Dizziness is one of the most difficult symptoms to treat due to the subjective nature of the discomfort. As such, a complete evaluation for both a diagnosis and treatment plan may take several visits and a number of studies. The evaluation begins with a physician visit at which time a determination is made of what studies to obtain based on a best guess of what may be causing the dizziness. You can click here to try and diagnose what may be causing your dizziness.
Keep in mind that all audiological balance testing can be performed only AFTER an evaluation by one of our ENT doctors. A referral or order from a physician outside our practice will NOT be accepted. As such, if you desire such testing in our office, you must first make an appointment with one of our ENT doctors.
Baseline initial audiolgoical studies that is obtained at time of initial office visit include:
Subsequent follow-up studies based on what the initial audiogram shows along with a normal Dix-Hallpike testing include (performed on a different day and time):
- Electronystagmography (ENG) or Videonystagmography (VNG) - Can be performed only in older children and adults
- Video Head Impulse Testing (VHIT) - Can be performed only in older children and adults
- Vestibular Evoked Myogenic Potentials (VEMPs)
- Auditory Brainstem Response and Otoacoustic Emission Testing
Other additional studies may be ordered including:
- MRI or CT scan
- RAST/immunoCAP allergy testing
- Cardiology, Neurology, Pulmonary consultations
Based on the results of the above listed studies (which is not all-inclusive), a treatment plan may be developed. Depending on the results of these studies, you may be prescribed VRE exercises or a specific maneuver like the Epley shown in the video below.
Some patients may be candidates for intra-tympanic steroid injections. Please note that our office will mainly focus on eliminating the labyrinth system of the ears as the cause. Further work-up is to be performed by your primary care physician.
The various causes of dizziness are listed below (NOT all-inclusive):
- Medication Side Effect
- Pulmonary Disease
- Cardiac Arrhthymias
- Vascular Disease (ie, carotid stenosis)
- Orthostatic Hypotension
- Benign Paroxysmal Positional Vertigo (BPPV)
- Meniere's Disease
- Otitis Media
- Serous Otitis Media
- Eustachian Tube Dysfunction
- Brain Tumors
- Acoustic Neuromas
- Poor Vision
- Cervical Stenosis
- Osteoarthritis of the Cervical Spine
- Proprioceptive Dysfunction (diabetes)
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