diz2Dizziness is a symptom that can range from being light headed to off balance, or unsteady, to a sensation of movement (either the room is spinning or you feel as if you are spinning).   The sensation of spinning is usually considered vertigo.  Causes can be just as varying.  This makes it difficult to explain what you are experiencing, as well as determining what is causing the problem.

Many medications have the side effect of dizziness.  Metabolic changes can cause you to feel unsteady or light headed – changes in blood pressure, blood sugar levels, thyroid function, etc. 

There are balance mechanisms in the inner ear & they are a main source of input for the central nervous system along with coordinating messages from the eyes, neck muscles, and muscles and joints in the limbs for maintaining balance.  An issue with any of these systems can cause a sensation of dizziness or imbalance or unsteadiness. 


Hearing loss, tinnitus or noise in the ears, dizziness together or alone may be a symptom of an inner ear problem.  The dizziness can be whirling or spinning, unsteadiness, or lightheadedness.  It can be constant but is often intermittent and aggravated by head movement or sudden change in position.  Nausea & vomiting may occur, but loss of consciousness is not a result of inner ear dizziness.


Evaluating and diagnosing dizziness may include many tests to rule out or point us toward the cause of dizziness.  It may include a hearing evaluation, a balance test (we do VNGs – video nystagmography testing), x-rays, MRIs, blood work & a general physical examination.

Sometimes imbalance is related to aging due to changes in the circulatory system of the small blood vessels of the inner ear and balance nerve.

Positional dizziness referred to as benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness.  Sometimes this will occur after a head injury and can also be caused by circulatory changes.  This can typically be treated with exercises or repositioning maneuvers. 

Neuritis is a change that occurs in the nerve after injury by trauma, a virus, autoimmune disease, or vascular compression.  This dizziness can be quite severe and possibly prolonged.  It takes time for the central nervous system to compensate for these changes.

Tumors on the auditory nerve can also cause dizziness.  These are typically not cancerous and slow growing and referral to a neuro-otologist is recommended.

Meniere’s disease is a common cause of repeated attacks of dizziness typically associated with hearing decrease in one ear with noise in the ear (typically described as a roaring or motor noise).  This is a condition that recurs and can sometimes be treated with medication and recommended diet changes to reduce the number and severity of attacks.

Treatment for each of these conditions will vary.  Often treatment will involve exercises for the vestibular system and visual system.  Other times medications are indicated.  Surgery may be needed in some extreme cases that do not respond to treatment.