Ear/Dizzy Topics
The Dizzy Patient Evaluation
by Dr. Christopher Chang, last modified on
4/13/21
DISCLAIMER : We do NOT consider ourselves "dizzy" experts, but provide the following info as a service to patients. As we are an ENT practice, we will only perform the appropriate testing and evaluation to see if the ears and/or allergies are a cause of a patient's dizziness. Anything more needs to be arranged through your primary care physician or another specialist. Generally speaking, a neurologist is the specialist able to provide the most comprehensive evaluation of dizziness.
The dizziness lasts continuously for weeks to months before improving...
...and no other symptoms present other than severe dizziness (along with nausea due to the dizziness) and stroke has already been ruled out.
You may be suffering from vestibular neuritis (inner ear infection of the balance system only with sparing of the cochlea). If one sided hearing loss and tinnitus is also present, then labyrinthitis may be present (inner ear infection of both the balance system and cochlea). This is a condition whereby the balance nerve going to one (or both) of your ears has been infected by a virus. There is no great treatment for this condition beyond supportive care (hydration and anti-nausea medications). Medications that do seem to help reduce the severity and duration include high dose steroids. Be aware that a cerebellar stroke can also present this way and needs to be checked out. As such, one should go to the emergency room or see a neurologist. Workup for this condition includes a MRI or CT scan of the brain to make sure no stroke has occurred. A HINTs exam is a quick bedside test to distinguish between stroke vs vestibular neuritis. If these studies come back normal, a hearing test and VNG are supportive studies on the diagnosis.
Home balance exercises or gaze stability exercises may be recommended to help with the dizziness.
An easy and quick test to determine if there is an inner ear balance weakness due to infection is to perform the head impulse test.
Read more about dizziness in general here.
Other ENT Topics
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