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Ménière’s Disease

In 1861 the French physician Prosper Ménière theorized that attacks of vertigo, ringing in the ear (tinnitus) and hearing loss came from the inner ear rather than from the brain, as was generally believed at the time. Once this idea was accepted, the name of Dr. Prosper Ménière began its long association with this inner ear disease and with inner ear balance disorders in general.

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Secondary Endolymphatic Hydrops (SEH)

Endolymphatic hydrops is a disorder of the inner ear and can affect the endolymphatic fluid of the cochlea, the vestibular apparatus, or both. Although its underlying cause and natural history are unknown, it is believed to result from abnormalities in the quantity, composition, and/or pressure of the endolymph (the fluid within the endolymphatic sac, a compartment of the inner ear).

In a normal inner ear, the endolymph is main­tained at a constant volume and with specific concentrations of sodium, potassium, chloride, and other electrolytes. This fluid bathes the sensory cells of the inner ear and allows them to function normally. In an inner ear affected by hydrops, these fluid-system controls are believed to be lost or damaged. This may cause the volume and concentration of the endolymph to fluctuate in response to changes in the body’s circulatory fluids and electrolytes.

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Vestibular Migraine

Approximately 40% of migraine patients have some accompanying vestibular syndrome involving disruption in their balance and/or dizziness at one time or another, which is often more persistent and debilitating than the original headache.

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Third Window Syndrome

Third window syndrome: What it is and how it’s treated What is Third Window Syndrome? Third window syndrome describes a group of inner ear disorders that results from a leakage of pressure and/or fluid from

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Tinnitus

Tinnitus is abnormal noise perceived in one or both ears or in the head. Tinnitus (pronounced either “TIN-uh-tus” or “tin-NY-tus”) may be intermittent, or it might appear as a constant or continuous sound. It can be experienced as a ringing, hissing, whistling, buzzing, or clicking sound and can vary in pitch from a low roar to a high squeal.

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Labyrinthitis and Vestibular Neuritis

Cause Infection or inflammation of the cochleovestibular nerve. Summary Vestibular Neuritis (or neuronitis) is a vestibular condition that is commonly caused by the inflammation of the vestibular branch of the 8th cranial nerve, which is

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Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of vertigo, which is a false sensation of spinning.

– Benign – it is not life-threatening
– Paroxysmal – it comes in sudden, brief spells
– Positional – it gets triggered by certain head positions or movements
– Vertigo – a false sense of rotational movement

BPPV is a mechanical problem in the inner ear. It occurs when some of the calcium carbonate crystals (otoconia) that are normally embedded in gel in the utricle become dislodged and migrate into one or more of the 3 fluid-filled semicircular canals, where they are not supposed to be. When enough of these particles accumulate in one of the canals they interfere with the normal fluid movement that these canals use to sense head motion, causing the inner ear to send false signals to the brain.

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Medications for Dizziness & Vertigo

The use of medication in treating vestibular disorders depends on whether the vestibular system dysfunction is in an initial or acute phase (lasting up to 5 days) or chronic phase (ongoing).

During the acute phase, and when other illnesses have been ruled out, medications that may be prescribed include vestibular suppressants to reduce motion sickness or anti-emetics to reduce nausea. Vestibular suppressants include three general drug classes: anticholinergics, antihistamines, and benzodiazepines. Examples of vestibular suppressants are meclizine and dimenhydinate (antihistamine-anticholinergics) and lorazepam and diazepam (benzodiazepines).

Other medications that may be prescribed are steroids (e.g., prednisone), antiviral drugs (e.g., acyclovir), or antibiotics (e.g., amoxicillin) if a middle ear infection is present. If nausea has been severe enough to cause excessive dehydration, intravenous fluids may be given.

During the chronic phase, symptoms must be actively experienced without interference in order for the brain to adjust, a process called vestibular compensation. Any medication that makes the brain sleepy, including all vestibular suppressants, can slow down or stop the process of compensation. Therefore, they are often not appropriate for long-term use. Physicians generally find that most patients who fail to compensate are either strictly avoiding certain movements, using vestibular suppressants daily, or both.

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Surgical Procedures for Vestibular Dysfunction

When is surgery necessary? When medical treatment isn't effective in controlling vertigo and other symptoms caused by vestibular system dysfunction, surgery may be considered. The type of surgery performed depends upon each individual's diagnosis and

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Canalith Repositioning Procedure (for BPPV)

The Canalith Repositioning Procedure is also known as the "Epley maneuver." BPPV (Benign Paroxysmal Positional Vertigo) occurs as a result of displaced otoconia, which are small crystals of calcium carbonate (also referred to as "otoliths"

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Home-based Exercise

Supplement for People with Chronic Dizziness Can balance retraining exercises help with dizziness? ‘Balance retraining’ is a therapy which can speed recovery from any change in balance system function - including changes caused by chronic

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Dietary Considerations

Changes in your diet can reduce dizziness Many people with Ménière’s disease (also called primary idiopathic endolymphatic hydrops), secondary endolymphatic hydrops, or vestibular migraine find that certain diet modifications help manage their condition. However, others

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