation of motion or spinning with the individual and/or their environment.
• Disequilibrium: loss of equilibrium; unsteady, imbalance, sensation of spatial disorientation.

When someone is experiencing a vestibular disorder, symptoms may be intense and persist for a duration ranging from 30 seconds to several minutes or even an extended period. This can have a detrimental effect on independence, daily functioning, social interactions, work ability, and ultimately, overall quality of life.  

Types of Vestibular Disorders

Vestibular disorders can originate from two different parts of the vestibular system. It is essential to determine the origin of symptoms to provide the most effective treatment.

• Peripheral: affects the inner ear and the vestibular nerve
  • Examples: Meniere’s disease, vestibular neuritis, Benign Paroxysmal Positional Vertigo (BPPV), vestibular hypofunction, labyrinthitis
• Central: affects parts of the brain that process balance and spatial information
  • Examples: stroke, benign tumor (vestibular schwannoma or acoustic neuroma), degenerative disorders, demyelinating disorders, vestibular migraine

If you are experiencing vertigo, dizziness, imbalance, or a sense of special disorientation, ask yourself the following questions. If you answer “yes” to any of these questions, be sure to follow up with a vestibular specialist.  

Do you experience any of the following:

• Unsteadiness
• Loss of balance
• Falls
• Spinning
• Symptoms when turning over in bed
• Swaying when your body is not actually moving
• Disorientation
• Lightheadedness
• Difficulty focusing your vision when moving
• Blurred vision
• Difficulty walking in crowded areas 

Other considerations to help make an accurate diagnosis:

• When do you feel dizzy, and how frequently does it occur?
• When do you feel off balance, and how often?
• Are you on medications?

You may also want to complete VeDA’s medical history questionnaire.

Take Dizziness Seriously

In addition to experiencing physical symptoms, dizziness associated with a vestibular disorder can have a profoundly detrimental effect on quality of life. For example, individuals may experience difficulties in social situations, at work, while traveling, performing routine daily activities, and navigating crowded areas. Individuals may become isolated, depressed, anxious, and fearful.   If you or someone you know is suffering from symptoms of dizziness, take it seriously. Consult with a vestibular specialist, such as an ENT, neurologist, or physical therapist. You may need to follow up with your primary care doctor to report your symptoms and determine if there is a particular specialist they can recommend. 

Author: Denise Schneider, DPT, FAAOMPT